Does Your Back Hurt? 9 Common Causes of Low Back Pain

Low back pain is very common. Most people will experience low back pain at least once in their lifetime. In fact, almost 40% of U.S. adults report having back back pain in the past 3 months. Low back pain often affects your quality of life, making it hard to go about your daily activities.

If you’ve had chronic lower back pain, you may have wondered what the cause is, how long it will last, and how to treat it. Although low back pain can be uncomfortable and frustrating, the good news is that most cases will go away on their own with minimal treatment in a few weeks or less. 

Let’s take a closer look at the most common causes of low back pain and what you can do to treat it at home. 

What are common causes of lower back pain?

Most cases of low back pain are acute. This means the pain comes on suddenly and goes away in less than 4 weeks. Acute low back pain usually has a musculoskeletal cause, meaning it comes from the spine or the muscles and ligaments around the spine. Often, the exact cause of the pain isn’t found, but it usually resolves on its own or with minimal treatment in less than a month.

There are more serious illnesses that can cause low back pain, but these are less common and cause different symptoms.

Listed below are nine common causes of musculoskeletal low back pain.

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1. Muscle strain

This is strain or sprain of the muscles and/or ligaments around the spine. It’s very common and accounts for about 70% of low back pain. Usually, this is caused by mild trauma or repetitive physical activity that strains the back. It causes pain that’s worse with movement and better with rest. The low back can be tender to the touch. 

2. Spondylosis

This is another name for arthritis of the spine. It’s common and can often be seen when imaging of the spine is done with X-ray or MRI. It doesn’t always cause symptoms, but it can cause pain and stiffness in the low back that’s worse with activity.

3. Degenerative disc disease

Degenerative disc disease is a condition of deterioration and changes in the spine that causes the discs (cushion between the vertebrae) to become thinner and bulge. This can be related to bony overgrowth or bone spurs in the vertebrae. Some people can develop low back pain as a result of these changes. 

4. Herniated disc

A herniated disc (or bulging disc) happens when the disc is displaced out of the space between the vertebrae. This can put pressure on the spinal cord and nerve roots nearby. This can cause low back pain, but it’s more likely to cause sciatic pain. This describes leg pain that occurs from pressure on nerves that start in the spinal cord and go to the legs. 

5. Spinal stenosis

This is a less common cause of low back pain. It usually affects adults older than 60 years. Spinal stenosis happens when the space around the spinal cord narrows. People with spinal stenosis often have pain, numbness, and tingling in one or both legs, and they usually feel better sitting down or leaning forward while walking (such as leaning on a grocery cart). 

6. Sacroiliac joint pain

The sacroiliac joints connect the sacrum (bone at the base of the spine) to the pelvis. These joints can become inflamed or unstable and cause low back pain. Sacroiliac joint pain can occur near the left or right buttock but not midline. Pain may get worse after sitting or standing for long periods. 

7. Facet joint pain

Arthritis in the facet joints (the joints between two vertebral bones) is a common source of low back pain. People with facet joint pain typically have back pain down one or both legs that stops above the knee. 

8. Lumbar radiculopathy

Radiculopathy, which is an irritated or pinched nerve in the lumbar spine, can be a cause of low back pain that goes down the leg. Symptoms of radiculopathy may show up in the leg, including:

• Weakness

• Numbness

• Tingling 

9. Myofascial pain syndrome

People with low back pain often have myofascial pain syndrome. This condition causes local contraction of muscle fibers, which can form “trigger points” and pain in predictable patterns.  

What are risk factors for back pain?

Risk factors for back pain can vary depending on the cause of your symptoms. These can include:

• Age: People with advancing age can have degenerative changes of the spine or discs that may be associated with back pain.

• Lack of exercise: People who are not physically fit are more prone to back pain.

• Strenuous exercise: Heavy lifting, or constant pushing, pulling, or twisting of the spine can lead to back pain.

• Sedentary lifestyle: Sitting for long periods of time, especially if you have improper posture or don’t have good chair support can also lead to back pain.

