Back pain causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief:Hilda Mahmoudi M.D., M.P.H.^[2]

Overview

The causes of back pain can be stratified according to age. Common causes of back pain in adults under the age of 50 years include ligament strain, nerve root irritation, spinal disc herniation, degenerative disc disease and isthmic spondylolisthesis. Common causes in adults over the age of 50 years include osteoarthritis (degenerative joint disease), spinal stenosis, trauma, cancer, infection, fractures, and inflammatory disease. Non-anatomical factors can also contribute to or cause back pain, such as stress, repressed anger, or depression. Even if an anatomical cause for the pain is present, a coexistent depression should be treated concurrently. When back pain lasts more than three months or when sciatica is present, a more specific diagnosis can be made.

Causes

Common Causes

• Abnormal posturing
• Degenerative disc disease
• Depression
• Discopathy
• osteoarthritis
• Pregnancy
• Premenstrual syndrome
• Sciatica
• Spinal disc herniation
• Spinal stenosis
• Trauma

Less Common Causes

• Arachnoiditis

• Cauda equina syndrome

• Adrenal hemorrhage
  

Life Threatening Causes

• Abdominal aortic aneurysm

• Adrenal hemorrhage

• Aortic dissection

• Arachnoiditis

• Cauda equina syndrome

• Cervical fracture

• Chronic stable angina

• Epidural abscess

• Pulmonary embolism

• Retroperitoneal hematoma

• Traumatic aortic rupture

• Vertebral fractures

Causes by Organ System

Cardiovascular	Abdominal aortic aneurysm, angina pectoris, aortic dissection, bacterial endocarditis, Leriche's syndrome, myocardial infarction, traumatic aortic rupture
Chemical / poisoning	No underlying causes
Dermatologic	Pilonidal cyst
Drug Side Effect	Abatacept, acitretin, albuterol, aldesleukin, alprazolam, amitriptyline, anagrelide, angiotensin II receptor antagonist, Artemether and lumefantrin, Bicalutamide, budesonide inhalation powder, calcitonin salmon nasal spray, candesartan, carbamazepine, carboplatin, caspofungin acetate, cetuximab injection, ciclesonide, clofarabine injection, cyanocobalamin injection, Dalfampridine, darbepoetin alfa injection, daunorubicin, desloratadine, didanosine, diflunisal, dofetilide, donepezil, drotrecogin alfa, Eculizumab, Eliglustat, efalizumab injection, epoetin alfa injection, eszopiclone, etodolac, fenoprofen, fexofenadine, formoterol, fulvestrant, glatiramer injection, ibandronate, Imiglucerase, indinavir, infliximab injection, leflunomide, lenalidomide, Lorcaserin, Losartan and Hydrochlorothiazide, meclofenamate, medroxyprogesterone injection, mefenamic acid, mesalamine, Meropenem, Mifepristone, modafinil, mycophenolate, Nabilone, nabumetone, nateglinide oral, Niacin/simvastatin, Olaparib, olanzapine, oxaliplatin injection, oxcarbazepine, oxybutynin, pergolide, piroxicam, posaconazole, praziquantel, pregabalin, ranibizumab injection, repaglinide, ribavirin, risedronate, rituximab injection, Ramucirumab, Roflumilast, rosiglitazone, salsalate, saquinavir, sargramostim injection, selegiline, sibutramine, Sipuleucel-T, sirolimus, sodium oxybate, solifenacin, sulfinpyrazone, sulindac, sunitinib, tacrolimus topical, tadalafil, tamsulosin, tegaserod, telbivudine, telmisartan, temozolomide, terazosin, Travoprost, Valdecoxib, valganciclovir, valproic acid, valsartan, vancomycin hydrochloride, vardenafil, zolpidem, zonisamide
Ear Nose Throat	No underlying causes
Endocrine	Addisons disease, Cushing's Disease, hyperparathyroidism
Environmental	Cadmium poisoning
Gastroenterologic	Achalasia, cholelithiasis, pancreatitis, peptic ulcer disease
Genetic	Marfan syndrome, spina bifida, osteogenesis imperfecta, sickle cell disease
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	Borreliosis, cat scratch fever, herpes zoster, Pott's disease, rift valley fever, urinary tract infection
Musculoskeletal / Ortho	Abnormal posturing, ankylosing spondylitis, cervical fracture, coxarthrosis, cramp, degenerative disc disease, disc space infection, dorsopathy, gonarthrosis, lumbar disc disease, muscle strain, myelofibrosis, myositis, myotendinosis, osteoarthritis, osteochondroma, osteochondrosis, osteogenesis imperfecta, osteogenic sarcoma, osteomalacia, osteomyelitis, osteoporosis, paget's disease, piriformis syndrome, poliomyelitis, polymyalgia rheumatica, Pott's disease, psoriatic arthritis, spinal disc herniation, spinal fusion, spinal stenosis, spinal tumor, spondylolisthesis, spondylolysis, spondylosis, sacroiliitis, sciatica, scoliosis, vertebral fractures, vertebral subluxation
Neurologic	Arachnoiditis, cauda equina syndrome, chronic inflammatory demyelinating polyneuropathy, dural ectasia, epidural abscess, posterior rami syndrome, subarachnoid hemorrhage, syringomyelia, tabes dorsalis, transverse myelitis
Nutritional / Metabolic	Osteomalacia, osteoporosis
Obstetric/Gynecologic	Cervical cancer, childbirth, ectopic pregnancy, endometriosis, menopause, ovarian cancer, pregnancy, salpingitis
Oncologic	Cervical cancer, desmoplastic small round cell tumor, hemangioma, lung cancer, meningioma, multiple myeloma, osteogenic Sarcoma, ovarian cancer
Opthalmologic	Reiter's Syndrome
Overdose / Toxicity	Bearberry
Psychiatric	Alexithymia, conversion syndrome, psychosomatic, tension myositis syndrome
Pulmonary	Hantavirus Pulmonary Syndrome, lung cancer, pleuritis, pneumonia, pulmonary embolism
Renal / Electrolyte	Urinary obstruction, nephrolithiasis, polycystic kidney disease, pyelonephritis, renal osteodystrophy, renal vein thrombosis
Rheum / Immune / Allergy	Ankylosing spondylitis, chronic inflammatory demyelinating polyneuropathy, rheumatoid Arthritis
Sexual	No underlying causes
Trauma	Injury
Urologic	Acute prostatitis
Miscellaneous	Fibromyalgia, chronic fatigue syndrome, dysraphia, facet Syndrome, mediastinitis, retroperitoneal fibrosis, retroperitoneal hematoma, Scheuermann's disease

