Why Does My Back Hurt? Causes of Back Pain, Prevention and Treatment Options

Back pain can strike suddenly, like when you lift a heavy object, or it can come on gradually over time, from issues like poor posture or weight gain. It is one of the most common reasons people visit their healthcare providers, with nearly 80% of adults likely to experience back pain symptoms at some point in their lives. In fact, low back pain is the leading cause of disability worldwide.¹

It's important to pinpoint why your back hurts so you can get the right treatment to relieve your back pain or numbness. Getting the right diagnosis and treatment for lower and upper back pain is key to keeping your back in good health.

If you find yourself wondering why your back hurts, keep reading to learn about common causes of lower and upper back pain and when it may be time to see a doctor or chiropractor for treatment.

What Causes Lower Back Pain?

The lower back includes the lumbar spine, a sturdy structure that supports the weight of the upper body, including the head and neck, and helps protect the spinal cord. Lower back pain, also known as lumbago, is much more common than upper back pain, with many factors that can cause pain. These causes of lower back pain are generally related to:

1. An accident or injury

A car accident, sports injury, a fall or lifting a heavy object can lead to a sprain, muscle spasm or fracture and cause pain in the back. Muscles and ligaments hold vertebrae in their proper position, so a muscle strain from overstretching or twisting your back can cause pain.²

2. Lifestyle factors

Lifestyle factors such as obesity, sitting for long periods of time, poor posture while sitting or standing, lack of exercise, stress that causes muscle tension in the back, being out of shape or carrying a heavy backpack may cause lower back pain. Overtraining or improper form while exercising can also cause lower back pain.³

3. Spine issues

Some lower back pain is caused by spinal issues in your joints, muscles, vertebrae or discs. Your healthcare provider can examine you for:⁴

• Herniated disc: Wear and tear over time can cause the soft tissue in the discs between the joints in your back to slip out, causing back pain, sciatica or other complications with bowel and bladder control.
• Spinal stenosis: A condition commonly found in patients over 60, spinal stenosis is a narrowing of the spinal canal, adding pressure to the spine and nerves and often causing shoulders or legs to feel numb.
• Cervical radiculopathy: A pinched nerve possibly caused by a herniated disc or bone spur
• Spondylosis: A degenerative condition of the spine often associated with arthritis and/or a herniated disc
• Scoliosis: A curvature of the spine that you are born with but may cause back pain later in life

4. Medical conditions

Lower back pain can be caused by certain underlying medical conditions, including:⁴

• Osteoporosis: Loss of bone density as you age can lead to bone fractures.
• Osteoarthritis: Arthritis due to the breakdown of cartilage and bone density, usually seen in middle age onward
• Pregnancy: Can cause pain in the lower back and pelvis as ligaments stretch and soften to prepare for labor

Lower back pain may also indicate a serious acute condition that requires immediate treatment, such as:³

• Kidney stones: Usually indicated by pain on one side of the lower back
• Osteomyelitis: Infection of the vertebrae
• Abdominal aortic aneurysm: Swelling of the abdominal blood vessel that supplies blood to your abdomen, pelvis and legs

What Causes Upper Back Pain?

Common causes of upper back pain include many of the same factors as lower back pain, but some behaviors and activities that commonly cause upper back pain include:⁵

• “Text neck" from hunching to use a mobile device
• Poor posture or slouching to view a computer screen
• Carrying a backpack or shoulder bag loaded with more than 20% of your body weight
• Overuse or repetitive movements
• Improper form while exercising

Common Back Pain Symptoms

Symptoms of back pain may not be limited to the back but may radiate to other parts of the body and become more noticeable with certain types of movement. Common symptoms of lower and upper back pain include:²

• A dull ache in the hips or pelvis
• Sharp pain that radiates to your buttocks or down the backs of your legs (sometimes called sciatica)
• Muscle spasms or tightness across the lower or upper back
• Pain that worsens with sitting but improves with walking
• Pain that's noticeably worse in the morning
• Stiffness or difficulty straightening your back or standing from a seated position, or decreased range of motion
• Posture problems in which it's painful to stand straight or the torso is bent or not aligned with the spine
• Areas of the back that are tender to the touch⁵
• Numbness in the legs⁵
• Headaches⁵
• Incontinence of the bladder or bowels⁵

When to See a Doctor for Back Pain

If the back pain you are experiencing has not improved within a few weeks of rest and self-care, is severe or keeps you from your daily activities, contact your healthcare provider. Be sure to inform them of any pain you experience when you lie down or if you feel pain, numbness or tingling that runs down one or both legs. Contact your healthcare provider immediately if fever, incontinence or unintentional weight loss accompany your back pain.³

Your provider can help identify the cause of your upper or lower back pain and recommend a treatment plan for pain relief.

How Is Back Pain Diagnosed?

Your doctor may start with a physical exam and ask about your back pain symptoms. They may order an imaging scan such as a spinal X-ray, MRI, CT scan or electromyography (EMG) to check for broken bones or fractures and provide a clearer picture of your vertebrae, ligaments and tendons.⁶

They may also order blood tests to check for genetic markers of conditions that cause back pain, or urine tests to check for indications of kidney stones.²

Tips for Back Pain Relief and Prevention

Most back pain is relieved within a few days to a few weeks. Depending on the cause of your upper or lower back pain, your healthcare provider may recommend home remedies, such as rest and applying ice to reduce inflammation, followed by a heating pad once swelling is under control.

The risk of developing lower or upper back pain tends to increase with age. Below, you will find some tips that can help you prevent back pain now and into the future:⁷

1. Lead an active lifestyle

Try to include weight-bearing exercises such as walking, jogging, weight lifting and planks to improve core muscle strength and bone density.