• Anxiety and depression: Stress and emotional problems can affect how you perceive pain and cause muscle tension. 

• Smoking: Smoking can affect the blood flow to the spine, leading to degenerative changes.

How to tell if back pain is related to the muscles or spine

Low back pain related to the muscles or spine is usually worse with certain movements and better with rest. If you have common, acute low back pain, it’s most likely coming from your spine or the surrounding muscles. 

If your back pain is unrelated to the spine or muscles, you’ll most likely have other symptoms with it that point to a different cause. These symptoms may include:

• Fever

• Weight loss

• Nausea or vomiting

• Decreased appetite

• Pain that doesn’t improve with rest

• Abdominal pain

• Chest pain

• Rash

• Urinary symptoms

If you have any of the above symptoms in addition to low back pain, discuss these with a healthcare professional as soon as you can. They can help you figure out the cause and the best treatment plan.

How do I know if my back pain is serious?

Most cases of low back pain aren’t serious and won’t lead to any long-term health effects. But there are some symptoms or situations that may indicate a more serious cause. These include:

• Severe numbness or weakness in the legs

• Inability to urinate

• Loss of bowel or bladder control

• Numbness in the groin

• Back pain caused by a major injury or trauma

• Previous spine surgery or procedure

It’s important to know that if you have low back pain with any of these symptoms or causes, you should get immediate medical care.

How can I make my back stop hurting?

Most cases of acute low back pain without serious symptoms will resolve on their own with time even without any treatment. More than 90% of people will recover within 6 weeks. But if your back is bothering you, there are some treatments you can try at home to lessen the pain. 

Home remedies for back pain

• Keep moving: You may want to stay in bed when you have back pain, but this can make the pain worse. It helps to do some nonstrenuous activity (such as walking) and continue with your regular activities as much as possible. Gentle stretching and yoga may also be helpful. 

• Over-the-counter (OTC) pain medications: Anti-inflammatory medications like ibuprofen and naproxen help decrease low back pain. They are generally safe, unless you’ve been told not to take them. But pain relievers for back pain should only be used for a short period of time (2 to 3 weeks). Acetaminophen is less helpful, but it may be considered in combination with other therapies, or if you can’t take anti-inflammatories. 

• Heat or ice: Heat or ice applied to the low back can provide temporary pain relief.

• OTC topical treatments: There are OTC patches and creams that are applied to the skin over the area of pain. Examples include lidocaine (Licoderm, Xylocaine) patches and creams containing pain relievers.

It’s important to know that these home remedies are designed to provide temporary pain relief and aren’t a cure for low back pain. Patience is key as it takes time for the pain to go away completely.

Nonsurgical solutions for back pain

If your low back pain is difficult to manage at home, or if it lasts more than 4 weeks without improvement, speak with a healthcare professional. Most cases of low back pain don’t need surgery — even those caused by herniated discs. A healthcare professional can help you determine the next best step. Other treatment options may include: 

• Prescription medications: OTC pain medications are best to try first. If these don’t work well enough, a healthcare professional may recommend a prescription medication. 

• Physical therapy and chiropractic therapy: Both can be helpful for low back pain. Studies have shown that when the two are compared, they both provide similar pain relief at about the same cost. 

• Massage, acupuncture, and osteopathic manipulation: There’s some evidence that these treatments can lead to a moderate improvement in acute low back pain.

The best treatment options for you will depend on your preferences, the cost of treatment, and a healthcare professional’s recommendations. You should also consider what’s most accessible where you live.

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Written by:

Sarah Pozniak, MD

Sarah Pozniak, MD, has 9 years of experience since graduating medical school (6 since completing residency). She is a board-certified general internal medicine physician and has practiced as a primary care physician in both Utah and Washington, D.C. Currently, she cares for patients with chronic illnesses such as diabetes and high blood pressure using telemedicine as part of a virtual care program.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Itza Rivera, MD

Dr. Rivera is a board-certified physical medicine and rehabilitation specialist. She completed her medical degree and residency training at the University of Puerto Rico School of Medicine, and her neuromuscular disorders subspecialty training at Northwestern University.

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