Lower back pain can be caused by a variety of problems with any parts of the complex, interconnected network of spinal muscles, nerves, bones, discs or tendons in the lumbar spine. Typical sources of low back pain include:
- The large nerve roots in the low back that go to the legs may be irritated
- The smaller nerves that supply the low back may be irritated
- The large paired lower back muscles (erector spinae) may be strained
- The bones, ligaments or joints may be damaged
- An intervertebral disc may be degenerating
- Learn more: Lumbar Spine Anatomy and Pain
An irritation or problem with any of these structures can cause lower back pain and/or pain that radiates or is referred to other parts of the body. Many lower back problems also cause back muscle spasms, which don't sound like much but can cause severe pain and disability.
While lower back pain is extremely common, the symptoms and severity of lower back pain vary greatly. A simple lower back muscle strain might be excruciating enough to necessitate an emergency room visit, while a degenerating disc might cause only mild, intermittent discomfort.
Identifying the symptoms and getting a diagnosis that pinpoints the underlying cause of the pain is the first step in obtaining effective pain relief.
Common Lower Back Pain Causes in Adults
Certain causes of lower back pain have a tendency to occur more often in younger individuals versus older adults:
- Younger adults (30 to 60 year olds) are more likely to experience back pain from the disc space itself (e.g. lumbar disc herniation or degenerative disc disease) or from a back muscle strain or other soft tissue strain.
- Older adults (over 60) are more likely to suffer from pain related to joint degeneration (such as osteoarthritis or spinal stenosis) or from a compression fracture.
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When to Seek Immediate Treatment for Lower Back Pain
Most cases of low back pain do not require urgent care, but anyone should see a doctor immediately if low back pain is a result of trauma, or if pain is accompanied by any of the following symptoms:
- Fever and chills
- Unexplained recent weight loss
- Significant leg weakness
- Sudden bowel and/or bladder incontinence—either difficulty passing urine or having a bowel movement, or loss of control of urination or bowel movement (cauda equina syndrome)
- Severe, continuous abdominal pain (abdominal aortic aneurysm)
In cases where immediate treatment is a required, physicians will investigate possible serious causes of the pain, including any type of spinal infection, tumor or fracture.