Back pain - Symptoms and causes (2025)

Overview

Back pain is one of the most common reasons people seek medical help or miss work. Back pain is a leading cause of disability worldwide.

Fortunately, measures can help prevent or relieve most back pain episodes, especially for people younger than age 60. If prevention fails, simple home treatment and using the body correctly often will heal the back within a few weeks. Surgery is rarely needed to treat back pain.

Symptoms

Back pain can range from a muscle aching to a shooting, burning or stabbing sensation. Also, the pain can radiate down a leg. Bending, twisting, lifting, standing or walking can make it worse.

When to see a doctor

Most back pain gradually improves with home treatment and self-care, usually within a few weeks. Contact your health care provider for back pain that:

  • Lasts longer than a few weeks.
  • Is severe and doesn't improve with rest.
  • Spreads down one or both legs, especially if the pain goes below the knee.
  • Causes weakness, numbness, or tingling in one or both legs.
  • Is paired with unexplained weight loss.

In rare cases, back pain can signal a serious medical problem. Seek immediate care for back pain that:

  • Causes new bowel or bladder problems.
  • Is accompanied by a fever.
  • Follows a fall, blow to the back or other injury.

More Information

  • Tailbone pain

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Causes

Back pain often develops without a cause that shows up in a test or imaging study. Conditions commonly linked to back pain include:

  • Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. For people in poor physical condition, constant strain on the back can cause painful muscle spasms.
  • Bulging or ruptured disks. Disks act as cushions between the bones in the spine. The soft material inside a disk can bulge or rupture and press on a nerve. However, a bulging or ruptured disk might not cause back pain. Disk disease is often found on spine X-rays, CT scans or MRIs done for another reason.
  • Arthritis. Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
  • Osteoporosis. The spine's vertebrae can develop painful breaks if the bones become porous and brittle.
  • Ankylosing spondylitis, also called axial spondyloarthritis. This inflammatory disease can cause some of the bones in the spine to fuse. This makes the spine less flexible.

Risk factors

Anyone can develop back pain, even children and teens. These factors can increase the risk of developing back pain:

  • Age. Back pain is more common with age, starting around age 30 or 40.
  • Lack of exercise. Weak, unused muscles in the back and abdomen might lead to back pain.
  • Excess weight. Excess body weight puts extra stress on the back.
  • Diseases. Some types of arthritis and cancer can contribute to back pain.
  • Improper lifting. Using the back instead of the legs can lead to back pain.
  • Psychological conditions. People prone to depression and anxiety appear to have a greater risk of back pain. Stress can cause muscle tension, which can contribute to back pain.
  • Smoking. Smokers have increased rates of back pain. This may occur because smoking causes coughing, which can lead to herniated disks. Smoking also can decrease blood flow to the spine and increase the risk of osteoporosis.

Prevention

Improving one's physical condition and learning and practicing how to use the body might help prevent back pain.

To keep the back healthy and strong:

  • Exercise. Regular low-impact aerobic activities — those that don't strain or jolt the back — can increase strength and endurance in the back and allow the muscles to work better. Walking, bicycling and swimming are good choices. Talk with your health care provider about which activities to try.
  • Build muscle strength and flexibility. Abdominal and back muscle exercises, which strengthen the core, help condition these muscles so that they work together to support the back.
  • Maintain a healthy weight. Being overweight strains back muscles.
  • Quit smoking. Smoking increases the risk of low back pain. The risk increases with the number of cigarettes smoked per day, so quitting should help reduce this risk.

Avoid movements that twist or strain the back. To use the body properly:

  • Stand smart. Don't slouch. Maintain a neutral pelvic position. When standing for long periods, place one foot on a low footstool to take some of the load off the lower back. Alternate feet. Good posture can reduce the stress on back muscles.
  • Sit smart. Choose a seat with good lower back support, armrests and a swivel base. Placing a pillow or rolled towel in the small of the back can maintain its normal curve. Keep knees and hips level. Change position frequently, at least every half-hour.
  • Lift smart. Avoid heavy lifting, if possible. If you must lift something heavy, let your legs do the work. Keep your back straight — no twisting — and bend only at the knees. Hold the load close to your body. Find a lifting partner if the object is heavy or awkward.

Buyer beware

Because back pain is common, many products promise prevention or relief. But there's no good evidence that special shoes, shoe inserts, back supports or specially designed furniture can help.

In addition, there doesn't appear to be one type of mattress that's best for people with back pain. It's probably a matter of what feels most comfortable.

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  1. Mississippi man finds relief at Mayo Clinic for excruciating back painEdward Markle was desperate. Despite receiving nerve blocks from his doctors, Edward says the pain from two herniated discs had become excruciating and unrelenting. He could not sit or walk without pain. He slept on the floor, two hours a night. He was increasingly worried about the future. "It shut my quality of life down to almost zero," he says. "I couldn't move. I could not get out. I could not find a way to…

By Mayo Clinic Staff

Feb. 18, 2023

Back pain - Symptoms and causes (2025)

FAQs

Back pain - Symptoms and causes? ›

Conditions commonly linked to back pain include: Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. For people in poor physical condition, constant strain on the back can cause painful muscle spasms.

