🕷️ Crawler Inspector

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Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 151 (from laksa088)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa151.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain","crawl_time":1776679058,"first_indexed_time":1495086533,"http_code":200,"src_unparsed":"com,spine-health!www,\/conditions\/lower-back-pain\/causes-lower-back-pain s443","src_root_hash":"12565626164814078751","history_drop_reason":null,"meta_title":"Causes of Lower Back Pain","meta_descriptions":["Low back pain causes typically include muscle strain, ligament sprain, disc problems, joint dysfunction, and nerve root irritation."],"attrs_boilerpipe_text":"There are many possible causes of lower back pain, including damage to the intervertebral discs, compression of nerve roots, spinal joint friction, and muscle strains and spasm.\nThis guide provides in-depth information on many causes of\nlow back pain\n, with links to further information as needed.\nLet’s start with the single most common cause of low back pain -- a torn or pulled back muscle and ligament.\nIn This Article:\nA Pulled or Strained Back Muscle\nA \nlow back sprain or strain\n can happen suddenly, or can develop slowly over time from repetitive movements.\nStrains occur when a muscle is stretched too far and tears, damaging the muscle itself.\nSprains happen when over-stretching and tearing affects ligaments, which connect the bones together.\nFor practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same.\nWatch\nLower Back Strain Video\nCommon causes include:\nLifting a heavy object, or twisting the spine while lifting\nSudden movements that place too much stress on the low back, such as a fall\nPoor posture over time\nSports injuries, especially in sports that involve twisting or large forces of impact\nWhile a\npulled muscle\ndoes not sound serious and does not typically cause long-lasting problems, the acute pain can be debilitating.\nSee\nPulled Back Muscle Treatment\nCommon Causes of Chronic Lower Back Pain\nPain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back is often caused by a disc problem, endplate damage, a joint problem, and\/or an irritated nerve root, such as:\nLumbar herniated disc\nThe soft inner core of a spinal disc can break through the tough outer layer and irritate a nearby nerve root. A\nlumbar herniated disc\ntypically causes pain through two mechanisms:\nThe herniated portion of the disc contains proteins that cause inflammation when they get near a nerve root\nThe portion of the disc that herniates through the disc wall can compress, or “pinch”, the nearby nerve root\nA herniated disc may cause low back pain with or without leg pain, typically referred to as\nsciatica\nor radicular pain.\nSee\nTreatment for a Lumbar Herniated Disc\nDegenerative disc disease\nAs people age and spinal discs are stressed over time, they tend to lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and the disc wall tends to weaken develop tears.\nLumbar degenerative disc disease\nis thought to cause pain through two mechanisms:\nInflammation in and around the disc and adjacent nerves\nMicromotion as the spinal segment becomes more unstable.   \nAs the disc degenerates and loses function, it can also lead to further spinal conditions such as\nspondylolisthesis\n,\nfacet joint osteoarthritis\n,\nspinal stenosis\n,\nvertebrogenic pain\n, and\/or a\nherniated disc\n.\nA general term for degenerative disc disease is discogenic pain, which means pain that is caused by the disc itself.\nWatch\nLumbar Degenerative Disc Disease Video\nFacet joint dysfunction\nThere is a pair of\nfacet joints\n behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is rich with nerves. Facet joints can degenerate and become painful (\nfacet joint osteoarthritis\n), or they can be a source of pain in conjunction with disc pain (discogenic pain).\nSee\nFacet Joint Disorders and Back Pain\nSacroiliac joint dysfunction\nThe sacroiliac joint connects the sacrum at the bottom of the spine to the hip bone on each side. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The\nsacroiliac joint\ncan become painful if:\nThe SI joint becomes inflamed, called\nsacroiliitis\nThere is too much or too little motion of the joint, called\nsacroiliac joint dysfunction\nWatch\nSacroiliac Joint Dysfunction Video\nVertebrogenic pain\nThe vertebral endplates are sandwiched between each end of the spinal disc and the adjacent vertebra (the bony building blocks of the spine).  These endplates connect the disc to the bone.  They have a rich supply of blood vessels and nerve fibers, and when the endplate becomes damaged, it can become a source of lower back pain called\nvertebrogenic pain\n.\n1\nLotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:\n10.1055\/s-0033-1347298\nWatch\nVertebrogenic Low Back Pain Animation\nSpinal stenosis\nLumbar spinal stenosis\ncauses pain through narrowing of the spinal canal where the lumbar nerve roots are located.  The narrowing tends to cause pain and\/or\nweakness in the legs\n, and\nspinal stenosis symptoms\nvary depending on which level or levels of the spine are affected.\nWatch\nLumbar Spinal Stenosis Video\nSpondylolisthesis\nThis condition occurs when one vertebra slips over the adjacent one. There are 5 types of \nspondylolisthesis\n but the most common are secondary to a defect or fracture of the pars (between the facet joints) or mechanical instability of the facet joints (degenerative). The pain felt in the lower back is due to instability, and pain and\/or weakness is felt in the legs if there is nerve compression.  This condition is common at the\nL5-S1 level\n.\nOsteoarthritis\nSpinal arthritis is typically caused by wear and tear of the disc and facet joints over a long period of time.  The condition is marked by low back pain, inflammation, spinal instability, and potentially stenosis.  It can occur at a single level or multiple levels of the lower spine. \nSpinal osteoarthritis\n is associated with aging and is slowly progressive. It is sometimes called\nspondylosis\nor degenerative joint disease.\nDeformity\nThe curvature of the spine can include \nscoliosis\n or \nkyphosis\n. The deformity may be associated with lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac joints, or stenosis.\nTrauma\nAcute fractures or dislocations of the spine can lead to pain. Lower back pain that develops after a trauma, such as a motor vehicle accident or a fall, should be promptly medically evaluated.\nVertebral fracture\nA fracture can occur in the cylindrical vertebra, in which the bone essentially caves in on itself, and this is called a\ncompression fracture or vertebral fracture\n.   Primary symptoms of vertebral fracture are sudden pain and possibly deformity that looks like a hunched back. This type of fracture is most common due to weak bones, such as from \nosteoporosis\n.\nWatch\nSpinal Compression Fracture Video\nSpinal infection\nOne spinal infection is\nosteomyelitis\n, and it is rare but can cause a lot of pain and is life-threatening if untreated. Osteomyelitis can be caused by surgical procedures, injections, or spread through the bloodstream. Patients with a compromised immune system are more susceptible to developing this type of infection in the spine.  The spinal disc can also become infected, and this is called discitis.  This type of infection can develop on its own or after surgery.\nSee\nOsteomyelitis Symptoms\nInfectious diseases\nCertain types of infectious disease sometimes have lower back pain as a prominent symptom.  Examples of these types of infection include Lyme disease and bartonella.\n2\nGovil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:\n10.3390\/pathogens12040576\n,\n3\nBartonella infections | cdc yellow book 2024. Available from\nhttps:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2024\/infections-diseases\/bartonella-infections\n. Last updated May 01, 2023.\n \nTumor\nMost \nspinal tumors\n start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis.\nWatch\nMetastatic Spinal Cancer Video\nAutoimmune disease\nBack pain is a possible symptom associated with autoimmune conditions, such as \nankylosing spondylitis\n,\nrheumatoid arthritis\n, lupus, Crohn’s disease, fibromyalgia, and others.\nIt is important to note that the presence of one or more of these conditions does not necessarily mean that it is the cause of pain. For example, osteoarthritis or degenerative disc disease could appear on an imaging study, but the person may not report pain.\nReferred Pain\nLow back pain can also be referred by another part of the body.  Common examples of disorders that can refer pain to the lower back include:\nAppendicitis\nAbdominal aortic aneurysm\nKidney stones or infection\nBladder infections\nGynecological problems, such as pelvic infections or ovarian cysts\nHip conditions, such a hip labral tears, frozen hip, or hip impingement\nObtaining a correct clinical diagnosis that identifies the underlying cause of the symptoms is a necessary first step to engaging in a successful course of treatment.\n1\nLotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:\n10.1055\/s-0033-1347298\n2\nGovil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:\n10.3390\/pathogens12040576\n3\nBartonella infections | cdc yellow book 2024. Available from\nhttps:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2024\/infections-diseases\/bartonella-infections\n. Last updated May 01, 2023.\nNext Page:\nLower Back Pain Symptoms\nPages:\n1\n2\n3\n4\n5\n6\n7\n8\nDr. Peloza is a board-certified, fellowship-trained minimally invasive orthopedic spine surgeon at Midwest Orthopedic and Spine Specialists, MO. Dr. Peloza has given several presentations at medical conferences and scientific meetings on topics that include minimally invasive surgery, scoliosis correction, and lumbar fusion.\nEditor’s Top Picks\nLower Back Pain Causes and Symptoms Video\nLumbar Herniated Disc: What You Should Know\nPulled Back Muscle and Lower Back Strain\nLower Back Pain Treatment Video\nLumbar Degenerative Disc Disease Video","attrs_markdown":"[Skip to main content](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#main-content)\n\n[Spine-health Home ![](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/fl_sanitize\/c_fill,g_west,h_50,w_270\/spine-health-horizontal-color.svg?_a=BAAAV6E0)](https:\/\/www.spine-health.com\/)   [Subscribe](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain)\n\n- [Conditions](https:\/\/www.spine-health.com\/conditions)\n  - [Arthritis](https:\/\/www.spine-health.com\/conditions\/arthritis)\n  - [Chronic Pain](https:\/\/www.spine-health.com\/conditions\/chronic-pain)\n  - [Degenerative Disc Disease](https:\/\/www.spine-health.com\/conditions\/degenerative-disc-disease)\n  - [Herniated Disc](https:\/\/www.spine-health.com\/conditions\/herniated-disc)\n  - [Lower Back Pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain)\n  - [Neck Pain](https:\/\/www.spine-health.com\/conditions\/neck-pain)\n  - [Osteoporosis](https:\/\/www.spine-health.com\/conditions\/osteoporosis)\n  - [Sciatica](https:\/\/www.spine-health.com\/conditions\/sciatica)\n  - [Spinal Stenosis](https:\/\/www.spine-health.com\/conditions\/spinal-stenosis)\n  - [All Conditions](https:\/\/www.spine-health.com\/conditions)\n- [Treatment](https:\/\/www.spine-health.com\/treatment)\n  - [Alternative Care](https:\/\/www.spine-health.com\/treatment\/alternative-care)\n  - [Artificial Disc Replacement](https:\/\/www.spine-health.com\/treatment\/artificial-disc-replacement)\n  - [Back Surgery](https:\/\/www.spine-health.com\/treatment\/back-surgery)\n  - [Chiropractic](https:\/\/www.spine-health.com\/treatment\/chiropractic)\n  - [Injections](https:\/\/www.spine-health.com\/treatment\/injections)\n  - [Pain Management](https:\/\/www.spine-health.com\/treatment\/pain-management)\n  - [Pain Medication](https:\/\/www.spine-health.com\/treatment\/pain-medication)\n  - [Physical Therapy](https:\/\/www.spine-health.com\/treatment\/physical-therapy)\n  - [Spinal Fusion](https:\/\/www.spine-health.com\/treatment\/spinal-fusion)\n  - [All Treatments](https:\/\/www.spine-health.com\/treatment)\n- [Wellness](https:\/\/www.spine-health.com\/wellness)\n  - [Ergonomics](https:\/\/www.spine-health.com\/wellness\/ergonomics)\n  - [Exercise](https:\/\/www.spine-health.com\/wellness\/exercise)\n  - [Massage Therapy](https:\/\/www.spine-health.com\/wellness\/massage-therapy)\n  - [Nutrition, Diet, and Weight Loss](https:\/\/www.spine-health.com\/wellness\/nutrition-diet-weight-loss)\n  - [Sleep](https:\/\/www.spine-health.com\/wellness\/sleep)\n  - [Stop Smoking](https:\/\/www.spine-health.com\/wellness\/stop-smoking)\n  - [All Wellness](https:\/\/www.spine-health.com\/wellness)\n- [Videos](https:\/\/www.spine-health.com\/video)\n- [Shop](https:\/\/www.spine-health.com\/shop)\n\nBack\n\n1. [Home](https:\/\/www.spine-health.com\/)\n2. [Conditions](https:\/\/www.spine-health.com\/conditions)\n3. [Lower Back Pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain)\n4. [Causes of Lower Back Pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain?slide=1)\n# Causes of Lower Back Pain\nBy: [John Peloza, MD, Orthopedic Surgeon](https:\/\/www.spine-health.com\/author\/john-peloza-md)\n\n[Peer-Reviewed](https:\/\/www.veritashealth.com\/editorial-process)    \\| [Español](https:\/\/www.spine-health.com\/es\/condiciones\/lumbalgia\/causas-lumbalgia)\n\nThere are many possible causes of lower back pain, including damage to the intervertebral discs, compression of nerve roots, spinal joint friction, and muscle strains and spasm.