Back Pain—Understanding the Causes

By Mike DuBose with Surb Guram, MD

Back pain is a highly prevalent condition worldwide and affects people of all ages and backgrounds. The Global Burden of Disease Study reported 65% of adults experience back pain during their lifetimes which is a leading cause of disabilities. Older individuals are more susceptible due to age-related degenerative spinal changes, while younger adults and adolescents may experience problems due to lifestyle factors, injuries, or conditions from birth. The symptoms range from mild discomfort to severe, debilitating pain, impacting daily activities.

I don’t have a history of back problems but occasionally, experienced temporary issues by picking up heavy weights improperly but in 2024, all that changed! Upon seeing an unknown box located in the rear of my closet, I pulled it out with my body positioned sideways. Suddenly, significant pain was felt. Of course, I wasn’t initially concerned since my back pain would ordinarily go away in a few days, but this time, it was a different story! Days later, I could hardly get out of bed because of severe pain and extra-strength, over-the-counter meds were ineffective. I didn’t know how to remedy my unusual situation that was worsening!

Let’s explore my real-life recovery journey in this two-part series based on engaging with different healthcare professionals and the latest research! This first article will review various causes of back pain which is essential for effective treatment and prevention strategies outlined in our next publication.

Poor Posture is a significant contributor, particularly in today’s sedentary lifestyles. Slouching, spending excessive time on computers or smartphones, standing/sitting too long, or watching television for extended periods can place undue stress on the spine and supporting muscles. Eventually, strains can lead to chronic pain and discomfort. Gravity works against us by pulling the body downward and forward which accelerates joint degeneration.

Muscle and Ligament Strains often occur due to sudden movements, lifting heavy objects incorrectly, or engaging in activities that strain back areas which can lead to microscopic tears in the muscle fibers or ligaments.

Injury and Trauma from car or other accidents, falls, or athletic activities can cause severe back pain. Shock to the spine, such as fractures, can damage the vertebrae, its 24 small discs, or surrounding tissues, leading to pain, inflammation, and potentially long-term complications. Friends who played high school and college sports complain about these agonizing injuries as they age.

Lifestyles, like lack of exercise, result in weak back and core muscles, decreasing space between our joints that resist pressure. This can lead to poor posture and increased vulnerability to strains or injuries. Being overweight places additional stress on the spine which contributes to structural problems and pain. Smoking reduces blood flow to the spine and inhibits the body’s ability to deliver nutrients to the discs, increasing degeneration and back pain risks.

Psychological Factors, including excessive worry, long-lasting anxiety, and depression, can cause or exacerbate back pain. Chronic stress creates back muscle tensions, spasms, and tightness, while making the body more sensitive to pain. Mayo Clinic reported that long-term over-activation of the nervous response system and stress hormones, like Cortisol, can disrupt many of the body’s processes. This places you at a higher risk of many traumatic, painful health problems.

Medical Conditions such as kidney stones can radiate to the lower back and mimic musculoskeletal suffering. Spinal infections can cause painful inflammation. Statin prescriptions lower cholesterol levels, but they can induce side effects such as muscle, joint, and back pains. Though less prevalent, cancer and tumors in the body’s rear area can result in significant suffering. Pregnancy, of course, is a back breaker but the pain usually diminishes after delivery.

Spinal Disks act as vertebrae cushions, absorbing shock and facilitating movement. When discs herniate or bulge outward, they can press on nearby nerves, causing rear pain that radiates down the leg (known as sciatica). Disc herniation can result from aging, wear and tear, or sudden spinal trauma.

Arthritis may affect the spine and contribute to back pain. Osteoarthritis causes cartilage breakdown between the joints, including those in the spine, leading to pain, stiffness, and reduced mobility. Rheumatoid arthritis may generate painful inflammation in the joints.

Skeletal Irregularities that develop during growth stages or from birth defects, affects spinal alignment and places uneven, painful pressure on the vertebrae and surrounding muscles.

Osteoporosis is a condition characterized by weakened bones that are more susceptible to fractures. When this condition affects the vertebrae, it can lead to compression fractures which can cause severe back pain and contribute to a stooped posture over time. This condition is more common in older adults and individuals with low-bone density.

The Bottom Line: Back pain has many potential causes, ranging from issues like muscle strain and poor posture to more complex factors such as arthritis, spinal abnormalities, and serious medical conditions. Identifying the underlying causes of back pain by experts is crucial in determining effective treatment approaches. By understanding these causes and taking proactive steps to maintain spinal health, individuals can reduce their risk of experiencing debilitating back pain and enjoy improved overall well-being.

If you suffer back pain, don’t accept your condition as permanent. While it may take time, experiment with different strategies in seeking relief! Our next article will share treatment options to consider, with your healthcare professional’s input, before major surgery.

Contact Mike at [email protected]. Visit his nonprofit website www.mikedubose.com and register to receive his monthly articles or Daily Thoughts plus free access to his books, including “The Art of Building Great Businesses.” The website includes 100+ published articles he has written on business, travel, and personal topics, in addition to health research with Surb Guram, MD and David Hurst, DMV.

Dr. Surb Guram, MD is a board-certified internist and a graduate of the University of South Carolina School of Medicine. He is a partner with the SC Internal Medicine Associates in Irmo, SC (www.scinternalmedicine.com) and has practiced internal medicine in the Midlands for the past 30+ years.