What are the causes and symptoms of back pain? ›

Conditions commonly linked to back pain include: Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. For people in poor physical condition, constant strain on the back can cause painful muscle spasms.

What are three things that could be causing back pain? ›

Possible causes of back pain include:
  • Ankylosing spondylitis.
  • Endometriosis.
  • Fibromyalgia.
  • Herniated disk.
  • Kidney infection (also called pyelonephritis)
  • Kidney stones (Hard buildups of minerals and salt that form inside the kidneys.)

What is a red flag for back pain? ›

Severe or Progressive Pain: If your back pain is sudden, severe, or progressively worsening over time, it should raise a red flag. Intense, unrelenting pain that is not relieved by rest or usual pain management strategies could indicate a more serious condition, such as a spinal fracture, infection, or tumor.

How do I know if my back pain is severe? ›

If your back pain wakes you up in the middle of the night or appears when you're in certain positions, such as lying down, then this could be a sign of a more serious problem. It could be a sign of a more systematic problem such as an infection, fracture, severe nerve compression or even cancer.

How to tell if back pain is muscle or disc? ›

Signs of pulled back muscle are that the pain is usually dull and aching. You'll find it feels like it is in the back and often gets work if you don't rest that area. With a slipped disc, the pain is much sharper. It can even feel like it's radiating through the back, into the shoulders or surrounding areas.

How to tell if back pain is muscular or kidney? ›

Kidney pain is often felt on either the left or right flank (side), under the rib cage, in the middle part of the back. Type of pain: Kidney pain comes from a deeper place than the muscles. This means it usually doesn't get worse with lifting, twisting, or bending like muscle pain does.

How do I know if my back pain is organ-related? ›

Organ-related back pain also tends to be achy and generalized, while muscular pain is typically sharp and more specific. It's worth noting that organ problems are often accompanied by other symptoms, such as nausea, fatigue, frequent urination, jaundice, and abdominal pain.

What organ damage causes back pain? ›

Lower back pain can often be attributed to injuries in muscles, ligaments or the spine. However, when the pain is felt on one side of your back, such as the lower left side of your back, it can be a sign of a more serious issue with internal organs like the kidneys, colon, uterus or pancreas.

What can back pain be an indicator of? ›

These could include mechanical or structural problems with the spine, inflammatory conditions, and other medical conditions. It is also possible that no specific cause can be identified for the start of back pain.

When should you not ignore back pain? ›

Back pain that's severe or persists for several weeks, on the other hand, should be evaluated by a doctor. Back pain that crops up with other symptoms – such as bowel or bladder problems or progressive neurological changes, like sudden or severe headaches or vision problems – also require immediate attention.

Which of the following symptoms suggests a more serious cause of back pain? ›

If your back pain is accompanied by any of the following symptoms, head to your closest emergency room because you could be dealing with a more serious condition or injury: Sudden spike in pain, discomfort, weakness or numbness. Loss of bladder function. High fever.

When is an MRI needed for back pain? ›

Your doctor might recommend an MRI if: Your history and physical exam show signs of a serious problem, such as a fracture, tumours, infection, or nerve damage. You are older than 70. Your doctor may also recommend testing if you are older than 50 and also have osteoporosis or a history of compression fracture.

How to tell if pain is muscular or internal? ›

Muscular pain often feels localized, tender to the touch, and worsens with movement or specific activities. It may also be accompanied by muscle spasms or visible signs of inflammation. Internal pain , on the other hand, may feel deeper, more widespread, and unrelated to movement.

What is the most painful type of back pain? ›

Also called Spondylolisthesis, a Slipped Disc can be one of the most painful spine conditions, depending on its severity. It occurs when a vertebra slips out of position and moves onto the bone directly below it, which puts pressure on the nerves in the spinal cord.

When should back pain be alarming? ›

If the pain lasts four weeks or longer. If the pain keeps getting worse as time goes by. If you are experiencing other symptoms, such as fever, major weight loss or weight gain, loss of function or weakness in extremities, bladder problems, etc.

What is the number one cause of back pain? ›

Arthritis of the spine — the slow degeneration of the spinal joints — is the most frequent cause of lower back pain. All of us experience wear and tear as we age, and it is normal for your lower back to start acting up as you get older.

What organ issues cause back pain? ›

However, when the pain is felt on one side of your back, such as the lower left side of your back, it can be a sign of a more serious issue with internal organs like the kidneys, colon, uterus or pancreas.

What are the four causes of back pain? ›

A common cause of back pain is an injury like a pulled muscle (strain). Sometimes, medical conditions like a slipped disc, sciatica (a trapped nerve) or ankylosing spondylitis can cause back pain. Very rarely, back pain can be a sign of a serious problem such as a broken bone, cancer or an infection.

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