\n\nThis guide provides in-depth information on many causes of [low back pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms-diagnosis-and-treatment \"Lower Back Pain Symptoms, Diagnosis, and Treatment\"), with links to further information as needed.\n\nLet’s start with the single most common cause of low back pain -- a torn or pulled back muscle and ligament.\n\n[Skip to video transcript](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#transcript-jwplayer-container-76sFeFHR)\n\nSave\n\nWatch [Lower Back Pain Causes and Symptoms Video](https:\/\/www.spine-health.com\/video\/lower-back-pain-causes-and-symptoms-video)\n\nShow Transcript\n\nIn This Article:\n\n- [Lower Back Pain Symptoms, Diagnosis, and Treatment](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms-diagnosis-and-treatment)\n- Causes of Lower Back Pain\n- [Lower Back Pain Symptoms](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms)\n- [Diagnosing Lower Back Pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/diagnosing-lower-back-pain)\n- [Non-Surgical Treatments for Lower Back Pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/non-surgical-treatments-lower-back-pain)\n- [Surgery for Lower Back Pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/surgery-lower-back-pain)\n- [Lower Back Pain Causes and Symptoms Video](https:\/\/www.spine-health.com\/video\/lower-back-pain-causes-and-symptoms-video)\n- [Lower Back Pain Treatment Video](https:\/\/www.spine-health.com\/video\/lower-back-pain-treatment-video)\n## A Pulled or Strained Back Muscle\nA low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements.\n\n- Strains occur when a muscle is stretched too far and tears, damaging the muscle itself.\n- Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together.\n\nFor practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same.\n\nWatch [Lower Back Strain Video](https:\/\/www.spine-health.com\/video\/lower-back-strain-video \"Lower Back Strain Video\")\n\nCommon causes include:\n\n- Lifting a heavy object, or twisting the spine while lifting\n- Sudden movements that place too much stress on the low back, such as a fall\n- Poor posture over time\n- Sports injuries, especially in sports that involve twisting or large forces of impact\n\nWhile a [pulled muscle](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/pulled-back-muscle-and-lower-back-strain \"Pulled Back Muscle and Lower Back Strain\") does not sound serious and does not typically cause long-lasting problems, the acute pain can be debilitating.\n\nSee [Pulled Back Muscle Treatment](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/pulled-back-muscle-treatment \"Pulled Back Muscle Treatment\")\n\nadvertisement\n\n## Common Causes of Chronic Lower Back Pain\nPain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back is often caused by a disc problem, endplate damage, a joint problem, and\/or an irritated nerve root, such as:\n\n### Lumbar herniated disc\n\n[Skip to video transcript](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#transcript-jwplayer-container-oN07hzxM)\n\nSave\n\nWatch [Lumbar Herniated Disc Video](https:\/\/www.spine-health.com\/video\/lumbar-herniated-disc-video)\n\nShow Transcript\n\nThe soft inner core of a spinal disc can break through the tough outer layer and irritate a nearby nerve root. A [lumbar herniated disc](https:\/\/www.spine-health.com\/conditions\/herniated-disc\/lumbar-herniated-disc \"Lumbar Herniated Disc: What You Should Know\") typically causes pain through two mechanisms:\n\n- The herniated portion of the disc contains proteins that cause inflammation when they get near a nerve root\n- The portion of the disc that herniates through the disc wall can compress, or “pinch”, the nearby nerve root\n\nA herniated disc may cause low back pain with or without leg pain, typically referred to as [sciatica](https:\/\/www.spine-health.com\/conditions\/sciatica\/what-you-need-know-about-sciatica \"What You Need to Know About Sciatica\") or radicular pain.\n\nSee [Treatment for a Lumbar Herniated Disc](https:\/\/www.spine-health.com\/conditions\/herniated-disc\/treatment-lumbar-herniated-disc \"Treatment for a Lumbar Herniated Disc\")\n\n### Degenerative disc disease\n\n![Degeneration of disc seen between L4 and L5 vertebrae.](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/c_fill,g_center,h_439,w_780\/q_auto:eco\/l4-l5disc-degeneration.png?_a=BAAAV6E0)\n\nSave\n\n*Intervertebral discs may undergo degeneration, leading to pain disc herniation.*\n\nAs people age and spinal discs are stressed over time, they tend to lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and the disc wall tends to weaken develop tears. [Lumbar degenerative disc disease](https:\/\/www.spine-health.com\/conditions\/degenerative-disc-disease\/lumbar-degenerative-disc-disease-ddd \"Lumbar Degenerative Disc Disease (DDD)\") is thought to cause pain through two mechanisms:\n\n- Inflammation in and around the disc and adjacent nerves\n- Micromotion as the spinal segment becomes more unstable.\n\nAs the disc degenerates and loses function, it can also lead to further spinal conditions such as [spondylolisthesis](https:\/\/www.spine-health.com\/conditions\/spondylolisthesis\/spondylolysis-and-spondylolisthesis \"Spondylolysis and Spondylolisthesis\"), [facet joint osteoarthritis](https:\/\/www.spine-health.com\/conditions\/arthritis\/facet-joint-osteoarthritis \"Facet Joint Osteoarthritis\"), [spinal stenosis](https:\/\/www.spine-health.com\/conditions\/spinal-stenosis\/lumbar-spinal-stenosis \"Lumbar Spinal Stenosis\"), [vertebrogenic pain](https:\/\/www.spine-health.com\/video\/vertebrogenic-low-back-pain-animation \"Vertebrogenic Low Back Pain Animation\"), and\/or a [herniated disc](https:\/\/www.spine-health.com\/conditions\/herniated-disc\/lumbar-herniated-disc \"Lumbar Herniated Disc: What You Should Know\").\n\nA general term for degenerative disc disease is discogenic pain, which means pain that is caused by the disc itself.\n\nWatch [Lumbar Degenerative Disc Disease Video](https:\/\/www.spine-health.com\/video\/lumbar-degenerative-disc-disease-video \"Lumbar Degenerative Disc Disease Video\")\n\n### Facet joint dysfunction\nThere is a pair of [facet joints](https:\/\/www.spine-health.com\/video\/facet-joint-anatomy-animation \"Facet Joint Anatomy Animation\") behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is rich with nerves. Facet joints can degenerate and become painful ([facet joint osteoarthritis](https:\/\/www.spine-health.com\/conditions\/arthritis\/facet-joint-osteoarthritis \"Facet Joint Osteoarthritis\")), or they can be a source of pain in conjunction with disc pain (discogenic pain).\n\nSee [Facet Joint Disorders and Back Pain](https:\/\/www.spine-health.com\/conditions\/arthritis\/facet-joint-disorders-and-back-pain \"Facet Joint Disorders and Back Pain\")\n\n### Sacroiliac joint dysfunction\n\n![An illustration showing anatomy of sacroiliac joint in the pelvis.](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/c_fill,g_center,h_439,w_780\/q_auto:eco\/adult-spine-si-joint-overview-front.png?_a=BAAAV6E0)\n\nSave\n\n*The sacroiliac joint functions as a shock-absorbing joint between the upper and lower body.*\n\nThe sacroiliac joint connects the sacrum at the bottom of the spine to the hip bone on each side. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The [sacroiliac joint](https:\/\/www.spine-health.com\/conditions\/spine-anatomy\/sacroiliac-joint-anatomy \"Sacroiliac Joint Anatomy\") can become painful if:\n\n- The SI joint becomes inflamed, called [sacroiliitis](https:\/\/www.spine-health.com\/conditions\/sacroiliac-joint-dysfunction\/all-about-sacroiliitis \"All About Sacroiliitis\")\n- There is too much or too little motion of the joint, called [sacroiliac joint dysfunction](https:\/\/www.spine-health.com\/conditions\/sacroiliac-joint-dysfunction\/sacroiliac-joint-dysfunction-si-joint-pain \"Sacroiliac Joint Dysfunction (SI Joint Pain)\")\n\nWatch [Sacroiliac Joint Dysfunction Video](https:\/\/www.spine-health.com\/video\/sacroiliac-joint-dysfunction-video \"Sacroiliac Joint Dysfunction Video\")\n\n### Vertebrogenic pain\nThe vertebral endplates are sandwiched between each end of the spinal disc and the adjacent vertebra (the bony building blocks of the spine). These endplates connect the disc to the bone. They have a rich supply of blood vessels and nerve fibers, and when the endplate becomes damaged, it can become a source of lower back pain called [vertebrogenic pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/vertebrogenic-pain-everything-you-need-know \"Vertebrogenic Pain: Everything You Need to Know \").[1](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnote1)Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:[10\\.1055\/s-0033-1347298](https:\/\/journals.sagepub.com\/doi\/10.1055\/s-0033-1347298)\n\nWatch [Vertebrogenic Low Back Pain Animation](https:\/\/www.spine-health.com\/video\/vertebrogenic-low-back-pain-animation \"Vertebrogenic Low Back Pain Animation\")\n\n### Spinal stenosis\n[Lumbar spinal stenosis](https:\/\/www.spine-health.com\/conditions\/spinal-stenosis\/lumbar-spinal-stenosis \"Lumbar Spinal Stenosis\") causes pain through narrowing of the spinal canal where the lumbar nerve roots are located. The narrowing tends to cause pain and\/or [weakness in the legs](https:\/\/www.spine-health.com\/blog\/why-do-my-legs-suddenly-give-out \"Why Do My Legs Suddenly Give Out?\"), and [spinal stenosis symptoms](https:\/\/www.spine-health.com\/conditions\/spinal-stenosis\/lumbar-spinal-stenosis-symptoms \"Lumbar Spinal Stenosis Symptoms\") vary depending on which level or levels of the spine are affected.\n\nWatch [Lumbar Spinal Stenosis Video](https:\/\/www.spine-health.com\/video\/lumbar-spinal-stenosis-video \"Lumbar Spinal Stenosis Video\")\n\nadvertisement\n\n### Spondylolisthesis\n![An illustration showing one vertebra slipping over the other.](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/c_fill,g_center,h_439,w_780\/q_auto:eco\/degenerative-spondylolisthesis-thumbnail.png?_a=BAAAV6E0)\n\nSave\n\n*Spondylolisthesis may cause spinal instability and potential compression of nerves.*\n\nThis condition occurs when one vertebra slips over the adjacent one. There are 5 types of [spondylolisthesis](https:\/\/www.spine-health.com\/conditions\/spondylolisthesis\/spondylolysis-and-spondylolisthesis \"Spondylolysis and Spondylolisthesis\") but the most common are secondary to a defect or fracture of the pars (between the facet joints) or mechanical instability of the facet joints (degenerative). The pain felt in the lower back is due to instability, and pain and\/or weakness is felt in the legs if there is nerve compression. This condition is common at the [L5-S1 level](https:\/\/www.spine-health.com\/conditions\/spine-anatomy\/all-about-l5-s1-lumbosacral-joint \"All about L5-S1 (Lumbosacral Joint)\").\n\n### Osteoarthritis\n\n![An illustration showing osteoarthritis of the lumbar spine.](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/c_fill,g_center,h_439,w_780\/q_auto:eco\/lumbar-bone-spurs.png?_a=BAAAV6E0)\n\nSave\n\n*Osteoarthritis pain is caused by gradual wear and tear of facet joints.*\n\nSpinal arthritis is typically caused by wear and tear of the disc and facet joints over a long period of time. The condition is marked by low back pain, inflammation, spinal instability, and potentially stenosis. It can occur at a single level or multiple levels of the lower spine. [Spinal osteoarthritis](https:\/\/www.spine-health.com\/conditions\/arthritis\/osteoarthritis-spine \"Osteoarthritis of the Spine\") is associated with aging and is slowly progressive. It is sometimes called [spondylosis](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/spondylosis-what-it-actually-means \"Spondylosis: What It Actually Means\") or degenerative joint disease.\n\n### Deformity\n\n![An image showing lumbar scoliosis.](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/c_fill,g_center,h_439,w_780\/q_auto:eco\/adult-spine-figure-lumbar-scoliosis.png?