Back Pain Causes: What's Really Hurting

Back pain is the leading cause of disability worldwide, affecting 80% of adults at some point in their lives. The vast majority (approximately 90%) of acute back pain episodes are 'non-specific' — meaning no serious underlying cause — and resolve within 6–12 weeks with conservative management.

Common causes of low back pain include: muscle or ligament strain (most common — often from lifting, sudden movements, or poor posture), lumbar disc herniation ('slipped disc' compressing a nerve root, causing sciatica), facet joint degeneration (osteoarthritis), spinal stenosis (narrowing of the spinal canal, causing leg pain with walking), and sacroiliac joint dysfunction.

See also: Lower Back Pain: Causes and Relief

Red flags that require urgent evaluation include: pain following trauma or falls, fever with back pain (possible spinal infection or osteomyelitis), unexplained weight loss (possible malignancy), new bladder or bowel dysfunction (cauda equina syndrome — surgical emergency), saddle anesthesia (numbness around the groin), bilateral leg weakness or numbness, and cancer history with new back pain.

Evidence-based first-line treatment for non-specific low back pain: staying active (bed rest is harmful), NSAIDs for short-term pain relief, physiotherapy focused on movement and strengthening, and reassurance that most episodes resolve. Psychological factors (catastrophizing, fear-avoidance) are among the strongest predictors of chronicity and benefit from cognitive behavioral therapy.

See also: Ear Pain: Common Causes and Treatment