Most causes of back pain are common in men and women, but some are exclusive to women such as the causes due to pregnancy and during menstruation.
Back pain is not a disease. It is a symptom or the patient’s complaint due to an underlying cause. Also referred to as a backache, it is more common in the lower part of the back and is referred to as low back pain.
You can also develop upper back pain in the area behind the neck and middle back pain behind the chest region. Each has its own set of reasons.
Again, the pain may be acute or chronic. Acute back pain may last for a few days to a few weeks. It is termed chronic back pain when its duration is more than 3 months. Acute pain becomes chronic when its cause is left untreated.
Some of the causes are common while some are rarely seen. Then, again, there are certain risk factors, which make you more prone to develop pain in the back.
Back pain is so common that it ranks second only to the common cold for people staying absent from work. 9 out 10 people experience acute back pain at some point in their lives. Read these facts:
- It may be acute or chronic.
- The type of pain may be dull, or piercing or a burning sensation.
- It may be constant or intermittent.
- It may be localized or may radiate to other parts of the body.
- The pain may be associated with other symptoms such tingling and numbness.
- In 98% of the cases, no specific or serious cause can be found even after a thorough medical investigation. It is the 2%, which can present with a serious pathology and require aggressive treatment.
Causes of back pain in men and women
In 98% of cases especially the lower back pain cases, the cause of pain is muscular. Wrong posture for a prolonged period or a sudden awkward movement or lifting a heavy weight while bending down may cause fibers of the back muscle to tear or the muscle may go into spasm.
This usually recedes after a few days when the muscle recovers. This is the most common cause of low back pain, which is due to wrong posture habits. The causes mentioned below cause you to suffer from back pain every day till the cause is sorted out.
Age and back pain
As age advances, there is muscular weakness, osteoporosis of the bones and degenerative changes in the bones of the elderly people.
When these changes affect the muscles and the bones of the back, the pain sets in. Age also causes degenerative changes in the intervertebral disc, which loses its moisture. This is called spondylosis. Depending on the location of the degenerative changes, this condition can cause upper, middle or low back pain.
Back muscle or ligament strain/sprain
Back muscle injury is the most common cause of back pain. This normally settles down within a few weeks. It is caused by the tearing of a muscle or ligament due to its abnormal stretching, as a result of some strenuous physical activity.
Ruptured herniated disc
As explained in the article on backbone, there is a disc made of fibrous cartilage between two adjacent vertebrae. It acts as a cushion to absorb shock and facilitates the movements of the back.
In the case of a herniated disc, the intervertebral disc herniates out of its usual space and presses on the spinal cord and/or a nerve, producing symptoms of back pain. In such cases, the pain can be quite severe.
If present in the lumbosacral region, it can press on the nerves (L4 to S3), which combine to form the sciatic nerve and runs down the lower back to the lower extremities. This can then cause tingling and numbness in the legs and feet.
Causes of Herniated Disc
- A result of an injury to the spine
- Repeated strain to the spine
- With age, the intervertebral disc loses its elasticity and ruptures with back movements. As a result, it herniates out of its space. Usually, herniated disc is present after the age of 30 years, but only 3% of these present symptoms.
Spinal stenosis is a result of the arthritis of the vertebral joints. Due to swelling of the vertebral joints, the spinal canal gets narrowed at the place of the arthritic joint. Spinal stenosis causes severe back pain.
Arthritis of the vertebral joints
The facet joints between the vertebrae are often victims of arthritis (inflammation of the joints). This causes joint swelling and even without spinal stenosis can give rise to pain in the back.
Osteoporosis of the vertebral bones
Osteoporosis of the vertebral bones causes them to become weak and prone to fracture. Due to the weakness, they lose their capacity to support the body weight and cause pain.
Metastasis is spread of cancer to a part of the backbone from a primary, which is situated somewhere else in the body. Most commonly: breast, lung, and prostate cancers spread to the backbone.
Formation of an epidural abscess
Epidural space is the space around the dura mater of the spinal cord. An abscess with pus formation may form in the epidural space due to infection and can cause severe pain. Infection generally spreads her via the blood.