2. Move around frequently

Avoid sitting, standing, slumping or slouching for long periods of time. Take frequent breaks to stand and move.

3. Practice good posture

Practice good posture when sitting and standing. If working at a desk, make sure you're able to sit in proper alignment with lumbar support and armrests. Adjust your screens to a height that allows you to read without hunching or straining.

4. Stop smoking

Smoking restricts blood flow to the discs that cushion the vertebrae and can accelerate degeneration. Smoking also reduces calcium absorption and new bone growth, increasing the risk of osteoporotic fractures.

5. Eat a balanced diet

Be sure to include plenty of calcium, vitamin D and protein to maintain healthy bones and muscles.

6. Get enough sleep

Use a pillow under your legs or between your knees to relieve pressure on the hips or spine while sleeping, and use a medium to firm mattress.

7. Increase flexibility and range of motion

As you age, your joints aren't as flexible as they once were, which means they won't completely move through their full range of motion. This can contribute to back pain over time due to the tightening of the muscles, especially in the lower back.⁸

Fortunately, regular stretching exercises can help improve your flexibility and range of motion, as well as:⁸

• Help with muscle balance
• Give you better posture
• Assist with reducing back pain
• Reduce tension in the muscles of the lower back

8. Try yoga stretches to improve flexibility

The best way to help improve your flexibility and reduce back pain is through yoga stretches. Not only do these stretches relieve tension in your back but they also help strengthen the muscles in your back.⁹

Stretches that boost your energy and help with back pain include:⁹

• Cat-Cow
• Child's pose
• Knee-to-chest stretch
• Pelvic tilt
• Piriformis stretch
• Seated spinal twist
• Sphinx stretch

9. Choose a better posture for better sleep

While having poor posture when you are sitting can contribute to back pain, having poor posture when you sleep can actually do the same. That's because some sleeping positions are better than others to help relieve back pain. Good sleep posture helps maintain the natural curvature of your spine while you are lying down.¹⁰

To maintain a healthy sleep posture and avoid back pain, consider sleeping:¹¹

• In the fetal position on your side with your legs bent and curled into your body
• On your side with your legs straight
• On your back with a pillow supporting your head and one under your knees as well

In general, avoid sleeping on your stomach, which can put a strain on your joints and spine, leading to back pain. If you do sleep on your stomach, consider placing a pillow under your pelvis to help support your spine and prevent lower back pain.¹¹

Back Pain Treatment Options

Depending on how severe your back pain is, your healthcare provider might recommend over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxers to relieve pain. More severe or persistent back pain might be treated with steroid injections to reduce inflammation.²

In many cases, a course of physical therapy is prescribed to strengthen the muscles that support the spine, improve movement and potentially prevent further injury.²

Other options to treat back pain can include:²

• Acupuncture⁶
• Massage therapy
• Chiropractic treatment
• Transcutaneous electrical nerve stimulation (TENS) treatment⁶
• Surgery, including minimally invasive techniques

Benefits of Treating Back Pain

If you're putting off getting help for your back pain, consider the following benefits of treatment.

1. Reduced need for pain medication

By treating the source of your back pain, whether through surgery, exercise or other alternative treatments such as acupuncture, you will reduce the need to alleviate your pain with medication. While pain medication is good for short-term treatment of back pain, long-term use can lead to other types of health problems, such as:¹²

• Liver damage from large doses of acetaminophen, higher than 3,000 milligrams per day
• An increased risk of heart attack, stomach upset, bruising or stroke from prolonged use of NSAIDs
• Dependence that can lead to addiction when using opioid-based pain relievers

Treatments like surgery may be able to permanently eliminate the need for pain medication for some types of back problems. Other treatments such as physical therapy can do the same and help with weight loss to reduce excess pressure on your spine.¹⁴

Your therapist may also recommend laser therapy and exercises such as yoga or tai chi, along with relaxation techniques that keep your mind focused on things other than your pain to reduce your need for pain medication in the long term.¹⁴

2. Alleviation of headaches

Did you know that back pain can literally give you a headache? Secondary headaches are a type of head pain caused by medical conditions in other parts of your body, such as your back.¹³

Headaches caused by back problems include:¹³

• Cervicogenic headaches, triggered by issues in the neck or cervical region of the spine. These issues can include conditions like spinal stenosis, injury to the muscles of the back, damaged discs and other types of spinal column problems.
• Spinal headaches, triggered by surgical procedures that puncture the spine, including epidural or anesthesia injections
• Referred pain headaches, which manifest as discomfort in the head even though the pain originates in another part of your body, such as your back
• Rebound headaches, triggered by continued use of pain relievers

In addition, those who experience lower back pain may have an increased risk of developing headaches. Fortunately, by treating the cause of the back pain with physical therapy, surgery or exercise, your headaches should subside.¹³

3. Improved quality of life

By treating your back pain, you can greatly improve your quality of life. That's because over time, back pain can decrease your quality of life by:¹⁵

• Negatively affecting your ability to do daily tasks such as bending and driving
• Reducing your ability to work, especially if you work a physically labor-intensive job
• Putting you at higher risk of developing depression or anxiety
• Socially isolating you by decreasing your desire to go out and socialize with friends due to pain
• Reducing your ability to exercise due to limited mobility, which could lead to other health problems
• Causing headaches, which can further debilitate you¹³

With treatment, you can enjoy an increased range of motion and eliminate pain that is affecting your everyday mental and physical health.

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Author Bio

Susan Paretts is a freelance writer with 19 years of experience covering health and wellness, pet care and more. Her work has been published by the American Kennel Club, Bayer Animal Health, Elanco, LIVESTRONG.com, The San Francisco Chronicle, Chewy and more.