What Causes Chronic Back Pain, and What Can You Do About It?

Content medically reviewed by Anthony Burrows, MD

If you experience back pain daily, you know it can have a significant impact on your life. Everyday tasks can become difficult, and the pain may even keep you from doing activities you love. But what causes chronic back pain, and what can you do about it?

“Chronic back pain, especially in the lower back, is a very common problem,” said Dr. Anthony Burrows, a neurosurgeon at Essentia Health. “But the good news is that there are things you can do about it. By understanding the cause of your pain, you can take steps to alleviate discomfort and live a better quality of life.”

Do You Have Risk Factors for Back Pain?

While anyone can develop back pain, having certain risk factors can make it more likely. These include –

• Age. Back pain is more common as you get older, especially after age 45.
• Fitness level. If you are not physically active, you may be more likely to have back pain. If you do not have sufficient core strength, meaning your back or stomach muscles are not strong enough to support your spine, back pain may result. You can also have back pain if you exercise too strenuously when your body isn’t used to it.
• Stress level. Having high stress levels can cause issues like poor sleep and anxiety, which can contribute to back pain and make it more severe.
• Weight. Carrying excess weight, especially if you have an inactive lifestyle, can put a strain on your back.
• Work-related factors. If you have a job that requires physical activity like heavy lifting or frequent twisting, back pain can result. Sitting at a desk for long periods can also cause back problems, especially if you have poor posture.   
• Heredity. This can also play a role, as some disorders that cause back pain run in families.

Causes of Chronic Back Pain

Depending on the cause, back pain can appear suddenly or develop gradually. If the pain occurs daily for at least 12 weeks, it is considered chronic.

Chronic back pain can come in many forms, ranging from dull, aching pain to sharp, intense pain. It may come and go or worsen and get better with certain activities. It might also start in your back and radiate to other areas, such as your buttocks or legs.  Common causes of chronic back pain include –

• Arthritis. Many people with back pain have arthritis, which causes joint inflammation. Ankylosing spondylitis is a type of arthritis that specifically affects the spine.
• Degenerative disc disease. As you get older, discs between vertebrae can begin to break down. This can lead to a condition called spinal stenosis, in which the spinal canal narrows, pressing on the spinal cord and triggering nerve pain.
• Herniated discs. When part of a disc between vertebrae in the spinal column slips out of place and pushes on nerves, it can cause pain in the back, legs, and other areas. This is a common cause of sciatic nerve pain, which travels from the lower back into the leg.
• Injuries. Strains, sprains, or fractures can trigger long-term pain.
• Spine curvature. Conditions like scoliosis and kyphosis that cause the spine to curve can cause long-term pain.Many other medical conditions can lead to back pain, including osteoporosis, fibromyalgia, kidney stones, infections, and cancer. 

What to Do About Chronic Back Pain

If your back pain is severe, does not improve within a few weeks, or is accompanied by any of the following symptoms, see your health care provider –

• Fever
• Numbness and tingling
• Pain, weakness, or numbness in your legs
• Trouble urinating
• Unexplained weight loss

Your provider will do a physical exam and may order tests, such as CT scans, X-rays or MRI of the spine, as well as blood tests.

Depending on the results of exams and tests, your provider might recommend different treatments, including –

• Taking medications, such as over-the-counter or prescription pain medicine, anti-inflammatory drugs, and muscle relaxants or seeing a pain management specialist
• Using cold packs for pain or hot packs to stimulate blood flow and promote healing in back muscles and tissues
• Wearing a back brace for support
• Working with a physical therapist or physiatrist to learn stretching and strengthening exercises, which can decrease pain and improve mobility and posture. Essentia Health offers an 8-week spine course called SpineX to help.

If physical therapy, medication, and other types of treatments do not improve your symptoms, your provider might recommend an epidural injection for certain types of pain. Surgery might be an option only if your pain is being caused by nerve or bone damage.

Tips for Living With and Preventing Chronic Back Pain

While you are recovering from back pain, there are things you can do to help lessen your pain and help your recovery –

• Avoid carrying too much at once.
• If you must sit for long periods, put support behind your back and be sure to get up and move around frequently.
• Sleep on your side with a pillow between your knees.
• Talk to your physical therapist or doctor about what exercises are best and what to avoid. Remember to add new exercises gradually.
• Wear comfortable, supportive shoes with a low heel.

Once your pain has healed, continue to take steps to prevent it from happening in the future. Things you can do include –

• Avoiding heavy lifting
• Exercising regularly, focusing on moves that improve back and core muscle strength and enhance balance
• Following a healthy diet that includes plenty of calcium and vitamin D, which help to keep your spine strong
• Practicing good posture
• Reaching and maintaining a healthy weight

“By staying committed to a healthy lifestyle, you can help avoid back pain and improve your overall wellness,” Dr. Burrows said. “Talk to your provider if you have questions about the best ways to take care of your back and prevent chronic pain from returning.”