Understanding Different Types of Back Pain and Their Causes

Back pain affects everyone differently. It can occur anywhere in the musculoskeletal system which consists of bones, muscles, ligaments and tendons.

Over-the-counter painkillers can ease most back problems. Simple exercises and a healthy diet can build up strength in the back and improve flexibility. This can prevent the need for invasive medical procedures.

Poor Posture

Good posture can have a dramatic effect on your back. Not only does it make you look and feel more confident, it can also help your body by reducing stress on your muscles, bones, and joints. However, bad posture can actually cause pain and a variety of other problems.

Poor posture refers to a faulty alignment of the spine, shoulders, and hips that causes increased pressure on certain muscle groups. This increased pressure can lead to fatigue, and the overworked muscles may eventually scream for help. Often, this is the root of lower back pain as well as neck and upper back pain.

Over time, poor posture can cause the natural curves of your spine to change shape. This can lead to a number of complications, including a swayback (when your lower back curves inward) and rounded shoulders (when your shoulders tilt forward toward your chest).

This type of posture is often the result of sitting for long periods of time and wearing high heels. However, it can occur due to other activities, as well. For example, sleeping in a twisted position can put excessive strain on the lower back and the muscles that support it.

Having poor posture can actually cause pain, even when you’re not standing or sitting for long periods of time. This is because the tissue in your body adapts to repeated stretches over time, and you can experience micro-damage that leads to pain. It’s important to change positions frequently if you must stay static for extended periods of time, and see a physiotherapist, chiropractor, or Alexander technique teacher to get the support you need. This will help prevent damage and reduce pain.

Muscle Strain

The back is a complex structure of bone and muscle, supported by cartilage and tendons and fed by a network of nerves. The lower back, or lumbar area, is particularly vulnerable to injury. When a muscle or tendon in the back is stretched, pulled or torn, it’s called a strain and can cause pain that can range from a dull ache to a stabbing sensation. Muscle strains are the most common cause of back pain, and most can be treated at home.

Muscle strains usually occur when you overuse a muscle or overstretch one, causing the fibers to tear. You’re more likely to get a back strain from activities that require repetitive motions, such as sports or a job where you lift heavy objects regularly. People with tight, inflexible muscles or who do not warm up before an activity are also at greater risk.

Most strains are mild and resolve within a few weeks, although you may still experience some pain flare-ups. If the pain is severe, it’s important to see a doctor because if left untreated, the injury can worsen and lead to long-term problems. Make sure to identify if the pain is localized or not.

Over-the-counter (OTC) painkillers, such as ibuprofen and acetaminophen, can ease the discomfort. Resting from strenuous activities can help, but moving around — with the help of a physiotherapist — will speed up the recovery process and prevent the muscles from weakening. If OTC medications don’t provide relief, doctors can prescribe stronger NSAIDs or even narcotics such as hydrocodone and codeine. These are generally only prescribed for short periods of time and must be monitored closely. A physiotherapist can recommend exercises to strengthen the affected muscle and improve flexibility.

Disc Herniation

When the outer part of a spinal disc breaks down, it can allow the inner nucleus pulposus to protrude into the space between your spinal bones (vertebrae), where it presses on nerves. This can cause pain, weakness or numbness. Most disk herniations happen in the lower lumbar spine.

The type of back pain you have can help determine whether you have a herniated disc or another condition that requires medical attention. For example, sharp pain that doesn’t subside may suggest a spinal injury or a problem with a ligament or muscle. Back pain that gets worse while sitting may indicate that a herniated disc is pushing on the spinal cord or nerve roots. Pain that “moves” or radiates into the legs or buttocks may also be a sign of a herniated disk.

If your back pain is accompanied by a fever, chills or loss of bowel or bladder control, you should seek emergency care. These symptoms can be signs of an infection in the spine (spinal osteomyelitis), which is rare but serious.

Over-the-counter pain medications, such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), can relieve most back pain. Your doctor can prescribe stronger pain medications if needed. Physical therapy can help strengthen the muscles that support your spine. If your pain is caused by a herniated disk, you may need to avoid certain activities, such as bending and twisting, until the problem heals. In some cases, your doctor may recommend an epidural injection of steroids and numbing medication into the area around the spinal cord. This is often successful in relieving severe herniated disk pain. Most herniated disk pain will get better within a few days or weeks and should be completely gone in 4 to 6 weeks.

Spinal Stenosis

Spinal stenosis is a condition that occurs when your spinal nerves become compressed, usually because of narrowing of the spine’s nerve root canal. You can have this problem in any area of your back, but it is most common in the lower (lumbar) spine. Symptoms can be dull or sharp, and may come and go. Usually the pain starts in the buttocks and moves down your leg. It may be worse when you stand for long periods of time or walk downhill. In more severe cases, you may experience numbness or tingling in your legs and feet. This is called radiculopathy and it can be very painful.

In some cases, stenosis develops as part of the normal aging process. The cushioning disc between your vertebrae dries out and shrinks, leading to narrowing of the space between your vertebrae. The facet joints at the back of your spine also tend to enlarge as they age, which can lead to more narrowing of the space in which the spinal nerves pass.

Over-the-counter drugs such as acetaminophen and NSAIDs can relieve pain and inflammation. If this doesn’t help, your doctor might inject you with a cortisone shot to reduce swelling and ease the pain. Surgery involves removing bone spurs and widening the space between your vertebrae. In the lower spine, surgeons might also fuse together some of your vertebrae to give them more stability.

Regular exercise, especially walking and swimming, can help to strengthen the muscles that support your spine. Over-doing it can make your pain worse, though, so listen to your body and don’t push yourself too hard. Your doctor can recommend other treatments to ease your symptoms, including hot and cold packs, acupuncture and chiropractic care.


The spine is a complex structure of bones, muscles, ligaments and discs that work together to support the body and enable movement. Back pain can occur when the spinal cord or nerves get compressed, pinched or irritated. Back pain can also result from injuries, accidents, surgery or general wear and tear. The vertebrae in your middle back and thoracic region are connected to the ribs that protect the heart and lungs, so back injuries can impact the cardiopulmonary system.

When the spine gets injured, the resulting back pain can be acute (short-lived), subacute (longer than three weeks) or chronic/persistent (lasting more than six months). It can also vary in severity from a broad ache to a sharp stab and in location, with some areas of the back more prone to injury than others.

Whether your back pain is acute or chronic, there are ways to reduce symptoms and heal the injury. Over-the-counter pain relievers like NSAIDs can reduce discomfort and ease stiffness, while applying heat or cold to the affected area can relax and strengthen muscles. In more severe cases, your provider may recommend physical therapy and/or injections to help reduce inflammation and improve mobility.

The best way to prevent back pain is by staying active and using the muscles around your spine regularly. When the muscles are strong, they can support your spine better and take pressure off the joints and bones. Keeping active will also help your spine maintain its natural range of motion, so you can move easily without discomfort.