What Causes Low Back Pain?

What causes low back pain? Low back pain affects 80% of adults at some point in their lives, making it one of the most common reasons people visit healthcare providers. At Chiropractic Health Club in Riverside, CA, I hear the same frustrated question daily: “Why does my back hurt?”

This comprehensive guide breaks down the most common causes of lower back pain, helping you understand what’s happening in your body and when to seek professional care.

Muscle Strains & Ligament Sprains

The most common culprits behind acute low back pain are damaged muscles and ligaments supporting your spine.

How they happen:

• Lifting injuries: Picking up heavy objects with improper form
• Sudden twisting movements: Quick rotations straining unprepared tissues
• Overuse from sports: Repetitive activities without adequate conditioning
• Poor lifting mechanics: Bending from your back instead of your knees
• Weak core muscles: Insufficient support forcing back muscles to overwork

These injuries typically cause immediate, sharp pain that worsens with movement. Most heal within 2-6 weeks with proper care, but without addressing underlying weakness or mechanics, they tend to recur.

Herniated or Bulging Discs

Your intervertebral discs cushion vertebrae, but they can tear or bulge outward, creating significant problems.

How discs become damaged:

• Repetitive bending and twisting movements
• Prolonged sitting increasing disc pressure
• Sudden trauma or lifting injuries
• Age-related degeneration weakening disc walls

When discs herniate: The soft inner material pushes through the tough outer layer, potentially compressing nearby nerve roots. This creates sciatica – pain radiating down your leg, often accompanied by numbness, tingling, or weakness.

Pain patterns indicating disc involvement:

• Sharp, shooting pain traveling into buttock, thigh, or calf
• Numbness or tingling in leg or foot
• Weakness affecting specific muscle groups
• Pain worsening with sitting, bending forward, or coughing

Degenerative Disc Disease

Despite its scary name, degenerative disc disease is simply age-related wear and tear affecting spinal discs.

What happens:

• Loss of disc hydration: Discs lose water content, becoming less springy
• Reduction in disc height: Vertebrae move closer together
• Chronic inflammation: Degenerative changes trigger inflammatory responses
• Chronic stiffness: Reduced flexibility and persistent discomfort

This condition typically develops gradually, creating recurring episodes of low back pain rather than constant severe pain. Morning stiffness that improves with movement is characteristic.

Facet Joint Dysfunction

Small joints on the back of your spine (facet joints) can become inflamed or arthritic, creating distinct pain patterns.

Key characteristics:

• Pain worsens with backward bending or twisting
• Localized tenderness over affected joints
• Often misdiagnosed as simple muscle strain
• May radiate into buttock or thigh (but not past knee like sciatica)

Facet dysfunction frequently coexists with disc problems, creating complex pain patterns requiring comprehensive evaluation.

Sacroiliac (SI) Joint Dysfunction

Where your spine connects to your pelvis, the SI joints can misalign or become inflamed, creating pain often confused with sciatica.

Distinctive features:

• Pelvic misalignment: Uneven hip heights or rotation
• Pain location: Lower back, buttock, or upper thigh
• One-sided symptoms: Usually affects one side more than the other
• Pain with specific movements: Standing from sitting, climbing stairs, or prolonged standing

Spinal Stenosis & Foraminal Narrowing

As we age, the spinal canal can narrow (stenosis) or openings where nerves exit can shrink (foraminal narrowing), compressing neural structures.

Common causes:

• Bone spurs from arthritis
• Thickened ligaments
• Disc bulging
• Combined degenerative changes

Characteristic symptoms:

• Pain worse with standing or walking
• Relief when sitting or bending forward
• Leg pain, numbness, or weakness
• “Shopping cart sign” (leaning forward for relief)

This condition is more common after age 50 and may eventually require surgical intervention if conservative care fails.

Scoliosis & Structural/Postural Imbalances

Does scoliosis cause low back pain? Yes – abnormal spinal curves and postural imbalances create uneven stress on lumbar structures.

Structural problems causing chronic pain:

Can poor posture cause lower back pain? Absolutely. Forward head posture, rounded shoulders, and anterior pelvic tilt create biomechanical stress that accumulates over years, eventually causing chronic symptoms.

As a chiropractor Riverside patients trust for structural correction, I see how addressing these underlying imbalances prevents recurring pain episodes.

Poor Posture & Sedentary Lifestyle

Modern life creates perfect conditions for developing low back pain through prolonged sitting and poor ergonomics.

Risk factors:

• Desk jobs requiring 8+ hours sitting daily
• Long commutes in car seats
• Rounded shoulders and slouched positioning
• Deconditioned spinal stabilizer muscles
• Lack of regular movement breaks

Repetitive Movements & Occupational Stress

What causes low back pain in adults with physically demanding jobs? Repetitive stress and overuse patterns.

