What Causes Back Pain and How to Find Relief, According to a Pain Doctor

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Thirty-nine percent of adults experience back pain in the United States. Maruti R. Kari, MD, UnityPoint Health, explains the causes of back pain along with non-surgical treatment options.

What Does Back Pain Feel Like?

Back pain feels different depending on the location. Lower back pain ranges from a dull ache to a sudden, sharp feeling. A burning pain in the back feels hot and achy, or like pins and needles, and typically occurs in a localized area of the back.

Back pain can be associated with another region of the body due to things like nerve compression or other issue. Commonly, back pain is accompanied by stomach pain, hip pain, nausea or pelvic pain.

The pain usually comes on gradually and lasts for more than six weeks. The exact cause of pain may be difficult to identify, because it can originate in soft tissue, bone, discs or nerves.

What Causes Back Pain?

Acute vs Chronic Back Pain

Back pain is acute or chronic, depending on how long it lasts. Acute back pain lasts less than six weeks, while chronic back pain lasts more than 12 weeks.

Acute Back Pain Causes

Acute back pain is typically caused by trauma or sudden changes in a chronic illness, such as:

Constipation: In some cases, severe gas or constipation causes back pain. It typically feels like a dull, aching pressure in the lower back. This pain goes away after a regular bowel movement.
Infections: When your immune system fights an infection, inflammation can cause back pain. A kidney infection or COVID-19 are infections that cause back pain. Often, back pain from an infection feels like a constant ache or sharp and stabbing. Accompanying symptoms such as fever or nausea are also common.
Injuries: Muscle or ligament strains, spasms or tears cause back pain. Strained back muscles typically feel sore or achy and can happen anywhere in the back.
Menstruation: It’s very common to have lower back pain before, or during, the menstrual cycle. However, if back pain doesn't sync with menstrual cycle and remains constant, it could be a sign of an underlying condition, such as uterine fibroids or endometriosis.
Movement and posture: Poor posture, awkward angles, lack of movement or carrying a heavy bag all result in lower back pain. It may get worse or more noticeable at certain times of the day or when sitting or standing in some positions.
Pregnancy and breastfeeding: Ligaments naturally become softer during pregnancy, which commonly causes back pain. Poor posture during breastfeeding can also lead to back pain. Talk to your doctor if you have back pain during your pregnancy.

Chronic Back Pain Causes

Chronic back pain can be age-related or result from an injury. In some cases, it's difficult to pinpoint the cause of chronic back pain. See our chronic back pain chart to understand common causes based on where you're having back pain.

Top of Back (Cervical) Pain

Pain in the top of your back, or cervical region, can be accompanied by neck pain, arm and shoulder pain, headache, numbness or tingling in arms or hands, poor balance and loss of dexterity in hands. Common causes include:

Arthritis of the spine (spondylosis): Spondylosis happens due to gradual thinning of the disc inside the spine or wear and tear of small joints in the spinal bones.
Bone spurs: Also known as osteophytes, bone spurs are bony growths that form on the ends of normal bone, usually in the joints or spine.
Degenerative disc disease: This common cause of back pain is due to the wearing away and loss of disc tissue cushioning, often related to aging.
Herniated disc: Also known as a slipped disc, a herniated or bulging disc is caused by wear and tear. The spinal disc bulges or is forced through a weak spot in the spine.
Spinal stenosis: Narrowing of the spinal canal may lead to nerve pain in the back with spinal stenosis.

Mid-Back (Thoracic) Pain

Pain in the middle of your back, or thoracic region, can be accompanied by rib and mid-back pain. Common causes include:

Compression fractures: A back compression fracture happens when one or more vertebrae (bones in your spine) fractures or breaks.
Disc herniation: A herniated or bulging disc is a common cause of back pain.
Spinal stenosis: Narrowing of the spinal canal may lead to nerve pain in the back with spinal stenosis.
Spine curvatures: Spinal curvatures like scoliosis or kyphosis can cause back pain.

Lower Back (Lumbar) Pain

Pain in the lower back, or lumbar region, can be accompanied by leg pain, numbness or tingling in the legs or feet, leg weakness or foot drop (difficulty lifting the front of your foot). Common causes include:

Arthritis of the spine (spondylosis): Spondylosis happens due to gradual thinning of the disc inside the spine or wear and tear of small joints in the spinal bones.
Bone spurs: Also known as osteophytes, bone spurs are bony growths that form on the ends of normal bone, usually in the joints or spine.
Cancer: Rarely, lower back pain is a sign of certain cancers, such as spinal, ovarian or cervical cancer,.
Degenerative disc disease: This is due to the wearing away and loss of disc tissue cushioning, often related to aging.
Herniated disc: Also known as a slipped disc, a herniated or bulging disc is caused by wear and tear. The spinal disc bulges or is forced through a weak spot in the spine.
Myofascial pain syndrome: Muscle pain and tenderness trigger points without a clear cause can be a sign of myofascial pain syndrome, which causes pain in the tissue and muscles.
Spinal stenosis: Narrowing of the spinal canal may lead to nerve pain in the back with spinal stenosis.
Spine curvatures: Spinal curvatures, like scoliosis or kyphosis, causes back pain.

Back Pain Chart

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How to Relieve Back Pain Fast at Home

For acute back pain, applying ice or heat at home, or taking over-the-counter pain medications, helps alleviate the pain until it’s gone.

Back Pain Treatment Options Without Surgery

For chronic issues, the following options help with back pain relief:

Physical therapy: Physical therapy can increase flexibility, strengthen back and abdominal muscles and improve posture. Regular use of these techniques can help keep pain from returning. Physical therapists also provide education about how to modify movements during an episode of back pain to avoid flaring pain symptoms.

Medication: Medication options can include pain relievers, muscle relaxants, topical pain relievers or narcotic pain medications.

Cortisone injections: If other measures don't relieve pain, an injection of cortisone, plus a numbing medication, into the space around the spinal cord and nerve roots might help. A cortisone injection decreases inflammation around the nerve roots. The duration of pain relief from such an injection may vary from person to person, but usually, you can expect at least three months of relief.

Implanted nerve stimulators: Devices implanted under the skin deliver electrical impulses to certain nerves to block pain signals.

Radiofrequency Ablation: This treatment involves needle-based electro-cautery to relieve pain primarily in the neck or low back. It lasts up to a year and can be repeated.

When To See a Doctor for Back Pain

If you're experiencing these back pain symptoms, it's time to make an appointment with a doctor. Be prepared to answer questions like: How long has the back pain been present? Is the back pain on one side or both? Is the pain aching or sharp?