_a=BAAAV6E0)\n\nSave\n\n*Scoliosis leads to triggering muscle spasms and lower back pain.*\n\nThe curvature of the spine can include [scoliosis](https:\/\/www.spine-health.com\/conditions\/scoliosis\/scoliosis-what-you-need-know \"Scoliosis: What You Need to Know\") or kyphosis. The deformity may be associated with lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac joints, or stenosis.\n\n### Trauma\nAcute fractures or dislocations of the spine can lead to pain. Lower back pain that develops after a trauma, such as a motor vehicle accident or a fall, should be promptly medically evaluated.\n\n### Vertebral fracture\nA fracture can occur in the cylindrical vertebra, in which the bone essentially caves in on itself, and this is called a [compression fracture or vertebral fracture](https:\/\/www.spine-health.com\/conditions\/osteoporosis\/when-back-pain-a-spine-compression-fracture \"When Back Pain Is a Spine Compression Fracture\"). Primary symptoms of vertebral fracture are sudden pain and possibly deformity that looks like a hunched back. This type of fracture is most common due to weak bones, such as from [osteoporosis](https:\/\/www.spine-health.com\/conditions\/osteoporosis\/what-you-need-know-about-osteoporosis \"What You Need to Know About Osteoporosis\").\n\nWatch [Spinal Compression Fracture Video](https:\/\/www.spine-health.com\/video\/spinal-compression-fracture-video \"Spinal Compression Fracture Video\")\n\n### Spinal infection\nOne spinal infection is [osteomyelitis](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/osteomyelitis-a-spinal-infection \"Osteomyelitis, a Spinal Infection\"), and it is rare but can cause a lot of pain and is life-threatening if untreated. Osteomyelitis can be caused by surgical procedures, injections, or spread through the bloodstream. Patients with a compromised immune system are more susceptible to developing this type of infection in the spine. The spinal disc can also become infected, and this is called discitis. This type of infection can develop on its own or after surgery.\n\nSee [Osteomyelitis Symptoms](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/osteomyelitis-symptoms \"Osteomyelitis Symptoms\")\n\n### Infectious diseases\nCertain types of infectious disease sometimes have lower back pain as a prominent symptom. Examples of these types of infection include Lyme disease and bartonella.[2](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnote2)Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:[10\\.3390\/pathogens12040576](https:\/\/www.mdpi.com\/2076-0817\/12\/4\/576),[3](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnote3)Bartonella infections \\| cdc yellow book 2024. Available from <https:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2024\/infections-diseases\/bartonella-infections>. Last updated May 01, 2023.\n\n### Tumor\n\n![An illustration showing metastatic tumor in the spine.](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/c_fill,g_center,h_439,w_780\/q_auto:eco\/metastatictumors.png?_a=BAAAV6E0)\n\nSave\n\n*Metastatic spinal tumors can cause a range of general and low back symptoms*\n\nMost [spinal tumors](https:\/\/www.spine-health.com\/conditions\/spinal-tumor\/types-spinal-tumors \"Types of Spinal Tumors\") start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis.\n\nWatch [Metastatic Spinal Cancer Video](https:\/\/www.spine-health.com\/video\/metastatic-spinal-cancer-video \"Metastatic Spinal Cancer Video\")\n\n### Autoimmune disease\nBack pain is a possible symptom associated with autoimmune conditions, such as [ankylosing spondylitis](https:\/\/www.spine-health.com\/conditions\/arthritis\/ankylosing-spondylitis \"Ankylosing Spondylitis\"), [rheumatoid arthritis](https:\/\/www.spine-health.com\/conditions\/arthritis\/rheumatoid-arthritis-spine \"Rheumatoid Arthritis in the Spine\"), lupus, Crohn’s disease, fibromyalgia, and others.\n\nIt is important to note that the presence of one or more of these conditions does not necessarily mean that it is the cause of pain. For example, osteoarthritis or degenerative disc disease could appear on an imaging study, but the person may not report pain.\n\nadvertisement\n\n## Referred Pain\nLow back pain can also be referred by another part of the body. Common examples of disorders that can refer pain to the lower back include:\n\n- Appendicitis\n- [Abdominal aortic aneurysm](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/abdominal-aortic-aneurysm \"Abdominal Aortic Aneurysm\")\n- Kidney stones or infection\n- Bladder infections\n- Gynecological problems, such as pelvic infections or ovarian cysts\n- Hip conditions, such a hip labral tears, frozen hip, or hip impingement\n\nObtaining a correct clinical diagnosis that identifies the underlying cause of the symptoms is a necessary first step to engaging in a successful course of treatment.\n\nReferences\n\n- [1](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnoteref1_hRKfyrjvgzna9EjHuo7YUWerZu2eenQpFU9ffUFjc_bk96OXlvLTOq) Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:[10\\.1055\/s-0033-1347298](https:\/\/journals.sagepub.com\/doi\/10.1055\/s-0033-1347298)\n- [2](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnoteref2_MBnh22kI8kG2zrZHGZVbTi8t9p4jAjAmWwFyOGL9v8_sjcObHPrjMiT) Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:[10\\.3390\/pathogens12040576](https:\/\/www.mdpi.com\/2076-0817\/12\/4\/576)\n- [3](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnoteref3_3RdQ4uAAWSgBM9DQLoKesvg1W78PI1RZdyCMvD6Jbqc_kBoC9tSpHOcz) Bartonella infections \\| cdc yellow book 2024. Available from <https:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2024\/infections-diseases\/bartonella-infections>. Last updated May 01, 2023.\n\n[Free newsletter. More pain relief.](https:\/\/www.spine-health.com\/newsletter?offer=default)\n\n## Pagination\nNext Page:  [Lower Back Pain Symptoms](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms)\n\nPages:\n\n- [1](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms-diagnosis-and-treatment)\n- 2\n- [3](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms)\n- [4](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/diagnosing-lower-back-pain)\n- [5](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/non-surgical-treatments-lower-back-pain)\n- [6](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/surgery-lower-back-pain)\n- [7](https:\/\/www.spine-health.com\/video\/lower-back-pain-causes-and-symptoms-video)\n- [8](https:\/\/www.spine-health.com\/video\/lower-back-pain-treatment-video)\n\n[![John Peloza](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/c_fill,g_north,h_120,w_120\/q_auto:eco\/john-peloza.jpeg?_a=BAAAV6E0)](https:\/\/www.spine-health.com\/author\/john-peloza-md)\n\nDr. Peloza is a board-certified, fellowship-trained minimally invasive orthopedic spine surgeon at Midwest Orthopedic and Spine Specialists, MO. Dr. Peloza has given several presentations at medical conferences and scientific meetings on topics that include minimally invasive surgery, scoliosis correction, and lumbar fusion.\n\n- [Share on Facebook](https:\/\/www.facebook.com\/sharer.php?u=&t=)\n- [Share on Pinterest](http:\/\/pinterest.com\/pin\/create\/link\/?url=&description=)\n- [Subscribe to our newsletter](https:\/\/www.spine-health.com\/newsletter)\n- Print this article\n- [Email this article](mailto:?body=%26subject=&body=&subject=)\n\nadvertisement\n\n## Editor’s Top Picks\n- [Lower Back Pain Causes and Symptoms Video](https:\/\/www.spine-health.com\/video\/lower-back-pain-causes-and-symptoms-video)\n- [Lumbar Herniated Disc: What You Should Know](https:\/\/www.spine-health.com\/conditions\/herniated-disc\/lumbar-herniated-disc)\n- [Pulled Back Muscle and Lower Back Strain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/pulled-back-muscle-and-lower-back-strain)\n- [Lower Back Pain Treatment Video](https:\/\/www.spine-health.com\/video\/lower-back-pain-treatment-video)\n- [Lumbar Degenerative Disc Disease Video](https:\/\/www.spine-health.com\/video\/lumbar-degenerative-disc-disease-video)\n\nadvertisement\n\nadvertisement\n\n## Popular Videos\n[![](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/w_150,h_84,q_80\/lowerbackpaintreatment-35.webp?_a=BAAAV6E0) 5:02 Lower Back Pain Treatment Video](https:\/\/www.spine-health.com\/video\/lower-back-pain-treatment-video)\n\n[![](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/w_150,h_84,q_80\/inflammatory-protein-nerve-contact.webp?_a=BAAAV6E0) 1:45 Herniated Disc Symptoms Animation](https:\/\/www.spine-health.com\/video\/herniated-disc-symptoms-animation)\n\n[![](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/w_150,h_84,q_80\/cervical-degenerative-disc-disease.webp?_a=BAAAV6E0) 1:31 Cervical Degenerative Disc Disease Video](https:\/\/www.spine-health.com\/video\/cervical-degenerative-disc-disease-video)\n\n[![](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/w_150,h_84,q_80\/vid-326.webp?_a=BAAAV6E0) 5:51 McKenzie Method Exercises for Back Pain and Sciatica Video](https:\/\/www.spine-health.com\/video\/mckenzie-method-exercises-back-pain-and-sciatica-video)\n\nPain Evaluation Tool\n\nSponsored by: [Boston Scientific](http:\/\/pubads.g.doubleclick.net\/gampad\/clk?id=6745229490&iu=\/1006215)\n\nYour Pain is Unique\n\nNo one knows your pain better than you. Help us understand what you're experiencing so we can guide you to the right information.\n\n[**Take the Pain Quiz \\>**](http:\/\/pubads.g.doubleclick.net\/gampad\/clk?id=6745229490&iu=\/1006215)\n\nadvertisement\n\n## Health Information (Sponsored)\n- [Your Lumbar Fusion Recovery Roadmap Starts Here](https:\/\/shop.spine-health.com\/products\/what-happens-after-lumbar-fusion-step-by-step-recovery)\n- [See if Spinal Cord Stimulation is Right for You](https:\/\/www.spine-health.com\/education-centers\/boston-scientific\/spinal-cord-stimulation)\n- [Take the Chronic Pain Quiz](https:\/\/www.spine-health.com\/education-centers\/boston-scientific\/spinal-cord-stimulation)\n- [Learn How Bone Growth Therapy Can Help You](https:\/\/www.spine-health.com\/education-centers\/orthofix\/spinal-fusion-therapy)\n\nadvertisement\n\n[Subscribe to the FREE Veritas Health newsletter NOW for the latest articles, videos, and health tips.](https:\/\/www.spine-health.com\/newsletter?offer=default)\n\nSubscribe\n\nSubscribe to Our Newsletters\n\nSign up for our informative free eNewsletter featuring the latest articles, videos and health tips plus sponsored offers from Veritas Health.\n\nWe respect your privacy. 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The information is produced and reviewed by over 200 medical professionals with the goal of providing trusted, uniquely informative information for people with painful health conditions.\n\nVeritas Health LLC,   580 N Bank Ln, Lake Forest, IL, 60045, USA","attrs_readable_markdown":"There are many possible causes of lower back pain, including damage to the intervertebral discs, compression of nerve roots, spinal joint friction, and muscle strains and spasm.\n\nThis guide provides in-depth information on many causes of [low back pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms-diagnosis-and-treatment \"Lower Back Pain Symptoms, Diagnosis, and Treatment\"), with links to further information as needed.\n\nLet’s start with the single most common cause of low back pain -- a torn or pulled back muscle and ligament.\n\nIn This Article:\n\nA Pulled or Strained Back Muscle\n\nA low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements.\n\n- Strains occur when a muscle is stretched too far and tears, damaging the muscle itself.\n- Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together.\n\nFor practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same.\n\nWatch [Lower Back Strain Video](https:\/\/www.spine-health.com\/video\/lower-back-strain-video \"Lower Back Strain Video\")\n\nCommon causes include:\n\n- Lifting a heavy object, or twisting the spine while lifting\n- Sudden movements that place too much stress on the low back, such as a fall\n- Poor posture over time\n- Sports injuries, especially in sports that involve twisting or large forces of impact\n\nWhile a [pulled muscle](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/pulled-back-muscle-and-lower-back-strain \"Pulled Back Muscle and Lower Back Strain\") does not sound serious and does not typically cause long-lasting problems, the acute pain can be debilitating.