High-risk occupations:

• Construction workers (bending, lifting, twisting)
• Nurses and healthcare workers (patient transfers)
• Teachers (prolonged standing)
• Retail workers (standing, reaching, lifting)
• Warehouse employees (repetitive lifting)

These jobs create cumulative microtrauma that eventually manifests as chronic pain or acute injury.

Being Overweight or Obese

Excess body weight significantly increases low back pain risk through multiple mechanisms:

• Increased mechanical stress: Extra pounds load lumbar discs and joints
• Systemic inflammation: Obesity creates inflammatory chemicals throughout the body
• Altered biomechanics: Changed center of gravity affects spinal positioning
• Reduced physical activity: Deconditioning weakens supporting muscles

Stress, Muscle Tension & Emotional Factors

Chronic low back pain causes aren’t always purely physical – psychological stress plays a significant role.

How stress creates pain:

• Protective muscle guarding: Unconscious tension in back muscles
• Reduced blood flow: Chronic tension restricts circulation to tissues
• Pain amplification: Stress lowers pain threshold
• Chronic pain cycle: Pain creates stress, stress worsens pain

Research by Linton in Pain demonstrated strong correlation between stress levels and low back pain severity and chronicity.

Arthritis & Inflammatory Conditions

Various forms of arthritis can affect the spine, creating distinct pain patterns:

• Osteoarthritis: Wear-and-tear arthritis causing joint degeneration, bone spurs, and stiffness
• Rheumatoid arthritis: Autoimmune condition attacking joint linings
• Ankylosing spondylitis: Inflammatory condition causing vertebrae to fuse, creating severe stiffness
• Morning stiffness patterns: Arthritis-related pain typically worsens after rest and improves with movement – opposite of mechanical pain patterns.

Osteoporosis & Spinal Compression Fractures

Weakened bones from osteoporosis can fracture with minimal trauma, creating sudden, severe low back pain.

Why fractures happen:

• Progressive bone density loss (especially postmenopausal women)
• Minor activities like bending, lifting, or even coughing
• Often occurring without obvious injury

Warning signs:

• Sudden onset severe pain after mild activity
• Pain worse with movement, better lying down
• Loss of height over time
• Increased forward curve in upper back

These require immediate medical evaluation and imaging.

Internal Organ-Related Causes (Referred Pain)

Not all low back pain originates from spinal structures. Certain medical conditions refer pain to the lower back:

• Kidney stones: Severe, colicky pain in flank radiating to groin
• Kidney infection: Fever, urinary symptoms, back pain
• Abdominal aortic aneurysm: Rare but life-threatening; pulsating mass, severe pain

Red flags requiring emergency care:

• Pain accompanied by fever
• Loss of bowel/bladder control
• Unexplained weight loss
• Severe abdominal pain with back pain
• Pain not relieved by any position

Female-Specific Causes

What causes low back pain in women includes unique factors related to reproductive health:

• Endometriosis: Uterine tissue growing outside the uterus, causing cyclical back pain
• Menstrual cycle-related pain: Hormonal changes and uterine cramping referring to lower back
• Pregnancy lower back pain: Growing baby shifting center of gravity, hormonal ligament loosening, increased spinal curve
• Postpartum changes: Weakened core muscles and altered biomechanics after delivery

Smoking & Reduced Disc Hydration

What causes sharp low back pain in smokers? Nicotine’s effects on spinal health.

How smoking damages your back:

• Reduces blood flow to spinal discs
• Decreases oxygen delivery to tissues
• Accelerates disc degeneration
• Impairs healing after injury
• Increases inflammatory markers

How Chiropractors Diagnose the Root Cause

Understanding causes of lower back pain requires comprehensive evaluation, not guesswork.

Our diagnostic process includes:

1. Detailed health history: When pain started, what makes it better/worse, previous injuries
2. Posture and spinal alignment assessment: Identifying structural imbalances
3. Digital X-rays & structural analysis: Revealing disc degeneration, arthritis, alignment problems
4. Orthopedic & neurological exams: Testing reflexes, strength, sensation, nerve function
5. Range-of-motion studies: Measuring flexibility and identifying restricted movements
6. Identifying exact tissue involvement: Determining whether discs, joints, muscles, or nerves are primary problem

This thorough approach ensures we treat the actual cause rather than just chasing symptoms.

Understanding Your Pain Opens the Door to Relief

What causes low back pain? As you’ve seen, the answer isn’t simple – but most causes are treatable with conservative care when properly diagnosed.

At Chiropractic Health Club, we specialize in identifying root causes through advanced diagnostics and creating personalized treatment plans addressing your specific problems – whether that’s disc herniation, postural imbalances, SI joint dysfunction, or degenerative changes.

Stop wondering why your back hurts. Schedule your comprehensive low back evaluation today. We’ll identify exactly what’s causing your pain, explain your condition in plain English, and create a treatment plan designed to provide lasting relief – not just temporary symptom management.

Don’t let low back pain control another day of your life. Expert diagnosis and evidence-based treatment can help you return to the active, pain-free life you deserve.