Lower Back Pain Causes & Symptoms: Common Reasons & Risk Factors

Overview of Lower Back Pain Causes

There are many lower back pain causes. It often appears after specific movements like lifting, bending, or twisting. Age also plays an important role, as our spines naturally change over time. As we get older, the structures in our spine—discs, joints, and muscles—undergo degenerative changes. These changes can begin as early as our 30s, or even younger, and may make the back more vulnerable to discomfort, especially after strenuous activity.

However, age-related changes in the spine do not automatically lead to severe pain or limit daily life. Many people remain active and pain-free well into their later years. For example, 70-year-old marathon runners often show signs of spinal degeneration on scans, yet they continue to live energetic, healthy lives.

Maintaining strong core muscles, staying physically active, practicing good posture, and avoiding excessive strain can help prevent or reduce low back pain, even as the spine ages.

Let’s study the most common causes of lower back pain, exploring their underlying factors and how they affect overall spinal health.

Causes of Lower Back Pain Diagram

What Causes Lower Back Pain

Lower Back Pain Causes

1. Overactivity

One of the most frequent reasons for lower back pain is muscle soreness caused by overactivity. When muscles and ligaments are overstretched or slightly injured, it can lead to discomfort and stiffness.

This type of pain often happens after activities your body isn’t used to, such as playing a sport for the first time in a season, spending long hours gardening, or shoveling snow all at once.

The muscles in your lower back may feel tight or achy, and the soreness usually improves within a few days with rest and gentle movement.

Understanding this can help prevent future episodes. Gradually increasing activity levels, warming up before exercise, and maintaining proper posture during physical tasks can significantly reduce the risk of overuse-related back pain.

2. Disk Injury

If your low back pain lasts more than a few days, it could be a sign of an intervertebral disk injury. These disks act as cushions between the spine bones, absorbing shock and supporting movement. Two common disk problems are disk tears and herniated disks (slipped disks).

Disk Tear

A disk tear happens when the outer layer of the disk, called the annulus fibrosus, develops small cracks or tears. This can occur naturally with aging or due to minor spinal stress.

Some people with disk tears experience no pain, while others may have discomfort that lasts weeks, months, or even years.

Chronic pain from disk tears can impact daily activities, but it’s not fully understood why some people feel pain and others don’t.

Herniated Disk (Slipped Disk)

A herniated disk occurs when the soft, jelly-like center of the disk (nucleus pulposus) pushes against or breaks through the outer layer.

When the disk bulges toward the spinal canal, it can press on spinal nerves, causing pain.

In the lower back, a herniated disk often affects the sciatic nerve, leading to sciatica—pain, numbness, tingling, or weakness in the buttocks, legs, or feet.

Common triggers include lifting heavy objects, twisting, bending, or sudden injuries.

3. Disk Degeneration

As we age, the intervertebral disks in our spine naturally start to wear down and lose height. In some cases, these disks may collapse completely, causing the facet joints to rub against each other.

This friction can lead to pain, stiffness, and reduced mobility. Lifestyle factors, such as smoking, can accelerate this disk degeneration and worsen symptoms.

The gradual wear and tear of these facet joints is known as osteoarthritis or spondylosis.

Over time, this condition can contribute to other spine issues. These issues are spinal stenosis, where the spinal canal narrows and places pressure on nerves, potentially causing numbness, tingling, or weakness in the legs.

Preventive strategies can slow spinal degeneration and improve overall back health. These include:

• Maintaining a healthy weight to reduce stress on the spine
• Staying physically active with exercises that strengthen core and back muscles
• Avoiding smoking and limiting activities that strain the back
• Practicing good posture to reduce wear on disks and joints

4. Degenerative Spondylolisthesis

As we get older, the joints and ligaments that support our spine naturally weaken due to aging and everyday wear and tear.

This can make it difficult for the spine to stay properly aligned, causing the vertebrae to shift more than they should.

In some cases, one vertebra may slide forward over another, a condition known as spinal slippage or spondylolisthesis.

When this happens, the misaligned bones can press on spinal nerves, leading to back pain, stiffness, numbness, or tingling in the legs.

5. Spinal Stenosis

Spinal stenosis is a condition where the spaces inside your spine become narrower, putting pressure on your spinal cord or the nerves that pass through small openings called neural foramina. This pressure can cause symptoms like pain, numbness, or muscle weakness.

Spinal stenosis is more common as people age, but some are born with a spine that has less space for the spinal cord.

Several factors can contribute to this condition, including aging, thickened bones and ligaments, arthritis of the spine, bone diseases, herniated discs, or injuries.

