Back pain or pain in your neck can often be a mystery, and it’s not always easy to figure out a possible cause. While this graphic is in no way exhaustive, we’ve created this easy-to-understand chart that may help you understand what could be causing your back pain.
Referred Coccyx Pain
SI Joint Pain
Naturally, pain is the most common symptom of most back problems. It’s what brought you here, after all! But be on the lookout for these other common symptoms that may accompany back pain:
- Weakness in the surrounding muscles or limbs
- Feelings of ‘electric shock’-like zapping
- Pins and needles
- Muscle spasms
Lordosis is defined as an excessive inward curve of the spine. The spine’s natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement.
Lordosis throws off the careful structure and alignment of the rest of the spine and, indeed, the entire body, forcing muscles and tendons to work harder to provide the necessary support.
Osteophytes – better known as bone spurs – are small, smooth bony growths that may develop near the edges of a vertebral body’s endplates (called spondylophytes) or the spine’s facet joints where cartilage has worn. A bone spur can grow at any level of the spinal column – neck, mid back, low back. They are thought to be caused by the body’s attempts at repairing age-related or degenerative injuries.
Also known as slipped discs or ruptured discs, this is a relatively common condition that can occur anywhere along the spine, but is most likely to affect the lower back or neck.
A herniated disk itself isn’t likely to cause back pain in, and of itself. The compressed nerves surrounding it, however, can cause back pain and loss of mobility.
Narrowing of the spinal canal – the space through which your spinal chord travels – is called spinal stenosis. Spinal stenosis may affect the cervical (neck), thoracic (chest), or lumbar (lower back) spine sections.
Typically, symptoms of stenosis progress over time. This is because nerves increasingly become more compressed, so minor signs of stenosis might eventually become more significant, and possibly chronic. For cervical or thoracic spinal stenosis in which the spinal cord is impinged, the symptoms typically consist of balance and gait difficulty, clumsiness, or dexterity issues using the hands.
Spondylolisthesis occurs when one vertebra slips forward over the vertebra below it. The term is pronounced spondy-low-lis-thesis and is derived from the Greek language: spondylo means vertebra and listhesis means to slip. There are several types or causes of spondylolisthesis; a few are listed below.
- Congenital spondylolisthesis means the disorder is present at birth.
- Isthmic spondylolisthesis occurs when a defect called a pars fracture occurs in a bony supporting vertebral structure at the back of the spine called the pars interarticularis.
- Degenerative spondylolisthesis is more common and is often associated with degenerative disc disease, wherein the discs (e.g., due to the effects of growing older) lose hydration and resiliency and provide less protection.
The most common symptoms of spondylolisthesis are:
- Back pain
- Pain that extends to the buttocks and thighs
- Pain that worsens with activity
- Stiff muscles, which can include tight hamstrings or muscle spasms in the hamstrings
- Difficulty with standing or walking
- Tired feeling, tingling, numbness, or weakness in legs
- Curvature of the spine, also known as kyphosis
Most people are completely unaware they slouch when sitting, standing or walking. Slouching is a sign of poor posture, and if not corrected can cause neck and back pain. Poor posture is easy, whereas adapting habits of good posture often requires conscious effort. The rewards of good posture – specifically the reduction of back pain – are well worth the effort.
Osteoporosis is a condition that causes weak, fragile, easily-broken bones. The effects of osteoporosis can strike anywhere in your body—including your spine. Osteoporosis, which means “porous bone”, is a serious disease that causes you to lose too much bone, make too little bone, or both.
As your bones lose density, they become weaker and more likely to break. People with osteopenia have lower than normal bone density, while those with osteoporosis have enough severe bone thinning to develop breaks.
The most common complication of osteoporosis is vertebral compression fractures (VCF). In people with advanced osteoporosis, compression fractures can occur while going about one’s daily activities, such as bending or carrying heavy loads, or as the result of a minor fall.
The vertebrae are the building blocks of the spine stacked one on top of each other. With osteoporosis the blocks become hollow boxes. Compression fractures occur when the vertebrae collapse. Spinal compression fractures may lead to difficulty walking and/or loss of balance leading to an increased risk of falling and breaking a hip, or other bones.
