Low back pain causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes

Radiographic abnormalities of the low back may occur in patients without pain.

Common Causes

Possible causes of low back pain:

• Mechanical:
  • Apophyseal osteoarthritis
  • Facet arthropathy
  • Diffuse idiopathic skeletal hyperostosis
  • Degenerative Discs
  • Scheuermann's kyphosis
  • Spinal disc herniation (slipped disc)
  • Spinal stenosis
  • Spondylolisthesis and other congenital abnormalities
  • Fractures
  • Non-specific muscular or ligamentous strains or sprains
  • Leg length difference
  • Restricted hip motion
  • Misaligned pelvis- pelvic obliquity, anteversion or retroversion
• Inflammatory:
  • Seronegative spondylarthritides (e.g. ankylosing spondylitis)
  • Rheumatoid arthritis
  • Infection - epidural abscess or osteomyelitis
• Neoplastic:
  • Bone tumors (primary or metastatic)
  • Intradural spinal tumors
• Metabolic:
  • Osteoporotic fractures
  • Osteomalacia
  • Ochronosis
  • Chondrocalcinosis
• Paget's disease
• Referred pain:
  • Pelvic/ abdominal disease
  • Posture
• Soft Tissue:
  • Ligament strain
  • Muscle spasm
  • Nerve root irritation, radiculopathy
  • Posterior rami syndrome
  • Sympathetic pain syndromes RSD,CRPS
• Depression
• Oxygen deprivation

Causes by Organ System

Cardiovascular	Aortic aneurysm, abdominal
Chemical / poisoning	No underlying causes
Dermatologic	Cobb syndrome
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	Adrenal hemorrhage
Environmental	No underlying causes
Gastroenterologic	Colorectal polyps, Colorectal polyps
Genetic	Danubian endemic familial nephropathy, Danubian endemic familial nephropathy, Danubian endemic familial nephropathy
Hematologic	Acute intermittent porphyria, Marchiafava-Micheli disease
Iatrogenic	No underlying causes
Infectious Disease	Epidural abscess, Transverse myelitis, Oophoritis, PID, Discitis, UTI, Enteropathic arthritis, Pelvic abscess, Tuberculosis, Chlamydia infection, Osteomyelitis, Prostatitis, Viral prostatitis, Transverse myelitis, Pyelonephritis, acute, Reiter's syndrome, Prostatitis
Musculoskeletal / Ortho	Ehlers-Danlos syndrome, Osteomyelitis, Paget disease of bone, Ankylosing spondylitis, Coccydynia, Diffuse idiopathic skeletal hyperostosis, Discitis, Intervertebral disc herniation, Juvenile osteochondrosis, Osteoporosis, Spondylolisthesis, Spondylolysis, Spondylosis, Tethered cord syndrome, Disc disorder, Vertebral dysfunction, Axial osteosclerosis , Degenerative disc disease, Diffuse idiopathic skeletal hyperostosis, Facet arthropathy, Juvenile osteoporosis, Misaligned pelvis- pelvic obliquity, anteversion or retroversion, Muscle spasm, Scheuermann's disease
Neurologic	Transverse myelitis' Posterior Rami Syndrome, Epidural abscess
Nutritional / Metabolic	Alkaptonuria, Cholesterol embolism, Ochronosis, Pompe's disease , Osteomalacia
Obstetric/Gynecologic	Dysmenorrhoea, Pelvic inflammatory disease, Pregnancy, Premenstrual syndrome, Uterine fibroids, Oophoritis
Oncologic	Malignancy, Cobb syndrome, Colorectal cancer, Pancreatic cancer, Myeloma, Leukemia, mast-cell, Prostate Cancer, Bone metastases, Breast cancer, Chordoma, Metastatic neoplasm, Intradural spinal tumors
Opthalmologic	Ehlers-Danlos syndrome
Overdose / Toxicity	Copper toxicity
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	Pyelonephritis, acute, Familial renal cell carcinoma, Polycystic kidney disease, adult (autosomal dominant), Chronic interstitial nephritis,UTI
Rheum / Immune / Allergy	Reiter's syndrome, Autoimmune oophoritis, Chondrocalcinosis, Psoriatic arthritis, Seronegative spondylarthritides
Sexual	No underlying causes
Trauma	Vertebral fracture, Disc injury, Spinal cord injury, acute, Back strain, Fractures, Ligament strain, Whiplash Injury
Urologic	Prostatitis, Prostate cancer
Miscellaneous	Polymyalgia rheumatica, Excessive lifting, Functional disorders, Retroperitoneal fibrosis, Retroperitoneal haemorrhage, Breakdance back syndrome, Multifocal fibrosclerosis, Posture, Spastic pelvic floor syndrome, Sympathetic pain syndromes

Causes in Alphabetical Order

• Acute intermittent porphyria
• Adrenal hemorrhage
• Alkaptonuria
• Ankylosing spondylitis
• Aortic aneurysm, abdominal
• Autoimmune oophoritis
• Axial osteosclerosis
• Back strain
• Bone metastases
• Breakdance back syndrome
• Breast cancer
• Cauda equina syndrome
• Chlamydia infection
• Chondrocalcinosis
• Chordoma
• Cholesterol embolism
• Chronic interstitial nephritis
• Chronic pancreatitis
• Clinical depression
• Cobb syndrome
• Coccydynia
• Colorectal polyps
• Colorectal cancer
• Copper toxicity
• Danubian endemic familial nephropathy
• Degenerative disc disease
• Diffuse idiopathic skeletal hyperostosis
• Disc disorder
• Discitis
• Dysmenorrhoea
• Ehlers-Danlos syndrome
• Enteropathic arthritis
• Epidural abscess
• Excessive lifting
• Facet arthropathy
• Familial renal cell carcinoma
• Fractures
• Functional disorders
• Intervertebral disc herniation
• Intradural spinal tumors
• Juvenile osteochondrosis of spine
• Juvenile osteoporosis
• Leukemia, mast-cell
• Ligament strain
• Malignancy
• Marchiafava-Micheli disease
• Metastatic neoplasm
• Misaligned pelvis- pelvic obliquity, anteversion or retroversion
• Multifocal fibrosclerosis
• Muscle spasm
• Myeloma
• Ochronosis
• Osteomalacia
• Osteomyelitis
• Osteoporosis
• Paget disease of bone
• Pancreatic cancer
• Pelvic abscess
• Pelvic inflammatory disease
• Polycystic kidney disease, adult (autosomal dominant)
• Polymyalgia rheumatica
• Pompe's disease
• Posterior Rami Syndrome
• Posture
• Pregnancy
• Premenstrual syndrome
• Prostate cancer
• Prostatitis
• Psoriatic arthritis
• Pyelonephritis, acute
• Reiter's syndrome
• Retroperitoneal fibrosis
• Retroperitoneal haemorrhage
• Scheuermann's disease
• Seronegative spondylarthritides
• Spastic pelvic floor syndrome
• Spinal cord injury, acute
• Spondylolisthesis
• Spondylolysis
• Spondylosis
• Sympathetic pain syndromes
• Tethered cord syndrome
• Transverse myelitis
• Tuberculosis
• Uterine fibroids
• UTI
• Vertebral dysfunction
• Vertebral fracture
• Viral prostatitis
• Whiplash Injuries