Low back pain can often be attributed to complex origins and symptoms, and it does not discriminate. It can originate from identified muscle trauma, or an unknown non-traumatic event. Low back pain can also begin in other regions of the body and eventually attack the muscles or other structures in the lower back. Sometimes low back pain can even begin in the nerves or nervous system. Other origins for low back pain are postneural difficulties, congenital disorders, trauma, infections, degenerative disorders, inflammatory diseases, circulatory disorders or any of other 30 additional causes.

It is often difficult for physicians to pinpoint the exact cause of a patient’s low back pain, because of the complex composition of the human spine. Bone, discs, muscles, ligaments, tendons and various other tissues are arranged like a three-dimensional puzzle to make up the spine. The complex make up can easily mask the exact cause of low back pain.

In addition, depression, anxiety, frustration, reinforcement, stress, anger, fear and many other psychological states can help to cause the onset of back pain, can be a reaction to prolonged pain, or exist concurrently with pain.

The emotional component can complicate the back pain diagnosis, sometimes resulting in needless surgery and disability and can sometimes mask the underlying physical causes of pain.

There are two different types of back pain, acute and chronic. Acute pain has a sudden onset and can be caused by trauma, arthritis, fractures, infections around the spine, and internal organ disease and cancer. Chronic back pain lasts for months with no relief and can have a myriad of causes.

The following are some of the most common causes and diagnoses of back pain:

Mechanical Disorders
Many people who suffer from back problems are experiencing mechanical pain, which means that a specific part of their spine, such as an intervertebral disc, a ligament, or a joint, is damaged and is not working correctly. Read More

Developmental Disorders
Developmental disorders of the lower back are caused by abnormalities in the formation and growth of the skeleton. Although the treatment for many of these conditions is conservative, surgery may be required to keep some disorders from worsening, and in order to prevent long-term disability and or deformity. Read More

Inflammatory and Infectious Disorders
Infections of the spinal column are not common, but they are important because they are difficult to diagnose and there are serious consequences in the delay of an accurate diagnosis. Read More

Tumors
Cancers and tumors of the spine and spinal cord are relatively rare. The most common symptom that patients with a spinal tumor have is pain. Because back pain is very common, it is also not a specific symptom of any one disease or medical condition. Read More

Trauma
Trauma to the spine refers to injury that has occurred to bony elements, soft tissues and or neurological structures. The two things that surgeons are most concerned about, in the case of spinal trauma, are instability of the vertebral column and actual or potential neurological injury. Read More

Pain

When you feel pain, it is really a reaction to signals transmitted throughout your body. These signals are sent from the pain source — such as a sore back, through the nerves in the spinal cord, and up to the brain, where they are perceived as pain.

Different Types of Pain
The origin of some pain is neuropathic, while other pain is nociceptive. This is important to know because different treatments work better for each type of pain.

Neuropathic pain is caused by damage to nerve tissue. It is often felt as a burning or stabbing pain. One example of neuropathic pain is a "pinched nerve."

Nociceptive pain is caused by an injury or disease outside the nervous system. It is often an ongoing dull ache or pressure, rather than the sharper, trauma-like pain that is characteristic of neuropathic pain. One example of nociceptive pain is arthritis pain.

Some people experience mixed pain, which is a combination of neuropathic and nociceptive pain.

Chronic versus Acute Back Pain
Chronic back pain is commonly described as deep, aching, dull or burning pain in one area of the back or traveling down the legs. Patients may experience numbness, tingling, burning, or a pins-and-needles type sensation in the legs. Regular daily activities may prove difficult or impossible for the chronic back pain patient. They may find it difficult or unbearable to work, for example, even when the job does not require manual labor. Chronic back pain tends to last a long time, and is not relieved by standard types of medical management. It may result from a previous injury long since healed, or it may have an ongoing cause, such as nerve damage or arthritis.

Acute back pain is commonly described as a very sharp pain or a dull ache, usually felt deep in the lowerpart of the back, and can be more severe in one area, such as the right side, left side, center, or the lower part of the back. Acute pain can be intermittent, but is usually constant, only ranging in severity.

Sometimes, acute back pain can be caused by injury or trauma to the back, but just as often has no known cause. Patients with acute back pain, even when it’s severe, will typically improve or completely recover within six to eight weeks.

Approximately half of all back pain patients have acute pain caused by trauma. A contusion, torn muscle, or strained joint resulting from a back injury can cause acute pain. Patients with any of these conditions typically exhibit pain, muscle spasms, and decreased functional activities. Treatment is short-term and usually successful. With physical therapy, follow-up treatment, and prevention practices, these patients typically return to full functionality in a few weeks. Occasionally, these patients will re-injure themselves and have to return for a short course of treatment. Patients with acute pain occurring more than three times in one year or who experience longer-lasting episodes of back pain that significantly interfere with functional activities (e.g., sleeping, sitting, standing, walking, bending, riding in or driving a car) tend to develop a chronic condition.

Mechanical back pain -­ a form of acute pain -­ is aggravated by movement and worsened by coughing. This type of pain is usually alleviated with rest. Mechanical back pain is typical of a herniated disc or stress fracture. For patients with this condition, forward movements of the spine usually cause pain. In addition, posture, coughing, sneezing, and movement can all influence pain coming from the spine.

When acute back pain is severe and travels down both legs, it could be caused by lumbar disc disease -­ the most common cause of true sciatica, another form of acute pain.