\n\nSee [Pulled Back Muscle Treatment](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/pulled-back-muscle-treatment \"Pulled Back Muscle Treatment\")\n\n## Common Causes of Chronic Lower Back Pain\nPain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back is often caused by a disc problem, endplate damage, a joint problem, and\/or an irritated nerve root, such as:\n\n### Lumbar herniated disc\n\nThe soft inner core of a spinal disc can break through the tough outer layer and irritate a nearby nerve root. A [lumbar herniated disc](https:\/\/www.spine-health.com\/conditions\/herniated-disc\/lumbar-herniated-disc \"Lumbar Herniated Disc: What You Should Know\") typically causes pain through two mechanisms:\n\n- The herniated portion of the disc contains proteins that cause inflammation when they get near a nerve root\n- The portion of the disc that herniates through the disc wall can compress, or “pinch”, the nearby nerve root\n\nA herniated disc may cause low back pain with or without leg pain, typically referred to as [sciatica](https:\/\/www.spine-health.com\/conditions\/sciatica\/what-you-need-know-about-sciatica \"What You Need to Know About Sciatica\") or radicular pain.\n\nSee [Treatment for a Lumbar Herniated Disc](https:\/\/www.spine-health.com\/conditions\/herniated-disc\/treatment-lumbar-herniated-disc \"Treatment for a Lumbar Herniated Disc\")\n\n### Degenerative disc disease\n\nAs people age and spinal discs are stressed over time, they tend to lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and the disc wall tends to weaken develop tears. [Lumbar degenerative disc disease](https:\/\/www.spine-health.com\/conditions\/degenerative-disc-disease\/lumbar-degenerative-disc-disease-ddd \"Lumbar Degenerative Disc Disease (DDD)\") is thought to cause pain through two mechanisms:\n\n- Inflammation in and around the disc and adjacent nerves\n- Micromotion as the spinal segment becomes more unstable.\n\nAs the disc degenerates and loses function, it can also lead to further spinal conditions such as [spondylolisthesis](https:\/\/www.spine-health.com\/conditions\/spondylolisthesis\/spondylolysis-and-spondylolisthesis \"Spondylolysis and Spondylolisthesis\"), [facet joint osteoarthritis](https:\/\/www.spine-health.com\/conditions\/arthritis\/facet-joint-osteoarthritis \"Facet Joint Osteoarthritis\"), [spinal stenosis](https:\/\/www.spine-health.com\/conditions\/spinal-stenosis\/lumbar-spinal-stenosis \"Lumbar Spinal Stenosis\"), [vertebrogenic pain](https:\/\/www.spine-health.com\/video\/vertebrogenic-low-back-pain-animation \"Vertebrogenic Low Back Pain Animation\"), and\/or a [herniated disc](https:\/\/www.spine-health.com\/conditions\/herniated-disc\/lumbar-herniated-disc \"Lumbar Herniated Disc: What You Should Know\").\n\nA general term for degenerative disc disease is discogenic pain, which means pain that is caused by the disc itself.\n\nWatch [Lumbar Degenerative Disc Disease Video](https:\/\/www.spine-health.com\/video\/lumbar-degenerative-disc-disease-video \"Lumbar Degenerative Disc Disease Video\")\n\n### Facet joint dysfunction\nThere is a pair of [facet joints](https:\/\/www.spine-health.com\/video\/facet-joint-anatomy-animation \"Facet Joint Anatomy Animation\") behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is rich with nerves. Facet joints can degenerate and become painful ([facet joint osteoarthritis](https:\/\/www.spine-health.com\/conditions\/arthritis\/facet-joint-osteoarthritis \"Facet Joint Osteoarthritis\")), or they can be a source of pain in conjunction with disc pain (discogenic pain).\n\nSee [Facet Joint Disorders and Back Pain](https:\/\/www.spine-health.com\/conditions\/arthritis\/facet-joint-disorders-and-back-pain \"Facet Joint Disorders and Back Pain\")\n\n### Sacroiliac joint dysfunction\n\nThe sacroiliac joint connects the sacrum at the bottom of the spine to the hip bone on each side. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The [sacroiliac joint](https:\/\/www.spine-health.com\/conditions\/spine-anatomy\/sacroiliac-joint-anatomy \"Sacroiliac Joint Anatomy\") can become painful if:\n\n- The SI joint becomes inflamed, called [sacroiliitis](https:\/\/www.spine-health.com\/conditions\/sacroiliac-joint-dysfunction\/all-about-sacroiliitis \"All About Sacroiliitis\")\n- There is too much or too little motion of the joint, called [sacroiliac joint dysfunction](https:\/\/www.spine-health.com\/conditions\/sacroiliac-joint-dysfunction\/sacroiliac-joint-dysfunction-si-joint-pain \"Sacroiliac Joint Dysfunction (SI Joint Pain)\")\n\nWatch [Sacroiliac Joint Dysfunction Video](https:\/\/www.spine-health.com\/video\/sacroiliac-joint-dysfunction-video \"Sacroiliac Joint Dysfunction Video\")\n\n### Vertebrogenic pain\nThe vertebral endplates are sandwiched between each end of the spinal disc and the adjacent vertebra (the bony building blocks of the spine). These endplates connect the disc to the bone. They have a rich supply of blood vessels and nerve fibers, and when the endplate becomes damaged, it can become a source of lower back pain called [vertebrogenic pain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/vertebrogenic-pain-everything-you-need-know \"Vertebrogenic Pain: Everything You Need to Know \").[1](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnote1)Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:[10\\.1055\/s-0033-1347298](https:\/\/journals.sagepub.com\/doi\/10.1055\/s-0033-1347298)\n\nWatch [Vertebrogenic Low Back Pain Animation](https:\/\/www.spine-health.com\/video\/vertebrogenic-low-back-pain-animation \"Vertebrogenic Low Back Pain Animation\")\n\n### Spinal stenosis\n[Lumbar spinal stenosis](https:\/\/www.spine-health.com\/conditions\/spinal-stenosis\/lumbar-spinal-stenosis \"Lumbar Spinal Stenosis\") causes pain through narrowing of the spinal canal where the lumbar nerve roots are located. The narrowing tends to cause pain and\/or [weakness in the legs](https:\/\/www.spine-health.com\/blog\/why-do-my-legs-suddenly-give-out \"Why Do My Legs Suddenly Give Out?\"), and [spinal stenosis symptoms](https:\/\/www.spine-health.com\/conditions\/spinal-stenosis\/lumbar-spinal-stenosis-symptoms \"Lumbar Spinal Stenosis Symptoms\") vary depending on which level or levels of the spine are affected.\n\nWatch [Lumbar Spinal Stenosis Video](https:\/\/www.spine-health.com\/video\/lumbar-spinal-stenosis-video \"Lumbar Spinal Stenosis Video\")\n\nSpondylolisthesis\n\nThis condition occurs when one vertebra slips over the adjacent one. There are 5 types of [spondylolisthesis](https:\/\/www.spine-health.com\/conditions\/spondylolisthesis\/spondylolysis-and-spondylolisthesis \"Spondylolysis and Spondylolisthesis\") but the most common are secondary to a defect or fracture of the pars (between the facet joints) or mechanical instability of the facet joints (degenerative). The pain felt in the lower back is due to instability, and pain and\/or weakness is felt in the legs if there is nerve compression. This condition is common at the [L5-S1 level](https:\/\/www.spine-health.com\/conditions\/spine-anatomy\/all-about-l5-s1-lumbosacral-joint \"All about L5-S1 (Lumbosacral Joint)\").\n\n### Osteoarthritis\n\nSpinal arthritis is typically caused by wear and tear of the disc and facet joints over a long period of time. The condition is marked by low back pain, inflammation, spinal instability, and potentially stenosis. It can occur at a single level or multiple levels of the lower spine. [Spinal osteoarthritis](https:\/\/www.spine-health.com\/conditions\/arthritis\/osteoarthritis-spine \"Osteoarthritis of the Spine\") is associated with aging and is slowly progressive. It is sometimes called [spondylosis](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/spondylosis-what-it-actually-means \"Spondylosis: What It Actually Means\") or degenerative joint disease.\n\n### Deformity\n\nThe curvature of the spine can include [scoliosis](https:\/\/www.spine-health.com\/conditions\/scoliosis\/scoliosis-what-you-need-know \"Scoliosis: What You Need to Know\") or kyphosis. The deformity may be associated with lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac joints, or stenosis.\n\n### Trauma\nAcute fractures or dislocations of the spine can lead to pain. Lower back pain that develops after a trauma, such as a motor vehicle accident or a fall, should be promptly medically evaluated.\n\n### Vertebral fracture\nA fracture can occur in the cylindrical vertebra, in which the bone essentially caves in on itself, and this is called a [compression fracture or vertebral fracture](https:\/\/www.spine-health.com\/conditions\/osteoporosis\/when-back-pain-a-spine-compression-fracture \"When Back Pain Is a Spine Compression Fracture\"). Primary symptoms of vertebral fracture are sudden pain and possibly deformity that looks like a hunched back. This type of fracture is most common due to weak bones, such as from [osteoporosis](https:\/\/www.spine-health.com\/conditions\/osteoporosis\/what-you-need-know-about-osteoporosis \"What You Need to Know About Osteoporosis\").\n\nWatch [Spinal Compression Fracture Video](https:\/\/www.spine-health.com\/video\/spinal-compression-fracture-video \"Spinal Compression Fracture Video\")\n\n### Spinal infection\nOne spinal infection is [osteomyelitis](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/osteomyelitis-a-spinal-infection \"Osteomyelitis, a Spinal Infection\"), and it is rare but can cause a lot of pain and is life-threatening if untreated. Osteomyelitis can be caused by surgical procedures, injections, or spread through the bloodstream. Patients with a compromised immune system are more susceptible to developing this type of infection in the spine. The spinal disc can also become infected, and this is called discitis. This type of infection can develop on its own or after surgery.\n\nSee [Osteomyelitis Symptoms](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/osteomyelitis-symptoms \"Osteomyelitis Symptoms\")\n\n### Infectious diseases\nCertain types of infectious disease sometimes have lower back pain as a prominent symptom. Examples of these types of infection include Lyme disease and bartonella.[2](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnote2)Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:[10\\.3390\/pathogens12040576](https:\/\/www.mdpi.com\/2076-0817\/12\/4\/576),[3](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnote3)Bartonella infections \\| cdc yellow book 2024. Available from <https:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2024\/infections-diseases\/bartonella-infections>. Last updated May 01, 2023.\n\n### Tumor\n\nMost [spinal tumors](https:\/\/www.spine-health.com\/conditions\/spinal-tumor\/types-spinal-tumors \"Types of Spinal Tumors\") start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis.\n\nWatch [Metastatic Spinal Cancer Video](https:\/\/www.spine-health.com\/video\/metastatic-spinal-cancer-video \"Metastatic Spinal Cancer Video\")\n\n### Autoimmune disease\nBack pain is a possible symptom associated with autoimmune conditions, such as [ankylosing spondylitis](https:\/\/www.spine-health.com\/conditions\/arthritis\/ankylosing-spondylitis \"Ankylosing Spondylitis\"), [rheumatoid arthritis](https:\/\/www.spine-health.com\/conditions\/arthritis\/rheumatoid-arthritis-spine \"Rheumatoid Arthritis in the Spine\"), lupus, Crohn’s disease, fibromyalgia, and others.\n\nIt is important to note that the presence of one or more of these conditions does not necessarily mean that it is the cause of pain. For example, osteoarthritis or degenerative disc disease could appear on an imaging study, but the person may not report pain.\n\n## Referred Pain\nLow back pain can also be referred by another part of the body. Common examples of disorders that can refer pain to the lower back include:\n\n- Appendicitis\n- [Abdominal aortic aneurysm](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/abdominal-aortic-aneurysm \"Abdominal Aortic Aneurysm\")\n- Kidney stones or infection\n- Bladder infections\n- Gynecological problems, such as pelvic infections or ovarian cysts\n- Hip conditions, such a hip labral tears, frozen hip, or hip impingement\n\nObtaining a correct clinical diagnosis that identifies the underlying cause of the symptoms is a necessary first step to engaging in a successful course of treatment.\n\n- [1](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnoteref1_hRKfyrjvgzna9EjHuo7YUWerZu2eenQpFU9ffUFjc_bk96OXlvLTOq) Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:[10\\.1055\/s-0033-1347298](https:\/\/journals.sagepub.com\/doi\/10.1055\/s-0033-1347298)\n- [2](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnoteref2_MBnh22kI8kG2zrZHGZVbTi8t9p4jAjAmWwFyOGL9v8_sjcObHPrjMiT) Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:[10\\.3390\/pathogens12040576](https:\/\/www.mdpi.com\/2076-0817\/12\/4\/576)\n- [3](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/causes-lower-back-pain#footnoteref3_3RdQ4uAAWSgBM9DQLoKesvg1W78PI1RZdyCMvD6Jbqc_kBoC9tSpHOcz) Bartonella infections \\| cdc yellow book 2024. Available from <https:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2024\/infections-diseases\/bartonella-infections>. Last updated May 01, 2023.