What Causes Low Back Pain?

Low back pain is a condition that affects most people at some point in their life. Despite the intense pain that is often experienced, the good news is that the condition is rarely related to a serious problem.

There are many thoughts as to what causes low back pain. Conditions such as a herniated disc, muscle strains, postural deficits, among others have all been implicated in the onset of low back pain. The fact is, despite all of the medical technology at our disposal, the true cause of low back pain is still an enigma.

Here we outline some of the broad categories of low back pain and the symptoms associated with each.

Causes of Low Pack Pain

The purpose of this article is to provide you with a framework of what we know about low back pain and to provide a foundation from which better questions can be asked. Keep in mind that, while these views are the consensus views of much of the scientific community, they, in no way, represent a definitive position on the matter. Instead, they formulate a logical explanation of the origin of low back pain based on the observation of tens of thousands of patients.

With that in mind, the first step to understanding low back pain is understanding that back pain describes a symptom and not a disease. The reality of this statement perplexes doctors everyday because the second leading reason for a person seeking medical attention is low back pain. And, with low back pain not being a treatable disease, coupled with the poor understanding of the origin of low back pain, and the fact that many of the problems associated with low back pain stem from outside the spine, management of the condition becomes difficult at best.

To assist patients, physicians, and other health care providers with a better understanding of low back pain, I have divided back pain into 5 categories: psychogenic, viscerogenic, neurogenic, vascular, and spondylogenic. A review of each of these entities follows.

Psychogenic Back Pain
Although rare in the truest sense of the word, many times a definitive, organic reason for a person’s back pain cannot be established. As a result, significant emotional overtones based on confusion and cloudiness of the facts can manifest themselves. In these cases, it is important for the treating clinician to wade through these issues, keeping the patient focused on real versus abstract issues. Fortunately, true psychogenic back pain is rare.

Viscerogenic Back Pain
Viscerogenic back pain is back pain that is derived from the organs such as the kidneys or gall bladder. The key to differentiating viscerogenic back pain from pain originating in the spine is that viscerogenic pain is not elicited by activity nor is it relieved by rest. In other words, the pain remains constant.

Vascular Back Pain
Aneurysms and peripheral vascular disease can produce symptoms that mimic the symptoms associated with sciatica or spinal stenosis. However, unlike sciatica or spinal stenosis where the back pain symptoms respond adversely to movement and positively to no movement, movements such as bending, lifting, or stooping, do not affect back pain of a vascular nature.

Neurogentic Back Pain
Neurogenic back pain is classically defined as irritation, tension, or compression of the spinal nerve roots that results in sciatica nerve pain or “numbness” in one or both legs. Although diagnostic evidence (MRI, CT scans) may suggest the problem being within the spine, often times the actual source of irritation is well outside the spine. A classic example of neurogenic back pain whose source is outside the spine is piriformis syndrome. What’s important to glean from this discussion is the fact that MRI and CT scans don’t always give us the “answer” to the back pain question. Clinical exam must corroborate the imaging studies for a definitive diagnosis to even be considered. (Read entire article)

If you have a comment or question about your experience with low back pain, leave it in the section below. Your experience may be an inspiration to someone else in pain.

Want to learn more about how to treat your low back pain, neck pain, or sciatica? Check out our 4 Steps To Back Pain Relief.

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