If you’re experiencing back pain or discomfort, spinal stenosis may be a reason, and early diagnosis can help manage the symptoms effectively.

6. Scoliosis

Scoliosis is a condition where the spine curves abnormally, forming an “S” or “C” shape instead of a straight line. It often develops in children and teenagers during growth spurts, but adults—especially those with arthritis—can also develop it.

This spinal condition can lead to back pain and, in some cases, may cause weakness, numbness, or pain in the legs if the nerves are affected.

Early detection is important, as timely treatment can help manage symptoms and prevent the curve from worsening.

7. Compression Fracture

Compression fractures happen when one or more vertebrae become cracked or broken. The most common cause of these fractures is osteoporosis, a condition where bones become weak and brittle. As people age, bones often lose calcium and other important minerals, making them more prone to fractures.

Besides osteoporosis, compression fractures can also result from:

• Injury or trauma to the back
• Cancer that spreads to the bones from other parts of the body
• Cancers that begin in the spine, such as multiple myeloma

When multiple compression fractures occur, it can cause a condition called kyphosis. Kyphosis is a forward curvature of the spine that creates a noticeable hump-like appearance.

Signs & Symptoms of Lower Back Pain

Low back pain (LBP) is a common condition that can range from a dull, persistent ache to sharp, intense pain. In many cases, the pain may spread to other areas, especially the legs, causing additional discomfort.

LBP can limit movement, making daily activities, work, school, and social participation more difficult. It can also affect sleep, mood, and overall well-being.

Types of Low Back Pain

• Acute LBP: Lasts less than 6 weeks and often improves on its own.
• Sub-acute LBP: Persists for 6–12 weeks.
• Chronic LBP: Lasts more than 12 weeks and may require ongoing management.

While most people with acute LBP recover fully, some cases progress to chronic pain, which can significantly impact quality of life.

Common Symptoms

• Start suddenly or develop over time.
• Occur after a specific action, such as bending to lift something heavy. Some people even hear a “pop” when it happens.
• Develop without any obvious cause.
• Feel sharp, dull, or achy.
• Come and go or remain constant.
• Spread from the lower back into the buttocks or down the back of the leg (a condition known as sciatica).
• Worsen in certain positions like bending or crouching, and improve when lying flat.

Associated Leg Pain (Sciatica or Radicular Pain)

Some people with LBP experience pain, numbness, tingling, or weakness in the legs, known as radicular pain or sciatica. This occurs when a spinal nerve root is compressed or irritated.

The pain may feel like a dull ache or a sharp, electric shock. In some cases, leg symptoms can appear even without noticeable back pain if a nerve is affected further away from the spine.

Stiffness

You might find it difficult to move, stand up, or stretch. Getting out of a chair could take longer, and you may feel the need to walk around or stretch to relieve tightness. A reduced range of motion is common.

Posture changes

Back pain often affects how you stand. You might lean to one side or appear bent instead of standing straight. The natural curve of the lower back may also seem flattened.

Muscle spasms

Strained muscles in the lower back can spasm or tighten suddenly, causing sharp pain. These spasms can make it hard to stand, walk, or move comfortably.

Impact on Daily Life

Chronic LBP and associated leg pain can reduce mobility, limit work capacity, and affect mental health. If it is not managed, it can lead to long-term challenges, including reduced earning potential, loss of bladder, bowel control and early retirement.

Risk Factors

Back pain can happen to anyone – even children and teenagers. It is more common in adults, especially after the age of 30 or 40. But certain habits and health issues can increase the likelihood of experiencing back pain. Here’s what to watch out for:

• Aging – As you age, your spine and muscles naturally weaken. This increases the likelihood of back pain over time.
• Lack of Exercise – Weak muscles in your back and core can cause poor posture and strain, increasing the risk of pain.
• Excess Weight – Carrying extra body fat puts added stress on your spine, which can lead to discomfort and injury.
• Medical Conditions – Diseases like arthritis, osteoporosis, and cancer can trigger or worsen back pain.
• Improper Lifting – Lifting heavy objects without bending your knees or using the right form can strain your back muscles.
• Mental Health Issues – Stress, anxiety, and depression can lead to muscle tension and make back pain worse.
• Smoking – Smoking reduces blood flow to the spine, weakens bones, and causes frequent coughing – all of which contribute to back problems.
• Poor Posture and Ergonomics – Slouching, standing awkwardly, or using chairs and desks that don’t support your body can add pressure to your back over time.

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