\n\nNext Page:  [Lower Back Pain Symptoms](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms)\n\nPages:\n\n- [1](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms-diagnosis-and-treatment)\n- 2\n- [3](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/lower-back-pain-symptoms)\n- [4](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/diagnosing-lower-back-pain)\n- [5](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/non-surgical-treatments-lower-back-pain)\n- [6](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/surgery-lower-back-pain)\n- [7](https:\/\/www.spine-health.com\/video\/lower-back-pain-causes-and-symptoms-video)\n- [8](https:\/\/www.spine-health.com\/video\/lower-back-pain-treatment-video)\n\n[![John Peloza](https:\/\/res.cloudinary.com\/da1molee1\/image\/upload\/c_fill,g_north,h_120,w_120\/q_auto:eco\/john-peloza.jpeg?_a=BAAAV6E0)](https:\/\/www.spine-health.com\/author\/john-peloza-md)\n\nDr. Peloza is a board-certified, fellowship-trained minimally invasive orthopedic spine surgeon at Midwest Orthopedic and Spine Specialists, MO. Dr. Peloza has given several presentations at medical conferences and scientific meetings on topics that include minimally invasive surgery, scoliosis correction, and lumbar fusion.\n\n## Editor’s Top Picks\n- [Lower Back Pain Causes and Symptoms Video](https:\/\/www.spine-health.com\/video\/lower-back-pain-causes-and-symptoms-video)\n- [Lumbar Herniated Disc: What You Should Know](https:\/\/www.spine-health.com\/conditions\/herniated-disc\/lumbar-herniated-disc)\n- [Pulled Back Muscle and Lower Back Strain](https:\/\/www.spine-health.com\/conditions\/lower-back-pain\/pulled-back-muscle-and-lower-back-strain)\n- [Lower Back Pain Treatment Video](https:\/\/www.spine-health.com\/video\/lower-back-pain-treatment-video)\n- [Lumbar Degenerative Disc Disease Video](https:\/\/www.spine-health.com\/video\/lumbar-degenerative-disc-disease-video)","meta_canonical":null}

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Boilerpipe Text	There are many possible causes of lower back pain, including damage to the intervertebral discs, compression of nerve roots, spinal joint friction, and muscle strains and spasm. This guide provides in-depth information on many causes of low back pain , with links to further information as needed. Let’s start with the single most common cause of low back pain -- a torn or pulled back muscle and ligament. In This Article: A Pulled or Strained Back Muscle A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements. Strains occur when a muscle is stretched too far and tears, damaging the muscle itself. Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together. For practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same. Watch Lower Back Strain Video Common causes include: Lifting a heavy object, or twisting the spine while lifting Sudden movements that place too much stress on the low back, such as a fall Poor posture over time Sports injuries, especially in sports that involve twisting or large forces of impact While a pulled muscle does not sound serious and does not typically cause long-lasting problems, the acute pain can be debilitating. See Pulled Back Muscle Treatment Common Causes of Chronic Lower Back Pain Pain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back is often caused by a disc problem, endplate damage, a joint problem, and/or an irritated nerve root, such as: Lumbar herniated disc The soft inner core of a spinal disc can break through the tough outer layer and irritate a nearby nerve root. A lumbar herniated disc typically causes pain through two mechanisms: The herniated portion of the disc contains proteins that cause inflammation when they get near a nerve root The portion of the disc that herniates through the disc wall can compress, or “pinch”, the nearby nerve root A herniated disc may cause low back pain with or without leg pain, typically referred to as sciatica or radicular pain. See Treatment for a Lumbar Herniated Disc Degenerative disc disease As people age and spinal discs are stressed over time, they tend to lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and the disc wall tends to weaken develop tears. Lumbar degenerative disc disease is thought to cause pain through two mechanisms: Inflammation in and around the disc and adjacent nerves Micromotion as the spinal segment becomes more unstable. As the disc degenerates and loses function, it can also lead to further spinal conditions such as spondylolisthesis , facet joint osteoarthritis , spinal stenosis , vertebrogenic pain , and/or a herniated disc . A general term for degenerative disc disease is discogenic pain, which means pain that is caused by the disc itself. Watch Lumbar Degenerative Disc Disease Video Facet joint dysfunction There is a pair of facet joints behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is rich with nerves. Facet joints can degenerate and become painful ( facet joint osteoarthritis ), or they can be a source of pain in conjunction with disc pain (discogenic pain). See Facet Joint Disorders and Back Pain Sacroiliac joint dysfunction The sacroiliac joint connects the sacrum at the bottom of the spine to the hip bone on each side. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The sacroiliac joint can become painful if: The SI joint becomes inflamed, called sacroiliitis There is too much or too little motion of the joint, called sacroiliac joint dysfunction Watch Sacroiliac Joint Dysfunction Video Vertebrogenic pain The vertebral endplates are sandwiched between each end of the spinal disc and the adjacent vertebra (the bony building blocks of the spine). These endplates connect the disc to the bone. They have a rich supply of blood vessels and nerve fibers, and when the endplate becomes damaged, it can become a source of lower back pain called vertebrogenic pain . 1 Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi: 10.1055/s-0033-1347298 Watch Vertebrogenic Low Back Pain Animation Spinal stenosis Lumbar spinal stenosis causes pain through narrowing of the spinal canal where the lumbar nerve roots are located. The narrowing tends to cause pain and/or weakness in the legs , and spinal stenosis symptoms vary depending on which level or levels of the spine are affected. Watch Lumbar Spinal Stenosis Video Spondylolisthesis This condition occurs when one vertebra slips over the adjacent one. There are 5 types of spondylolisthesis but the most common are secondary to a defect or fracture of the pars (between the facet joints) or mechanical instability of the facet joints (degenerative). The pain felt in the lower back is due to instability, and pain and/or weakness is felt in the legs if there is nerve compression. This condition is common at the L5-S1 level . Osteoarthritis Spinal arthritis is typically caused by wear and tear of the disc and facet joints over a long period of time. The condition is marked by low back pain, inflammation, spinal instability, and potentially stenosis. It can occur at a single level or multiple levels of the lower spine. Spinal osteoarthritis is associated with aging and is slowly progressive. It is sometimes called spondylosis or degenerative joint disease. Deformity The curvature of the spine can include scoliosis or kyphosis . The deformity may be associated with lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac joints, or stenosis. Trauma Acute fractures or dislocations of the spine can lead to pain. Lower back pain that develops after a trauma, such as a motor vehicle accident or a fall, should be promptly medically evaluated. Vertebral fracture A fracture can occur in the cylindrical vertebra, in which the bone essentially caves in on itself, and this is called a compression fracture or vertebral fracture . Primary symptoms of vertebral fracture are sudden pain and possibly deformity that looks like a hunched back. This type of fracture is most common due to weak bones, such as from osteoporosis . Watch Spinal Compression Fracture Video Spinal infection One spinal infection is osteomyelitis , and it is rare but can cause a lot of pain and is life-threatening if untreated. Osteomyelitis can be caused by surgical procedures, injections, or spread through the bloodstream. Patients with a compromised immune system are more susceptible to developing this type of infection in the spine. The spinal disc can also become infected, and this is called discitis. This type of infection can develop on its own or after surgery. See Osteomyelitis Symptoms Infectious diseases Certain types of infectious disease sometimes have lower back pain as a prominent symptom. Examples of these types of infection include Lyme disease and bartonella. 2 Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi: 10.3390/pathogens12040576 , 3 Bartonella infections \| cdc yellow book 2024. Available from https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/bartonella-infections . Last updated May 01, 2023. Tumor Most spinal tumors start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis. Watch Metastatic Spinal Cancer Video Autoimmune disease Back pain is a possible symptom associated with autoimmune conditions, such as ankylosing spondylitis , rheumatoid arthritis , lupus, Crohn’s disease, fibromyalgia, and others. It is important to note that the presence of one or more of these conditions does not necessarily mean that it is the cause of pain. For example, osteoarthritis or degenerative disc disease could appear on an imaging study, but the person may not report pain. Referred Pain Low back pain can also be referred by another part of the body. Common examples of disorders that can refer pain to the lower back include: Appendicitis Abdominal aortic aneurysm Kidney stones or infection Bladder infections Gynecological problems, such as pelvic infections or ovarian cysts Hip conditions, such a hip labral tears, frozen hip, or hip impingement Obtaining a correct clinical diagnosis that identifies the underlying cause of the symptoms is a necessary first step to engaging in a successful course of treatment. 1 Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi: 10.1055/s-0033-1347298 2 Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi: 10.3390/pathogens12040576 3 Bartonella infections \| cdc yellow book 2024. Available from https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/bartonella-infections . Last updated May 01, 2023. Next Page: Lower Back Pain Symptoms Pages: 1 2 3 4 5 6 7 8 Dr. Peloza is a board-certified, fellowship-trained minimally invasive orthopedic spine surgeon at Midwest Orthopedic and Spine Specialists, MO. Dr. Peloza has given several presentations at medical conferences and scientific meetings on topics that include minimally invasive surgery, scoliosis correction, and lumbar fusion. Editor’s Top Picks Lower Back Pain Causes and Symptoms Video Lumbar Herniated Disc: What You Should Know Pulled Back Muscle and Lower Back Strain Lower Back Pain Treatment Video Lumbar Degenerative Disc Disease Video
