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What causes back pain?

Your back is a complex structure made up of bones, muscles, nerves and joints, so pinpointing the exact cause of the pain can often be difficult.

In a small number of cases, back pain is caused by a specific medical condition.

Medical conditions

Pain in the legs, neck and shoulders can also be felt as back pain. However, it may be caused by another condition and you should consider seeing your doctor if you think the following might apply to you:

  • pain in the lower back that moves down the buttocks into one or both of the legs may be a symptom of sciatica (caused by pressure on the nerve endings that come out of the spine)
  • soreness in the lower back, muscle weakness, tight muscles and loss of bladder control may be the result of a slipped disc
  • back pain, buttock pain, swollen joints and tendons and extreme tiredness are common symptoms of ankylosing spondylitis
  • lower back pain, stiffness, numbness and tingling can be caused by spondylolisthesis (a bone in the spine slipping out of position)
  • pain in the joints (including the back) when walking, and stiffness first thing in the morning are symptoms of arthritis
  • painful stiffness of the shoulder, which makes it very difficult to dress, drive or sleep, may be a sign of a frozen shoulder
  • neck pain and stiffness, headaches and lower back pain following an accident are common symptoms of whiplash.

The following serious conditions can also cause back pain:

  • a broken bone in the spine
  • an infection
  • cancer.

Most cases of back pain, however, are not caused by disease or serious damage but by sprains, minor strains, minor injuries or a pinched or irritated nerve.

Back pain triggers

Back pain can be brought on, or ‘triggered’, by everyday activities either at home or at work. Pain can also develop over time as a result of sitting, standing or lifting badly. Common triggers that can cause back pain include:

  • bending awkwardly
  • lifting, carrying, pushing or pulling incorrectly
  • slouching in chairs
  • standing or bending down for long periods
  • twisting
  • overstretching
  • driving in a hunched position
  • driving for long periods without taking a break
  • overuse of the muscles, usually due to sport or repetitive movements (repetitive strain injury).

Sometimes the pain develops suddenly and for no apparent reason. A person can wake up with back pain and have no idea what has caused it.

Risk factors

Some conditions increase the risk that someone will develop back pain. These include:

  • being overweight – the extra weight puts pressure on the spine. Use the healthy weight body mass index BMI calculator to find out if you need to lose weight
  • smoking – this could be due to damage to tissue in the back caused by smoking, or because smokers tend to have unhealthier lifestyles than non-smokers - get help quitting here
  • being pregnant – carrying a baby means extra weight, which can place additional strain on the back
  • long-term use of medicines that are known to weaken the bones, such as corticosteroids
  • stress – it is thought that stress can cause tension in the muscles of the back, which can cause back pain
  • depression – back pain can make people feel depressed, which can sometimes result in weight gain leading to more severe pain and a cycle of worsening depression.

When to see a doctor

You should see a doctor for help and advice:

  • if you are in pain or get advice on medicines you can take
  • if your back pain lasts for more than 6 weeks
  • if you develop numbness or pain in the buttocks, leg or foot.

You should also see your doctor urgently or go to the emergency department if you lose control of your bladder or bowels.

Not sure what to do next?

If you are still concerned about your back pain, why not use healthdirect’s online Symptom Checker to get advice on when to seek medical attention.

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self-care, talking to a health professional, going to a hospital or calling triple zero (000).



Last reviewed: July 2015

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