Osteomyelitis of the spine
Osteomyelitis of the spine or vertebral osteomyelitis refers to an infection in the vertebra and is a rare condition. The lumbar vertebra is the most commonly affected especially in young adults. The infection spreads to the vertebra through the blood.
Lumbar radiculopathy refers to a disease, which involves the lumbar spinal nerve root. This presents as pain, numbness, or weakness of the buttock and leg muscles. It is the most common cause of low back pain caused by compression of the spinal nerve root. Lumbar radiculopathy is more commonly referred to as sciatica.
Low back pain again is one of the most common and early signs of iron deficiency anemia. Iron is necessary along with vitamin C in the formation of connective tissue and collagen that give strength to the muscle tissues. The lumbosacral muscles are the most load bearing of all muscles and are the first ones to complain of pain due to weakness.
A cause originating from elsewhere besides the back can cause back pain.
Abdominal pain due to some local pathological cause in the abdomen pain gets referred to the back. Such conditions are
- GERD – Gastroesophageal reflux disease causes heartburn or acid indigestion
- Kidney diseases and kidney stones
- Urinary bladder stones
- Infection in the pelvis region
- Pelvic tumors and
- Diseases affecting the uterus and ovaries
- Prostate cancer
Similarly, certain conditions in the chest can cause pain in the middle part of the back. They include
- Aneurysm of the aorta
- Heart attack
- Chronic cough and troubled breathing of asthma
- Breast cancer
- Pulmonary embolism
- A cracked rib
Of the causes of back pain mentioned above, the common causes include muscle strain, herniation of the intervertebral disc, referred pain due to kidney infection and pregnancy
Less common causes include infection of the spine such as osteomyelitis, ankylosing spondylitis, and cancer of the vertebral bones.
Causes of back pain in women
Besides the causes of back pain mentioned above, there are additional causes attributed to women due to the reproductive system anatomy. This pain is typically lower in the back.
Causes of lower back pain during pregnancy
Lower back pain during pregnancy is common and occurs due to a number of reasons. It starts during the late second trimester and proceeds throughout the third trimester. This pain is felt every day till labor. The causes of back pain during pregnancy include:
- The increase in weight due to the growing fetus. Women typically gain 25 to 35 pounds during pregnancy. The growing uterus presses on the blood vessels and nerves of the back, which causes pain in the low back.
- Change in posture due to the change in the center of gravity of the body as a result of the increasing abdomen
- Increase in progesterone (a hormone) levels during pregnancy, which soften and loosen the muscles and ligaments that are going to stretch as the pregnancy progresses and facilitate delivery of the baby. During pregnancy, the hormone relaxin increases 10 times its normal concentration, which causes the changes described above. This pain can be felt even during early pregnancy, ie. the first trimester.
Back pain during menstruation
Some women experience more abdominal pain during their periods. This is called dysmenorrhea and is primarily due to stronger uterine contractions that occur during menstruation to get rid of the endothelium (inner lining of the uterus).
Back pain causes during labor
Most women feel intense lower back pain when in labor. This is called back labor. This is because of the uterine contractions when giving birth to the baby and is attributed to the pressure of the baby’s head on the lower back. Secondly, it could also be due to the pull on the ligaments that attach the uterus to the back.
Back pain during ovulation
About 20% of pregnant women feel a slight pain when the ovary releases an egg. This type of pain is felt on one side of the back, the side on which the ovary has released the egg.
Other causes in women
Other causes include ovarian and uterine tumors, benign or malignant, and ectopic pregnancy.
Back Pain Risk Factors
Certain conditions and factors increase your risk of developing back pain. They include:
- Obesity. The excess weight of the body that the back has to bear causes fatigue, strain, and weakness of the back muscles resulting in back pain.
- Mental stress causes muscular tightness and spasm, which can cause pain in the back.
- Smoking does cause malnutrition, which reflects on the back muscles and the intervertebral discs.
- Pregnancy results in tightening of the back ligaments.
- Certain medications such as corticosteroids, when taken long-term can cause weakness of the bones, which then cry out in pain.
- Occupations that require lifting of heavy weights
- Occupations that require sitting on a desk for hours every day and that can cause slipping into improper posture on the chair