Markdown	[Skip to main content](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#main-content) [Spine-health Home ![](https://res.cloudinary.com/da1molee1/image/upload/fl_sanitize/c_fill,g_west,h_50,w_270/spine-health-horizontal-color.svg?_a=BAAAV6E0)](https://www.spine-health.com/) [Subscribe](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain) - [Conditions](https://www.spine-health.com/conditions) - [Arthritis](https://www.spine-health.com/conditions/arthritis) - [Chronic Pain](https://www.spine-health.com/conditions/chronic-pain) - [Degenerative Disc Disease](https://www.spine-health.com/conditions/degenerative-disc-disease) - [Herniated Disc](https://www.spine-health.com/conditions/herniated-disc) - [Lower Back Pain](https://www.spine-health.com/conditions/lower-back-pain) - [Neck Pain](https://www.spine-health.com/conditions/neck-pain) - [Osteoporosis](https://www.spine-health.com/conditions/osteoporosis) - [Sciatica](https://www.spine-health.com/conditions/sciatica) - [Spinal Stenosis](https://www.spine-health.com/conditions/spinal-stenosis) - [All Conditions](https://www.spine-health.com/conditions) - [Treatment](https://www.spine-health.com/treatment) - [Alternative Care](https://www.spine-health.com/treatment/alternative-care) - [Artificial Disc Replacement](https://www.spine-health.com/treatment/artificial-disc-replacement) - [Back Surgery](https://www.spine-health.com/treatment/back-surgery) - [Chiropractic](https://www.spine-health.com/treatment/chiropractic) - [Injections](https://www.spine-health.com/treatment/injections) - [Pain Management](https://www.spine-health.com/treatment/pain-management) - [Pain Medication](https://www.spine-health.com/treatment/pain-medication) - [Physical Therapy](https://www.spine-health.com/treatment/physical-therapy) - [Spinal Fusion](https://www.spine-health.com/treatment/spinal-fusion) - [All Treatments](https://www.spine-health.com/treatment) - [Wellness](https://www.spine-health.com/wellness) - [Ergonomics](https://www.spine-health.com/wellness/ergonomics) - [Exercise](https://www.spine-health.com/wellness/exercise) - [Massage Therapy](https://www.spine-health.com/wellness/massage-therapy) - [Nutrition, Diet, and Weight Loss](https://www.spine-health.com/wellness/nutrition-diet-weight-loss) - [Sleep](https://www.spine-health.com/wellness/sleep) - [Stop Smoking](https://www.spine-health.com/wellness/stop-smoking) - [All Wellness](https://www.spine-health.com/wellness) - [Videos](https://www.spine-health.com/video) - [Shop](https://www.spine-health.com/shop) Back 1. [Home](https://www.spine-health.com/) 2. [Conditions](https://www.spine-health.com/conditions) 3. [Lower Back Pain](https://www.spine-health.com/conditions/lower-back-pain) 4. [Causes of Lower Back Pain](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain?slide=1) # Causes of Lower Back Pain By: [John Peloza, MD, Orthopedic Surgeon](https://www.spine-health.com/author/john-peloza-md) [Peer-Reviewed](https://www.veritashealth.com/editorial-process) \\| [Español](https://www.spine-health.com/es/condiciones/lumbalgia/causas-lumbalgia) There are many possible causes of lower back pain, including damage to the intervertebral discs, compression of nerve roots, spinal joint friction, and muscle strains and spasm. This guide provides in-depth information on many causes of [low back pain](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms-diagnosis-and-treatment "Lower Back Pain Symptoms, Diagnosis, and Treatment"), with links to further information as needed. Let’s start with the single most common cause of low back pain -- a torn or pulled back muscle and ligament. [Skip to video transcript](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#transcript-jwplayer-container-76sFeFHR) Save Watch [Lower Back Pain Causes and Symptoms Video](https://www.spine-health.com/video/lower-back-pain-causes-and-symptoms-video) Show Transcript In This Article: - [Lower Back Pain Symptoms, Diagnosis, and Treatment](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms-diagnosis-and-treatment) - Causes of Lower Back Pain - [Lower Back Pain Symptoms](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms) - [Diagnosing Lower Back Pain](https://www.spine-health.com/conditions/lower-back-pain/diagnosing-lower-back-pain) - [Non-Surgical Treatments for Lower Back Pain](https://www.spine-health.com/conditions/lower-back-pain/non-surgical-treatments-lower-back-pain) - [Surgery for Lower Back Pain](https://www.spine-health.com/conditions/lower-back-pain/surgery-lower-back-pain) - [Lower Back Pain Causes and Symptoms Video](https://www.spine-health.com/video/lower-back-pain-causes-and-symptoms-video) - [Lower Back Pain Treatment Video](https://www.spine-health.com/video/lower-back-pain-treatment-video) ## A Pulled or Strained Back Muscle A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements. - Strains occur when a muscle is stretched too far and tears, damaging the muscle itself. - Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together. For practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same. Watch [Lower Back Strain Video](https://www.spine-health.com/video/lower-back-strain-video "Lower Back Strain Video") Common causes include: - Lifting a heavy object, or twisting the spine while lifting - Sudden movements that place too much stress on the low back, such as a fall - Poor posture over time - Sports injuries, especially in sports that involve twisting or large forces of impact While a [pulled muscle](https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-and-lower-back-strain "Pulled Back Muscle and Lower Back Strain") does not sound serious and does not typically cause long-lasting problems, the acute pain can be debilitating. See [Pulled Back Muscle Treatment](https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-treatment "Pulled Back Muscle Treatment") advertisement ## Common Causes of Chronic Lower Back Pain Pain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back is often caused by a disc problem, endplate damage, a joint problem, and/or an irritated nerve root, such as: ### Lumbar herniated disc [Skip to video transcript](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#transcript-jwplayer-container-oN07hzxM) Save Watch [Lumbar Herniated Disc Video](https://www.spine-health.com/video/lumbar-herniated-disc-video) Show Transcript The soft inner core of a spinal disc can break through the tough outer layer and irritate a nearby nerve root. A [lumbar herniated disc](https://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc "Lumbar Herniated Disc: What You Should Know") typically causes pain through two mechanisms: - The herniated portion of the disc contains proteins that cause inflammation when they get near a nerve root - The portion of the disc that herniates through the disc wall can compress, or “pinch”, the nearby nerve root A herniated disc may cause low back pain with or without leg pain, typically referred to as [sciatica](https://www.spine-health.com/conditions/sciatica/what-you-need-know-about-sciatica "What You Need to Know About Sciatica") or radicular pain. See [Treatment for a Lumbar Herniated Disc](https://www.spine-health.com/conditions/herniated-disc/treatment-lumbar-herniated-disc "Treatment for a Lumbar Herniated Disc") ### Degenerative disc disease ![Degeneration of disc seen between L4 and L5 vertebrae.](https://res.cloudinary.com/da1molee1/image/upload/c_fill,g_center,h_439,w_780/q_auto:eco/l4-l5disc-degeneration.png?_a=BAAAV6E0) Save Intervertebral discs may undergo degeneration, leading to pain disc herniation. As people age and spinal discs are stressed over time, they tend to lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and the disc wall tends to weaken develop tears. [Lumbar degenerative disc disease](https://www.spine-health.com/conditions/degenerative-disc-disease/lumbar-degenerative-disc-disease-ddd "Lumbar Degenerative Disc Disease (DDD)") is thought to cause pain through two mechanisms: - Inflammation in and around the disc and adjacent nerves - Micromotion as the spinal segment becomes more unstable. As the disc degenerates and loses function, it can also lead to further spinal conditions such as [spondylolisthesis](https://www.spine-health.com/conditions/spondylolisthesis/spondylolysis-and-spondylolisthesis "Spondylolysis and Spondylolisthesis"), [facet joint osteoarthritis](https://www.spine-health.com/conditions/arthritis/facet-joint-osteoarthritis "Facet Joint Osteoarthritis"), [spinal stenosis](https://www.spine-health.com/conditions/spinal-stenosis/lumbar-spinal-stenosis "Lumbar Spinal Stenosis"), [vertebrogenic pain](https://www.spine-health.com/video/vertebrogenic-low-back-pain-animation "Vertebrogenic Low Back Pain Animation"), and/or a [herniated disc](https://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc "Lumbar Herniated Disc: What You Should Know"). A general term for degenerative disc disease is discogenic pain, which means pain that is caused by the disc itself. Watch [Lumbar Degenerative Disc Disease Video](https://www.spine-health.com/video/lumbar-degenerative-disc-disease-video "Lumbar Degenerative Disc Disease Video") ### Facet joint dysfunction There is a pair of [facet joints](https://www.spine-health.com/video/facet-joint-anatomy-animation "Facet Joint Anatomy Animation") behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is rich with nerves. Facet joints can degenerate and become painful ([facet joint osteoarthritis](https://www.spine-health.com/conditions/arthritis/facet-joint-osteoarthritis "Facet Joint Osteoarthritis")), or they can be a source of pain in conjunction with disc pain (discogenic pain). See [Facet Joint Disorders and Back Pain](https://www.spine-health.com/conditions/arthritis/facet-joint-disorders-and-back-pain "Facet Joint Disorders and Back Pain") ### Sacroiliac joint dysfunction ![An illustration showing anatomy of sacroiliac joint in the pelvis.](https://res.cloudinary.com/da1molee1/image/upload/c_fill,g_center,h_439,w_780/q_auto:eco/adult-spine-si-joint-overview-front.png?_a=BAAAV6E0) Save The sacroiliac joint functions as a shock-absorbing joint between the upper and lower body. The sacroiliac joint connects the sacrum at the bottom of the spine to the hip bone on each side. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The [sacroiliac joint](https://www.spine-health.com/conditions/spine-anatomy/sacroiliac-joint-anatomy "Sacroiliac Joint Anatomy") can become painful if: - The SI joint becomes inflamed, called [sacroiliitis](https://www.spine-health.com/conditions/sacroiliac-joint-dysfunction/all-about-sacroiliitis "All About Sacroiliitis") - There is too much or too little motion of the joint, called [sacroiliac joint dysfunction](https://www.spine-health.com/conditions/sacroiliac-joint-dysfunction/sacroiliac-joint-dysfunction-si-joint-pain "Sacroiliac Joint Dysfunction (SI Joint Pain)") Watch [Sacroiliac Joint Dysfunction Video](https://www.spine-health.com/video/sacroiliac-joint-dysfunction-video "Sacroiliac Joint Dysfunction Video") ### Vertebrogenic pain The vertebral endplates are sandwiched between each end of the spinal disc and the adjacent vertebra (the bony building blocks of the spine). These endplates connect the disc to the bone. They have a rich supply of blood vessels and nerve fibers, and when the endplate becomes damaged, it can become a source of lower back pain called [vertebrogenic pain](https://www.spine-health.com/conditions/lower-back-pain/vertebrogenic-pain-everything-you-need-know "Vertebrogenic Pain: Everything You Need to Know ").[1](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnote1)Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:[10\.1055/s-0033-1347298](https://journals.sagepub.com/doi/10.1055/s-0033-1347298) Watch [Vertebrogenic Low Back Pain Animation](https://www.spine-health.com/video/vertebrogenic-low-back-pain-animation "Vertebrogenic Low Back Pain Animation") ### Spinal stenosis [Lumbar spinal stenosis](https://www.spine-health.com/conditions/spinal-stenosis/lumbar-spinal-stenosis "Lumbar Spinal Stenosis") causes pain through narrowing of the spinal canal where the lumbar nerve roots are located. The narrowing tends to cause pain and/or [weakness in the legs](https://www.spine-health.com/blog/why-do-my-legs-suddenly-give-out "Why Do My Legs Suddenly Give Out?"), and [spinal stenosis symptoms](https://www.spine-health.com/conditions/spinal-stenosis/lumbar-spinal-stenosis-symptoms "Lumbar Spinal Stenosis Symptoms") vary depending on which level or levels of the spine are affected. Watch [Lumbar Spinal Stenosis Video](https://www.spine-health.com/video/lumbar-spinal-stenosis-video "Lumbar Spinal Stenosis Video") advertisement ### Spondylolisthesis ![An illustration showing one vertebra slipping over the other.](https://res.cloudinary.com/da1molee1/image/upload/c_fill,g_center,h_439,w_780/q_auto:eco/degenerative-spondylolisthesis-thumbnail.png?_a=BAAAV6E0) Save Spondylolisthesis may cause spinal instability and potential compression of nerves. This condition occurs when one vertebra slips over the adjacent one. There are 5 types of [spondylolisthesis](https://www.spine-health.com/conditions/spondylolisthesis/spondylolysis-and-spondylolisthesis "Spondylolysis and Spondylolisthesis") but the most common are secondary to a defect or fracture of the pars (between the facet joints) or mechanical instability of the facet joints (degenerative). The pain felt in the lower back is due to instability, and pain and/or weakness is felt in the legs if there is nerve compression. This condition is common at the [L5-S1 level](https://www.spine-health.com/conditions/spine-anatomy/all-about-l5-s1-lumbosacral-joint "All about L5-S1 (Lumbosacral Joint)"). ### Osteoarthritis ![An illustration showing osteoarthritis of the lumbar spine.](https://res.cloudinary.com/da1molee1/image/upload/c_fill,g_center,h_439,w_780/q_auto:eco/lumbar-bone-spurs.png?_a=BAAAV6E0) Save Osteoarthritis pain is caused by gradual wear and tear of facet joints. Spinal arthritis is typically caused by wear and tear of the disc and facet joints over a long period of time. The condition is marked by low back pain, inflammation, spinal instability, and potentially stenosis. It can occur at a single level or multiple levels of the lower spine. [Spinal osteoarthritis](https://www.spine-health.com/conditions/arthritis/osteoarthritis-spine "Osteoarthritis of the Spine") is associated with aging and is slowly progressive. It is sometimes called [spondylosis](https://www.spine-health.com/conditions/lower-back-pain/spondylosis-what-it-actually-means "Spondylosis: What It Actually Means") or degenerative joint disease. ### Deformity ![An image showing lumbar scoliosis.](https://res.cloudinary.com/da1molee1/image/upload/c_fill,g_center,h_439,w_780/q_auto:eco/adult-spine-figure-lumbar-scoliosis.png?