Causes in Alphabetical Order

Abatacept Abdominal aortic aneurysm Abnormal posturing Achalasia Acitretin Acute intermittent porphyria Acute prostatitis Addisons disease Adrenal hemorrhage Albuterol Aldesleukin Alexithymia Alkaptonuria Alprazolam Amitriptyline Anagrelide Angina pectoris Angiotensin II receptor antagonist Ankylosing Spondylitis Aortic Dissection Arachnoiditis Artemether and lumefantrin Bearberry Bechterew's Disease Bone metastasis Borreliosis Bortezomib Breast cancer Bright's disease Budesonide inhalation powder Buprenorphine Cadmium poisoning Calcitonin salmon nasal spray Candesartan Carbamazepine Carboplatin Cat scratch fever Cauda equina syndrome Cervical cancer Cervical fracture Cetuximab injection Childbirth Cholelithiasis Cholesterol embolism Chordoma Chronic fatigue syndrome Chronic inflammatory demyelinating polyneuropathy Clofarabine injection Cobb syndrome Coccydynia Colorectal cancer Conversion syndrome Coxarthrosis Cramp Cushing's disease Cyanocobalamin injection Darbepoetin alfa injection Daunorubicin Degenerative disc disease Desloratadine Desmoplastic small round cell tumor Didanosine Diffuse idiopathic skeletal hyperostosis Diflunisal Disc space infection Discitis Dofetilide Donepezil Dorsopathy Drotrecogin alfa Dural ectasia Dysraphia Ectopic pregnancy Eculizumab Efalizumab Injection Ehlers-Danlos syndrome Emtricitabine Endometriosis Epidural abscess Epoetin Alfa Injection

Eszopiclone Etodolac Facet syndrome Fenoprofen Fexofenadine Fibromyalgia Formoterol Fulvestrant injection Gemeprost Glatiramer injection Gonarthrosis Hantavirus pulmonary syndrome Hemangioma Herpes Zoster Hyperparathyroidism Ibandronate Idiopathic Indinavir Infliximab injection Injury Janumet (sitagliptin and metformin) Juvenile osteochondrosis of spine Leflunomide Leg length discrepancy Leriche's syndrome Listeria monocytogenes Losartan and Hydrochlorothiazide Lumbago syndrome Lumbar disc disease Lumbar strain Lung cancer Marfan syndrome Meclofenamate Mediastinitis Medroxyprogesterone injection Mefenamic acid Meningioma Menopause Mesalamine Metastases Mifepristone Modafinil Multiple myeloma Mycophenolate Myelofibrosis Myocardial infarction Myositis Myotendinosis Nabilone Nabumetone Nateglinide oral Nephrolithiasis Olanzapine Osteoarthritis Osteochondroma Osteochondrosis Osteogenesis imperfecta Osteogenic sarcoma Osteomalacia Osteomyelitis Osteoporosis Ovarian cancer Oxaliplatin injection Oxcarbazepine Oxybutynin Paget's disease Pancreatic cancer Pancreatitis Pelvic inflammatory disease Peptic ulcer disease Pergolide Pilonidal cyst Piriformis syndrome Piroxicam Pleuritis Pneumonia Poliomyelitis Polycystic kidney disease Polymyalgia rheumatica Posaconazole Posterior rami syndrome Postlaminectomy Posttraumatic spinal stenosis

Pott's disease Praziquantel Prednisolone Pregabalin Pregnancy Premenstrual syndrome Prostate cancer Prostatitis Psoriatic arthritis Psychosomatic Pulmonary embolism Pyelonephritis Ramucirumab Ranibizumab injection Reiter's Syndrome Renal osteodystrophy Renal vein thrombosis Repaglinide Retroperitoneal fibrosis Retroperitoneal hematoma Rheumatoid arthritis Ribavirin Rift Valley fever Risedronate Rituximab injection Rosiglitazone Sacroiliitis Salpingitis Salsalate Saquinavir Sargramostim injection Scheuermann's disease Sciatica Scoliosis Selegiline Sibutramine Sickle cell disease Sipuleucel-T Sirolimus Sodium oxybate Solifenacin Spina Bifida Spinal cord compression Spinal disc herniation Spinal fusion Spinal stenosis Spinal tumor Spondylolisthesis Spondylolysis Spondylosis Subarachnoid hemorrhage Sulfinpyrazone Sulindac Sunitinib Syringomyelia Tabes dorsalis Tacrolimus topical Tadalafil Tamsulosin Tegaserod Telbivudine Telmisartan Temozolomide Tenofovir disoproxil fumarate Tension myositis syndrome Terazosin Tethered cord syndrome Transverse myelitis Traumatic aortic rupture Triamterene urinary obstruction Urinary tract infection Valganciclovir Valproic acid Valsartan Vancomycin hydrochloride Vardenafil Vertebral fractures Vertebral subluxation Zolpidem Zonisamide