Eighty to 90% of people in the United States will suffer from back pain during their lifetime. Back pain is the second most common reason for visits to the doctor. It is also a direct cause of enormous health care expenses.
What are the causes of low back pain?
Back strain is by far the leading cause (80% to 85% of cases) of low back pain in the United States. Other causes include:
- Disc herniation: A herniated disk is a rupture of the fibrocartilage surrounding the invertebral disk. Pressure from the vertebrae above and below the disk squeeze the cushioning substance (nucleus pulposus) out of the disk. The nucleus pulposus can press against spinal nerve roots. This can be very painful and cause nerve damage if not treated properly.
- Osteoarthritis/spinal stenosis: This is characterized by the constriction or narrowing of the vertebral canal.
- Spondylolisthesis: Spondylolisthesis is the partial forward dislocation of one vertebra over the one below it. Usually the fifth lumbar is dislocated over the first sacral vertebra.
- Ankylosing spondylitis: Ankylosing spondylitis is a chronic inflammatory disease that first affects the spine and adjacent structures. As the disease progresses, vertebrae will fuse together. This disease has a strong hereditary tendency and primarily affects men under 30 years of age.
- Nonspinal causes: Nonspinal causes of low back pain include abdominal aortic aneurism, kidney stone, infection, or stomach ulcer.
Diagnosis and Tests
How is low back pain diagnosed ?
Extensive testing, including X-rays, MRI/CT scans, EMGs, and lab tests are necessary in only a small number of cases. If the pain is caused by trauma, a neurological change, persistent fever, or if the patient is losing weight, one or more of these imaging test may be done immediately.
Management and Treatment
How is low back pain treated?
Most back injuries will heal with a conservative treatment approach. Usually, with conservative treatment, the pain will subside within 4 to 7 days. Conservative treatment includes bed rest (no more than 2 to 3 days), acetaminophen (non-aspirin over-the-counter pain killer) or an anti-inflammatory medication, and cold packs to diminish swelling and muscle spasm. If there is no improvement after 4 to 7 days, contact your doctor.
- National Institute of Neurological Disorders and Stroke. Back Pain Information Page Accessed 12/29/2016.
- American Academy of Orthopaedic Surgeons. Low Back Pain Accessed 12/29/2106.
- Bhangle SD, Sapru S, Panush RS. Back pain made simple: an approach based on principles and evidence. Cleve Clin J Med. 2009;76:393–399.
- North American Spine Society. Chronic Low Back Pain (PDF) Accessed 12/29/2016.
© Copyright 1995-2020 The Cleveland Clinic Foundation. All rights reserved.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
This document was last reviewed on: 11/01/2016