_a=BAAAV6E0) Save Scoliosis leads to triggering muscle spasms and lower back pain. The curvature of the spine can include [scoliosis](https://www.spine-health.com/conditions/scoliosis/scoliosis-what-you-need-know "Scoliosis: What You Need to Know") or kyphosis. The deformity may be associated with lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac joints, or stenosis. ### Trauma Acute fractures or dislocations of the spine can lead to pain. Lower back pain that develops after a trauma, such as a motor vehicle accident or a fall, should be promptly medically evaluated. ### Vertebral fracture A fracture can occur in the cylindrical vertebra, in which the bone essentially caves in on itself, and this is called a [compression fracture or vertebral fracture](https://www.spine-health.com/conditions/osteoporosis/when-back-pain-a-spine-compression-fracture "When Back Pain Is a Spine Compression Fracture"). Primary symptoms of vertebral fracture are sudden pain and possibly deformity that looks like a hunched back. This type of fracture is most common due to weak bones, such as from [osteoporosis](https://www.spine-health.com/conditions/osteoporosis/what-you-need-know-about-osteoporosis "What You Need to Know About Osteoporosis"). Watch [Spinal Compression Fracture Video](https://www.spine-health.com/video/spinal-compression-fracture-video "Spinal Compression Fracture Video") ### Spinal infection One spinal infection is [osteomyelitis](https://www.spine-health.com/conditions/lower-back-pain/osteomyelitis-a-spinal-infection "Osteomyelitis, a Spinal Infection"), and it is rare but can cause a lot of pain and is life-threatening if untreated. Osteomyelitis can be caused by surgical procedures, injections, or spread through the bloodstream. Patients with a compromised immune system are more susceptible to developing this type of infection in the spine. The spinal disc can also become infected, and this is called discitis. This type of infection can develop on its own or after surgery. See [Osteomyelitis Symptoms](https://www.spine-health.com/conditions/lower-back-pain/osteomyelitis-symptoms "Osteomyelitis Symptoms") ### Infectious diseases Certain types of infectious disease sometimes have lower back pain as a prominent symptom. Examples of these types of infection include Lyme disease and bartonella.[2](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnote2)Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:[10\.3390/pathogens12040576](https://www.mdpi.com/2076-0817/12/4/576),[3](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnote3)Bartonella infections \\| cdc yellow book 2024. Available from <https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/bartonella-infections>. Last updated May 01, 2023. ### Tumor ![An illustration showing metastatic tumor in the spine.](https://res.cloudinary.com/da1molee1/image/upload/c_fill,g_center,h_439,w_780/q_auto:eco/metastatictumors.png?_a=BAAAV6E0) Save Metastatic spinal tumors can cause a range of general and low back symptoms Most [spinal tumors](https://www.spine-health.com/conditions/spinal-tumor/types-spinal-tumors "Types of Spinal Tumors") start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis. Watch [Metastatic Spinal Cancer Video](https://www.spine-health.com/video/metastatic-spinal-cancer-video "Metastatic Spinal Cancer Video") ### Autoimmune disease Back pain is a possible symptom associated with autoimmune conditions, such as [ankylosing spondylitis](https://www.spine-health.com/conditions/arthritis/ankylosing-spondylitis "Ankylosing Spondylitis"), [rheumatoid arthritis](https://www.spine-health.com/conditions/arthritis/rheumatoid-arthritis-spine "Rheumatoid Arthritis in the Spine"), lupus, Crohn’s disease, fibromyalgia, and others. It is important to note that the presence of one or more of these conditions does not necessarily mean that it is the cause of pain. For example, osteoarthritis or degenerative disc disease could appear on an imaging study, but the person may not report pain. advertisement ## Referred Pain Low back pain can also be referred by another part of the body. Common examples of disorders that can refer pain to the lower back include: - Appendicitis - [Abdominal aortic aneurysm](https://www.spine-health.com/conditions/lower-back-pain/abdominal-aortic-aneurysm "Abdominal Aortic Aneurysm") - Kidney stones or infection - Bladder infections - Gynecological problems, such as pelvic infections or ovarian cysts - Hip conditions, such a hip labral tears, frozen hip, or hip impingement Obtaining a correct clinical diagnosis that identifies the underlying cause of the symptoms is a necessary first step to engaging in a successful course of treatment. References - [1](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnoteref1_hRKfyrjvgzna9EjHuo7YUWerZu2eenQpFU9ffUFjc_bk96OXlvLTOq) Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:[10\.1055/s-0033-1347298](https://journals.sagepub.com/doi/10.1055/s-0033-1347298) - [2](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnoteref2_MBnh22kI8kG2zrZHGZVbTi8t9p4jAjAmWwFyOGL9v8_sjcObHPrjMiT) Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:[10\.3390/pathogens12040576](https://www.mdpi.com/2076-0817/12/4/576) - [3](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnoteref3_3RdQ4uAAWSgBM9DQLoKesvg1W78PI1RZdyCMvD6Jbqc_kBoC9tSpHOcz) Bartonella infections \\| cdc yellow book 2024. Available from <https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/bartonella-infections>. Last updated May 01, 2023. [Free newsletter. More pain relief.](https://www.spine-health.com/newsletter?offer=default) ## Pagination Next Page: [Lower Back Pain Symptoms](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms) Pages: - [1](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms-diagnosis-and-treatment) - 2 - [3](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms) - [4](https://www.spine-health.com/conditions/lower-back-pain/diagnosing-lower-back-pain) - [5](https://www.spine-health.com/conditions/lower-back-pain/non-surgical-treatments-lower-back-pain) - [6](https://www.spine-health.com/conditions/lower-back-pain/surgery-lower-back-pain) - [7](https://www.spine-health.com/video/lower-back-pain-causes-and-symptoms-video) - [8](https://www.spine-health.com/video/lower-back-pain-treatment-video) [![John Peloza](https://res.cloudinary.com/da1molee1/image/upload/c_fill,g_north,h_120,w_120/q_auto:eco/john-peloza.jpeg?_a=BAAAV6E0)](https://www.spine-health.com/author/john-peloza-md) Dr. Peloza is a board-certified, fellowship-trained minimally invasive orthopedic spine surgeon at Midwest Orthopedic and Spine Specialists, MO. Dr. Peloza has given several presentations at medical conferences and scientific meetings on topics that include minimally invasive surgery, scoliosis correction, and lumbar fusion. - [Share on Facebook](https://www.facebook.com/sharer.php?u=&t=) - [Share on Pinterest](http://pinterest.com/pin/create/link/?url=&description=) - [Subscribe to our newsletter](https://www.spine-health.com/newsletter) - Print this article - [Email this article](mailto:?body=%26subject=&body=&subject=) advertisement ## Editor’s Top Picks - [Lower Back Pain Causes and Symptoms Video](https://www.spine-health.com/video/lower-back-pain-causes-and-symptoms-video) - [Lumbar Herniated Disc: What You Should Know](https://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc) - [Pulled Back Muscle and Lower Back Strain](https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-and-lower-back-strain) - [Lower Back Pain Treatment Video](https://www.spine-health.com/video/lower-back-pain-treatment-video) - [Lumbar Degenerative Disc Disease Video](https://www.spine-health.com/video/lumbar-degenerative-disc-disease-video) advertisement advertisement ## Popular Videos [![](https://res.cloudinary.com/da1molee1/image/upload/w_150,h_84,q_80/lowerbackpaintreatment-35.webp?_a=BAAAV6E0) 5:02 Lower Back Pain Treatment Video](https://www.spine-health.com/video/lower-back-pain-treatment-video) [![](https://res.cloudinary.com/da1molee1/image/upload/w_150,h_84,q_80/inflammatory-protein-nerve-contact.webp?_a=BAAAV6E0) 1:45 Herniated Disc Symptoms Animation](https://www.spine-health.com/video/herniated-disc-symptoms-animation) [![](https://res.cloudinary.com/da1molee1/image/upload/w_150,h_84,q_80/cervical-degenerative-disc-disease.webp?_a=BAAAV6E0) 1:31 Cervical Degenerative Disc Disease Video](https://www.spine-health.com/video/cervical-degenerative-disc-disease-video) [![](https://res.cloudinary.com/da1molee1/image/upload/w_150,h_84,q_80/vid-326.webp?_a=BAAAV6E0) 5:51 McKenzie Method Exercises for Back Pain and Sciatica Video](https://www.spine-health.com/video/mckenzie-method-exercises-back-pain-and-sciatica-video) Pain Evaluation Tool Sponsored by: [Boston Scientific](http://pubads.g.doubleclick.net/gampad/clk?id=6745229490&iu=/1006215) Your Pain is Unique No one knows your pain better than you. 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Readable Markdown	There are many possible causes of lower back pain, including damage to the intervertebral discs, compression of nerve roots, spinal joint friction, and muscle strains and spasm. This guide provides in-depth information on many causes of [low back pain](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms-diagnosis-and-treatment "Lower Back Pain Symptoms, Diagnosis, and Treatment"), with links to further information as needed. Let’s start with the single most common cause of low back pain -- a torn or pulled back muscle and ligament. In This Article: A Pulled or Strained Back Muscle A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements. - Strains occur when a muscle is stretched too far and tears, damaging the muscle itself. - Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together. For practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same. Watch [Lower Back Strain Video](https://www.spine-health.com/video/lower-back-strain-video "Lower Back Strain Video") Common causes include: - Lifting a heavy object, or twisting the spine while lifting - Sudden movements that place too much stress on the low back, such as a fall - Poor posture over time - Sports injuries, especially in sports that involve twisting or large forces of impact While a [pulled muscle](https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-and-lower-back-strain "Pulled Back Muscle and Lower Back Strain") does not sound serious and does not typically cause long-lasting problems, the acute pain can be debilitating. See [Pulled Back Muscle Treatment](https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-treatment "Pulled Back Muscle Treatment") ## Common Causes of Chronic Lower Back Pain Pain is considered chronic once it lasts for more than three months and exceeds the body’s natural healing process. Chronic pain in the low back is often caused by a disc problem, endplate damage, a joint problem, and/or an irritated nerve root, such as: ### Lumbar herniated disc The soft inner core of a spinal disc can break through the tough outer layer and irritate a nearby nerve root. A [lumbar herniated disc](https://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc "Lumbar Herniated Disc: What You Should Know") typically causes pain through two mechanisms: - The herniated portion of the disc contains proteins that cause inflammation when they get near a nerve root - The portion of the disc that herniates through the disc wall can compress, or “pinch”, the nearby nerve root A herniated disc may cause low back pain with or without leg pain, typically referred to as [sciatica](https://www.spine-health.com/conditions/sciatica/what-you-need-know-about-sciatica "What You Need to Know About Sciatica") or radicular pain. See [Treatment for a Lumbar Herniated Disc](https://www.spine-health.com/conditions/herniated-disc/treatment-lumbar-herniated-disc "Treatment for a Lumbar Herniated Disc") ### Degenerative disc disease As people age and spinal discs are stressed over time, they tend to lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and the disc wall tends to weaken develop tears. [Lumbar degenerative disc disease](https://www.spine-health.com/conditions/degenerative-disc-disease/lumbar-degenerative-disc-disease-ddd "Lumbar Degenerative Disc Disease (DDD)") is thought to cause pain through two mechanisms: - Inflammation in and around the disc and adjacent nerves - Micromotion as the spinal segment becomes more unstable. As the disc degenerates and loses function, it can also lead to further spinal conditions such as [spondylolisthesis](https://www.spine-health.com/conditions/spondylolisthesis/spondylolysis-and-spondylolisthesis "Spondylolysis and Spondylolisthesis"), [facet joint osteoarthritis](https://www.spine-health.com/conditions/arthritis/facet-joint-osteoarthritis "Facet Joint Osteoarthritis"), [spinal stenosis](https://www.spine-health.com/conditions/spinal-stenosis/lumbar-spinal-stenosis "Lumbar Spinal Stenosis"), [vertebrogenic pain](https://www.spine-health.com/video/vertebrogenic-low-back-pain-animation "Vertebrogenic Low Back Pain Animation"), and/or a [herniated disc](https://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc "Lumbar Herniated Disc: What You Should Know"). A general term for degenerative disc disease is discogenic pain, which means pain that is caused by the disc itself. Watch [Lumbar Degenerative Disc Disease Video](https://www.spine-health.com/video/lumbar-degenerative-disc-disease-video "Lumbar Degenerative Disc Disease Video") ### Facet joint dysfunction There is a pair of [facet joints](https://www.spine-health.com/video/facet-joint-anatomy-animation "Facet Joint Anatomy Animation") behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is rich with nerves. Facet joints can degenerate and become painful ([facet joint osteoarthritis](https://www.spine-health.com/conditions/arthritis/facet-joint-osteoarthritis "Facet Joint Osteoarthritis")), or they can be a source of pain in conjunction with disc pain (discogenic pain). See [Facet Joint Disorders and Back Pain](https://www.spine-health.com/conditions/arthritis/facet-joint-disorders-and-back-pain "Facet Joint Disorders and Back Pain") ### Sacroiliac joint dysfunction The sacroiliac joint connects the sacrum at the bottom of the spine to the hip bone on each side. