The Cause of Lower Back Pain and Symptoms

There are many types of problems that can be the cause of lower back pain symptoms. Luckily, the most common causes of lower back pain are not serious and usually the symptoms get better with time and non-surgical treatment.

Several trustworthy groups (2,3,4) have developed guidelines that help us decide what is the cause of lower back pain, they recommend that lower back pain is grouped into three main categories:

• Non-specific low back pain (simple low back pain)
• Nerve root irritation
• Specific ( more serious) pathology.

Each of these groups of back pain has different sub categories within it. The following table gives an overview. Click on the links to get a fuller description of each of the different things that are the cause of lower back pain.

Group	Subcategory
Non specific back pain By far and above the most common type of back pain. 95 % of people will have back pain that falls into this category (4)	There are lots of terms used to describe the same thing in this category. They include: Simple back ache/lumbago/ mechanical/postural back pain/Back muscle strain and muscle spasm. Changes of age - degenerative disc disease and spinal degeneration. Piriformis syndrome Sacroiliac joint dysfunction
Nerve root irritation or "pinched nerve" Less than 5% of people have true nerve root irritation (4). It is usually caused by bulging discs or disc prolapses. This is sometimes called lumbar radiculopathy.	Disc Bulges and prolapses / Sciatic nerve pain or Sciatica
Specific pathologies This is the more serious end of things although luckily only a tiny percentage of people have these problems. Many of these problems are perfectly treatable but they may need more specialist medical care. Less than 1% of people with lower back pain have a serious disease.	Cancer Infection Fractures Inflammatory disease e.g.Ankylosing spondylitis Spondylolisthesis and spondylolysis Spinal stenosis Cauda equina
Health professionals use a series of special questions to decide if a back problem is serious, positive responses to these questions are known as Red Flags and require further investigation. Check this page for Red Flag information.

For more information to help you understand the cause of lower back pain please check the anatomy section.

(1) Waddell, G. (2004) The back pain revolution. 2nd edn. London: Churchill Livingstone.

(2) National Institute for Clinical Excellence.
Referral advice. A guide to appropriate referral from general to specialist services.2001.

(3) Royal College of General Practitioners. Clinical Guidelines for the Management of Acute Low Back Pain.1999.

(4)Prodigy Guidelines

Date Page Modified: 02-Jun-2008