Kyphosis is defined as a curvature of the spine measuring 50 degrees or greater on an X-ray, a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film. The normal spine can bend from 20 to 45 degrees of curvature in the upper back area. Kyphosis is a type of spinal deformity, commonly caused by a combination of aging and genetics.
Other disorders that could raise your risk include:
- Compression fractures: These injuries can be a big culprit for kyphosis, especially if you have a fracture that causes the vertebrae to collapse toward each other. Osteoporosis—when your bones become thin and weak—makes compression fractures much more likely.
- Degenerative spinal arthritis: Like any kind of arthritis, the kind in your spine can create stiffness and may get worse over time.
- Ankylosing spondylitis: A form of inflammatory arthritis, ankylosing spondylitis usually strikes in early adulthood.
- Muscular dystrophy: This genetic condition causes weakening of the muscles, including the ones around the spine.
- Spinal tumor: Whether or not a tumor turns out to be cancerous, it can cause compression and affect your flexibility, causing that hunched-forward posture.
Age is another major factor. As you start losing bone density, that can put more pressure on spinal discs. Subsequent compression can cause the spine to curve forward into hyperkyphosis.
Scoliosis is a condition in which the spine curves laterally and rotates, or twists vertically. The two main types of scoliosis are adolescent idiopathic scoliosis (AIS) and adult degenerative scoliosis (ADS).
To receive a medical diagnosis of scoliosis, a person must have curves that meet or exceed 10 degrees of lateral curvature as determined by X-ray imaging. AIS causes disfigurement and disability in over 10% of people who have it.
Spinal compression fractures are also called vertebral compression fractures (VCF). This type of spinal fracture can cause severe back pain and adversely affect your overall health. A VCF occurs when one or more of your spine’s bones—the vertebrae or vertebral bodies—fractures causing spinal bone to compress. When a vertebral compression fracture occurs, the vertebral body may collapse causing loss of normal vertebral body height.
Sciatica is not a disorder itself but is a general term used to describe the pain that occurs when nerve roots in the lumbosacral spine (low back) become compressed (pinched), irritated, or inflamed, often from a herniated disc or other narrowing of the spinal canal (called stenosis). Sciatica may be accompanied by numbness/tingling and muscle weakness.
Pain is the hallmark sciatica symptom. Although sciatica symptoms may be felt anywhere along the sciatic nerve, classic sciatica radiates from the low back into the butt, and down the leg to below the knee. In fact, your doctor will usually check for sciatica if you have low back pain. Less commonly, sciatica pain may be felt starting in the buttocks or hip area and radiates down the leg.
Referred Coccyx Pain
Tailbone pain, called “coccydynia,” is pain in and around the small triangular bone at the very bottom of your spinal column, above the cleft of your buttocks.
Tailbone pain ranges from a dull ache to a fierce stab. It can last for weeks, months or sometimes longer. There are three types of events that cause tailbone pain:
- External Trauma: A bruised, broken or dislocated coccyx caused by a fall.
- Internal Trauma: Trauma caused by a difficult childbirth or from sitting on a narrow or hard surface for too long.
- Others: Infection, abscess and tumors.
Interestingly, for one-third of those with coccydynia, the cause is unknown.
- Abnormal, excessive mobility of the tailbone.
- Poor posture, especially from sitting too long in a position that puts pressure on the coccyx.
- Being overweight, which can put excess pressure on the coccyx.
- Being underweight, which can cause the coccyx to rub against and irritate the tissue around it due to lack of fat in the buttocks.
- Age-related tissue breakdown
- Childbirth is one of the most common causes of lower back pain in the sacrum or coccyx. Childbirth can cause muscles and ligaments around the coccyx to overstretch.
- A hard impact to the base of the spine, such as might happen during contact sports.
- Falling backwards onto the coccyx, such as a fall during ice skating. This may result in bruising, but can be more severe, resulting in dislocation or a fracture.
SI Joint Injury
Sacroiliac (SI) joint dysfunction is a common cause of low back pain. Other terms for this condition include sacroiliitis, SI joint inflammation, SI joint syndrome, sacroiliac joint dysfunction, and SI joint strain. This condition can make daily activities, such as sitting, standing, walking, and even sleeping difficult.
The main symptom of sacroiliac joint dysfunction is low back pain. But SI joint dysfunction can also cause pain in your hips, buttocks, thighs, or groin.