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. The [sacroiliac joint](https://www.spine-health.com/conditions/spine-anatomy/sacroiliac-joint-anatomy "Sacroiliac Joint Anatomy") can become painful if: - The SI joint becomes inflamed, called [sacroiliitis](https://www.spine-health.com/conditions/sacroiliac-joint-dysfunction/all-about-sacroiliitis "All About Sacroiliitis") - There is too much or too little motion of the joint, called [sacroiliac joint dysfunction](https://www.spine-health.com/conditions/sacroiliac-joint-dysfunction/sacroiliac-joint-dysfunction-si-joint-pain "Sacroiliac Joint Dysfunction (SI Joint Pain)") Watch [Sacroiliac Joint Dysfunction Video](https://www.spine-health.com/video/sacroiliac-joint-dysfunction-video "Sacroiliac Joint Dysfunction Video") ### Vertebrogenic pain The vertebral endplates are sandwiched between each end of the spinal disc and the adjacent vertebra (the bony building blocks of the spine). These endplates connect the disc to the bone. They have a rich supply of blood vessels and nerve fibers, and when the endplate becomes damaged, it can become a source of lower back pain called [vertebrogenic pain](https://www.spine-health.com/conditions/lower-back-pain/vertebrogenic-pain-everything-you-need-know "Vertebrogenic Pain: Everything You Need to Know ").[1](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnote1)Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:[10\.1055/s-0033-1347298](https://journals.sagepub.com/doi/10.1055/s-0033-1347298) Watch [Vertebrogenic Low Back Pain Animation](https://www.spine-health.com/video/vertebrogenic-low-back-pain-animation "Vertebrogenic Low Back Pain Animation") ### Spinal stenosis [Lumbar spinal stenosis](https://www.spine-health.com/conditions/spinal-stenosis/lumbar-spinal-stenosis "Lumbar Spinal Stenosis") causes pain through narrowing of the spinal canal where the lumbar nerve roots are located. The narrowing tends to cause pain and/or [weakness in the legs](https://www.spine-health.com/blog/why-do-my-legs-suddenly-give-out "Why Do My Legs Suddenly Give Out?"), and [spinal stenosis symptoms](https://www.spine-health.com/conditions/spinal-stenosis/lumbar-spinal-stenosis-symptoms "Lumbar Spinal Stenosis Symptoms") vary depending on which level or levels of the spine are affected. Watch [Lumbar Spinal Stenosis Video](https://www.spine-health.com/video/lumbar-spinal-stenosis-video "Lumbar Spinal Stenosis Video") Spondylolisthesis This condition occurs when one vertebra slips over the adjacent one. There are 5 types of [spondylolisthesis](https://www.spine-health.com/conditions/spondylolisthesis/spondylolysis-and-spondylolisthesis "Spondylolysis and Spondylolisthesis") but the most common are secondary to a defect or fracture of the pars (between the facet joints) or mechanical instability of the facet joints (degenerative). The pain felt in the lower back is due to instability, and pain and/or weakness is felt in the legs if there is nerve compression. This condition is common at the [L5-S1 level](https://www.spine-health.com/conditions/spine-anatomy/all-about-l5-s1-lumbosacral-joint "All about L5-S1 (Lumbosacral Joint)"). ### Osteoarthritis Spinal arthritis is typically caused by wear and tear of the disc and facet joints over a long period of time. The condition is marked by low back pain, inflammation, spinal instability, and potentially stenosis. It can occur at a single level or multiple levels of the lower spine. [Spinal osteoarthritis](https://www.spine-health.com/conditions/arthritis/osteoarthritis-spine "Osteoarthritis of the Spine") is associated with aging and is slowly progressive. It is sometimes called [spondylosis](https://www.spine-health.com/conditions/lower-back-pain/spondylosis-what-it-actually-means "Spondylosis: What It Actually Means") or degenerative joint disease. ### Deformity The curvature of the spine can include [scoliosis](https://www.spine-health.com/conditions/scoliosis/scoliosis-what-you-need-know "Scoliosis: What You Need to Know") or kyphosis. The deformity may be associated with lower back pain if it leads to the breakdown of the discs, facet joints, sacroiliac joints, or stenosis. ### Trauma Acute fractures or dislocations of the spine can lead to pain. Lower back pain that develops after a trauma, such as a motor vehicle accident or a fall, should be promptly medically evaluated. ### Vertebral fracture A fracture can occur in the cylindrical vertebra, in which the bone essentially caves in on itself, and this is called a [compression fracture or vertebral fracture](https://www.spine-health.com/conditions/osteoporosis/when-back-pain-a-spine-compression-fracture "When Back Pain Is a Spine Compression Fracture"). Primary symptoms of vertebral fracture are sudden pain and possibly deformity that looks like a hunched back. This type of fracture is most common due to weak bones, such as from [osteoporosis](https://www.spine-health.com/conditions/osteoporosis/what-you-need-know-about-osteoporosis "What You Need to Know About Osteoporosis"). Watch [Spinal Compression Fracture Video](https://www.spine-health.com/video/spinal-compression-fracture-video "Spinal Compression Fracture Video") ### Spinal infection One spinal infection is [osteomyelitis](https://www.spine-health.com/conditions/lower-back-pain/osteomyelitis-a-spinal-infection "Osteomyelitis, a Spinal Infection"), and it is rare but can cause a lot of pain and is life-threatening if untreated. Osteomyelitis can be caused by surgical procedures, injections, or spread through the bloodstream. Patients with a compromised immune system are more susceptible to developing this type of infection in the spine. The spinal disc can also become infected, and this is called discitis. This type of infection can develop on its own or after surgery. See [Osteomyelitis Symptoms](https://www.spine-health.com/conditions/lower-back-pain/osteomyelitis-symptoms "Osteomyelitis Symptoms") ### Infectious diseases Certain types of infectious disease sometimes have lower back pain as a prominent symptom. Examples of these types of infection include Lyme disease and bartonella.[2](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnote2)Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:[10\.3390/pathogens12040576](https://www.mdpi.com/2076-0817/12/4/576),[3](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnote3)Bartonella infections \\| cdc yellow book 2024. Available from <https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/bartonella-infections>. Last updated May 01, 2023. ### Tumor Most [spinal tumors](https://www.spine-health.com/conditions/spinal-tumor/types-spinal-tumors "Types of Spinal Tumors") start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis. Watch [Metastatic Spinal Cancer Video](https://www.spine-health.com/video/metastatic-spinal-cancer-video "Metastatic Spinal Cancer Video") ### Autoimmune disease Back pain is a possible symptom associated with autoimmune conditions, such as [ankylosing spondylitis](https://www.spine-health.com/conditions/arthritis/ankylosing-spondylitis "Ankylosing Spondylitis"), [rheumatoid arthritis](https://www.spine-health.com/conditions/arthritis/rheumatoid-arthritis-spine "Rheumatoid Arthritis in the Spine"), lupus, Crohn’s disease, fibromyalgia, and others. It is important to note that the presence of one or more of these conditions does not necessarily mean that it is the cause of pain. For example, osteoarthritis or degenerative disc disease could appear on an imaging study, but the person may not report pain. ## Referred Pain Low back pain can also be referred by another part of the body. Common examples of disorders that can refer pain to the lower back include: - Appendicitis - [Abdominal aortic aneurysm](https://www.spine-health.com/conditions/lower-back-pain/abdominal-aortic-aneurysm "Abdominal Aortic Aneurysm") - Kidney stones or infection - Bladder infections - Gynecological problems, such as pelvic infections or ovarian cysts - Hip conditions, such a hip labral tears, frozen hip, or hip impingement Obtaining a correct clinical diagnosis that identifies the underlying cause of the symptoms is a necessary first step to engaging in a successful course of treatment. - [1](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnoteref1_hRKfyrjvgzna9EjHuo7YUWerZu2eenQpFU9ffUFjc_bk96OXlvLTOq) Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164. doi:[10\.1055/s-0033-1347298](https://journals.sagepub.com/doi/10.1055/s-0033-1347298) - [2](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnoteref2_MBnh22kI8kG2zrZHGZVbTi8t9p4jAjAmWwFyOGL9v8_sjcObHPrjMiT) Govil S, Capitle E, Lacqua A, Khianey R, Coyle PK, Schutzer SE. Common Neurologic Features of Lyme Disease That May Present to a Rheumatologist. Pathogens. 2023;12(4):576. Published 2023 Apr 9. doi:[10\.3390/pathogens12040576](https://www.mdpi.com/2076-0817/12/4/576) - [3](https://www.spine-health.com/conditions/lower-back-pain/causes-lower-back-pain#footnoteref3_3RdQ4uAAWSgBM9DQLoKesvg1W78PI1RZdyCMvD6Jbqc_kBoC9tSpHOcz) Bartonella infections \\| cdc yellow book 2024. Available from <https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/bartonella-infections>. Last updated May 01, 2023. Next Page: [Lower Back Pain Symptoms](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms) Pages: - [1](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms-diagnosis-and-treatment) - 2 - [3](https://www.spine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms) - [4](https://www.spine-health.com/conditions/lower-back-pain/diagnosing-lower-back-pain) - [5](https://www.spine-health.com/conditions/lower-back-pain/non-surgical-treatments-lower-back-pain) - [6](https://www.spine-health.com/conditions/lower-back-pain/surgery-lower-back-pain) - [7](https://www.spine-health.com/video/lower-back-pain-causes-and-symptoms-video) - [8](https://www.spine-health.com/video/lower-back-pain-treatment-video) [![John Peloza](https://res.cloudinary.com/da1molee1/image/upload/c_fill,g_north,h_120,w_120/q_auto:eco/john-peloza.jpeg?_a=BAAAV6E0)](https://www.spine-health.com/author/john-peloza-md) Dr. Peloza is a board-certified, fellowship-trained minimally invasive orthopedic spine surgeon at Midwest Orthopedic and Spine Specialists, MO. Dr. Peloza has given several presentations at medical conferences and scientific meetings on topics that include minimally invasive surgery, scoliosis correction, and lumbar fusion. ## Editor’s Top Picks - [Lower Back Pain Causes and Symptoms Video](https://www.spine-health.com/video/lower-back-pain-causes-and-symptoms-video) - [Lumbar Herniated Disc: What You Should Know](https://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc) - [Pulled Back Muscle and Lower Back Strain](https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-and-lower-back-strain) - [Lower Back Pain Treatment Video](https://www.spine-health.com/video/lower-back-pain-treatment-video) - [Lumbar Degenerative Disc Disease Video](https://www.spine-health.com/video/lumbar-degenerative-disc-disease-video)
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