Back pain causes

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

Overview

Muscle strains (pulled muscles) are commonly identified as the cause of back pain, as are muscle imbalances. Pain from such an injury often remains as long as the muscle imbalances persist. The muscle imbalances cause a mechanical problem with the skeleton, building up pressure at points along the spine, which causes the pain. Ligament strain is a very common cause of back pain as well. Another cause of acute low back pain is a Meniscoid Occlusion. The more mobile regions of the spine have invaginations of the synovial membrane that act as a cushion to help the bones move over each other smoothly. The synovial membrane is well supplied with blood and nerves. When it becomes pinched or trapped it can cause sudden severe pain. The pinching causes the membrane to become inflamed, causing greater pressure and ongoing pain. Symptoms include severe low back pain that may be accompanied by muscle spasm, pain with walking, concentration of pain to one side, and no radiculopathy (radiating pain down buttock and leg). Relief should be felt with flexion (bending forward),and exacerbated with extension (bending backward). Transient back pain is likely one of the first symptoms of influenza.

When back pain lasts more than three months, or if there is more radicular pain (sciatica) than back pain, a more specific diagnosis can usually be made. There are several common causes of back pain: for adults under age 50, these include ligament strain, nerve root irritation, spinal disc herniation and degenerative disc disease or isthmic spondylolisthesis; in adults over age 50, common causes also include osteoarthritis (degenerative joint disease) and 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 there is an anatomical cause for the pain, if depression is present it should also be treated concurrently.

New attention has been focused on non-discogenic back pain, where patients have normal or near-normal MRI and CT scans. One of the newer investigations looks into the role of the dorsal ramus in patient's pain that have normal radiographic evidence. See Posterior Rami Syndrome. Diagnostic musculoskeletal ultrasonography has been shown to be helpful in objectifying multifidus atropy.

Causes

Common Causes

• Discopathy
• Idiopathic lumbago
• Trauma due to lifting
• Ligament strain
• Radiculopathy
• Posterior Rami Syndrome

Causes by Organ System

Cardiovascular	Abdominal Aortic Aneurysm, Angina pectoris, Aortic Dissection, Endocarditis (bacterial) 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, Budesonide Inhalation Powder, Calcitonin Salmon Nasal Spray, Candesartan, Carbamazepine, Carboplatin, Cetuximab Injection, Clofarabine Injection, Cyanocobalamin Injection, Darbepoetin Alfa Injection, Daunorubicin, Desloratadine, Didanosine, Diflunisal, Dofetilide, Donepezil, Drotrecogin alfa, Efalizumab Injection, Epoetin Alfa Injection, Eszopiclone, Etodolac, Fenoprofen, Fexofenadine, Formoterol, Fulvestrant Injection, Glatiramer Injection, Ibandronate, Indinavir, Infliximab Injection, Leflunomide, Meclofenamate, Medroxyprogesterone Injection, Mefenamic Acid, Mesalamine, Modafinil, Mycophenolate, Nabumetone, Nateglinide oral, Olanzapine, Oxaliplatin injection, Oxcarbazepine, Oxybutynin, Pergolide, Piroxicam, Posaconazole, Praziquantel, Pregabalin, Ranibizumab injection, Repaglinide, Ribavirin, Risedronate, Rituximab injection, Rosiglitazone, Salsalate, Saquinavir, Sargramostim injection, Selegiline, Sibutramine, Sirolimus, Sodium oxybate, Solifenacin, Sulfinpyrazone, Sulindac, Sunitinib, Tacrolimus topical, Tadalafil, Tamsulosin, Tegaserod, Telbivudine, Telmisartan, Temozolomide, Terazosin, Valganciclovir, Valproic Acid, Valsartan, Vancomycin Hydrochloride, Vardenafil, Zolpidem, Zonisamide
Ear Nose Throat	No underlying causes
Endocrine	Addisons disease, Cushing's Disease, Hyperparathyroidism (primary/secondary)
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, Abnormally flexible ribs, Ankylosing Spondylitis, Cervical fracture, Coxarthrosis, Cramp, Degenerative disc disease, Disc space infection, Dorsopathy, Gonarthrosis, Lumbar disc disease, Lumbar strain, Malignant processes of vertebral body, 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, 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	Chronic uteral 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 of Disci and ligaments
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 Abnormally flexible ribs 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 aneurysm(Abdominal) Aortic Dissection Arachnoiditis Bearberry Bechterew's Disease Bone metastases Borreliosis Bortezomib Breast cancer Bright's disease Budesonide Inhalation Powder 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 Chronic uteral obstruction 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 Efalizumab Injection Ehlers-Danlos syndrome 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 (primary/secondary) Ibandronate Idiopathic Indinavir Infliximab Injection Injury of disci and ligaments Juvenile osteochondrosis of spine Leflunomide Leg length discrepancy Leriche's Syndrome Listeria monocytogenes Lumbago Syndrome Lumbar disc disease Lumbar strain Lung cancer Malignant processes of vertebral body Marfan syndrome Meclofenamate Mediastinitis Medroxyprogesterone Injection Mefenamic Acid Meningioma Menopause Mesalamine Metastases Modafinil Multiple Myeloma Mycophenolate Myelofibrosis Myocardial infarction Myositis Myotendinosis 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 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 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 Tension myositis syndrome Terazosin Tethered cord syndrome Transverse myelitis Traumatic aortic rupture Triamterene Urinary tract infection Valganciclovir Valproic Acid Valsartan Vancomycin Hydrochloride Vardenafil Vertebral Fractures Vertebral subluxation Zolpidem Zonisamide

References

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