Back pain comes in several forms and may occur due to problems with the discs between spinal vertebrae, nerve issues, sciatica, scoliosis or vertical compression fractures.
Vertebral compression fractures are breaks in the bones that make up the spine, the vertebrae. The most common cause is osteoporosis, a disease that makes the bones fragile as they lose calcium. Other causes include trauma or injury to the back or tumors that affect the bone. Compression fractures may occur suddenly and cause sharp pain, usually felt in the middle or lower spine. Pain can take weeks or months to fade. With osteoporosis, the fractures may develop slowly, at first without symptoms. The resulting hunched posture can lead to numbness, tingling or weakness, difficulty walking, and loss of bowel or bladder control.
Pain can occur in the upper back as well as the lower back, though upper back pain isn’t as common. Sometimes, if a nerve is irritated or pinched where the ribs attach to your spine, pain may travel with the nerve to other places, such as your limbs, chest and belly. Upper back pain may have a variety of causes, such as poor posture, muscle stress or injury, pressure on the spinal nerves from other problems, myofascial pain, or fracture of a vertebra.
Spinal stenosis symptoms include neck or back pain; numbness, weakness, cramping or pain in the limbs; pain going down the leg; and foot issues. It’s caused by a narrowing of the spinal canal that puts pressure on the nerves and spinal cord. It’s most common in people over 50, though injury or a genetically smaller spinal canal can lead to issues in younger people, too. Arthritis and scoliosis also can cause spinal stenosis.
Scoliosis leads to a sideways curve of the spine, often shaped like a “C” or “S.” It occurs most commonly in late childhood or the early teens, during periods of rapid growth, and it can be hereditary. A person with scoliosis may lean to one side or have uneven shoulders or hips.
The sciatic nerve, the largest in the body, controls muscles in the back of your knee and lower leg and also provides sensation to the back of the thigh, lower leg and sole of the foot. A problem with this nerve is called sciatica and may lead to pain, numbness, weakness or tingling from the lower back on down. Sciatica usually affects one side of the body. Causes may be a ruptured disc, narrowing of the spinal canal (spinal stenosis) or an injury.
The sacroiliac joint is where the sacrum, at the base of the spine, connects with the two large bones of the pelvis, or the iliac bones. Pain may be due to pregnancy, tight muscles, arthritis, wear on cartilage between bones, trauma, or a history of injuries. The pain may occur in the lower back or hip. It may be uncomfortable to stand or bend over after sitting for long periods.
Low back pain (or lower back pain) affects about 80 percent of adults at some point, leading to missed work and sometimes disability. Pain can be dull and constant or sharp and sudden. It can initiate with an accident or hefting a weight or develop over time. Most low back pain lasts for a few days or weeks, defined as acute. Subacute pain lasts 4 to 12 weeks. Chronic pain lasts for 12 weeks or longer.
Stresses and injuries to the spine can lead to degeneration of the discs in between vertebrae. They cushion the spine, but over time, the tough ligament that holds a disc together can be injured. Scar tissue that forms after injuries isn’t as strong as the original material, making the discs weaker. The space between vertebrae may narrow, and bone spurs may form. The result is back pain that can spread to the buttocks and thighs.
Bulging discs and especially herniated discs in the spine can be a source of pain. Discs made of cartilage cushion the bones in your spine; when a disc bulges, it sticks out of the space it’s supposed to occupy. Bulging occurs with age and often does not cause pain. Herniated discs — also called ruptured or slipped discs — occur when the tougher outer layer of cartilage on a disc fractures enough to let some of the soft insides push out. They are more likely to cause pain.
Cervicogenic headaches are caused by referred pain — pain generated in the neck. It’s really a disease of the cervical spine. As pressure is placed on the neck during repetitive activities or a sudden trauma, damage may occur to the joints, muscles, ligaments and nerves. Typically, a cervicogenic headache originates in the top three vertebra of the neck. The nerves that affect the upper neck also supply the skin over the head, so the pain can affect the head, too.