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Back pain causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2] Zehra Malik, M.B.B.S[3]

Overview

The causes of back pain can be stratified according to age. Common causes of back pain in adults under the age of 50 years include, ligament strain, nerve root irritation, spinal disc herniation, degenerative disc disease and isthmic spondylolisthesis. Common causes in adults over the age of 50 years include osteoarthritis (degenerative joint disease), spinal stenosis, trauma, cancer, infection, fractures, and inflammatory disease. Non-anatomical factors can also lead to back pain, such as stress, repressed anger, or depression. Even if an anatomical cause for the pain is present, a coexisting depression should be treated concurrently.

Causes

Common Causes

Common causes of back pain include:[1][2][3][4][5]

Less Common Causes

Less common causes of back pain include:[5][6][7]

Life Threatening Causes

Urgent intervention is required in the following causes of back pain as they may be life-threatening:[8][7][9][5][10][11]

Causes by Organ System

Cardiovascular

Abdominal aortic aneurysm, angina pectoris, aortic dissection, bacterial endocarditis, 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, Artemether and lumefantrin, Bicalutamide, budesonide inhalation powder, calcitonin salmon nasal spray, candesartan, carbamazepine, carboplatin, caspofungin acetate, cetuximab injection, ciclesonide, clofarabine injection, cyanocobalamin injection, Dalfampridine, darbepoetin alfa injection, daunorubicin, desloratadine, didanosine, diflunisal, dofetilide, donepezil, drotrecogin alfa, Eculizumab, Eliglustat, efalizumab injection, epoetin alfa injection, eszopiclone, etodolac, fenoprofen, fexofenadine, formoterol, fulvestrant, glatiramer injection, ibandronate, Imiglucerase, indinavir, infliximab injection, leflunomide, lenalidomide, Lorcaserin, Losartan and Hydrochlorothiazide, meclofenamate, medroxyprogesterone injection, mefenamic acid, mesalamine, Meropenem, Mifepristone, modafinil, mycophenolate, Nabilone, nabumetone, nateglinide oral, Niacin/simvastatin, Olaparib, olanzapine, oxaliplatin injection, oxcarbazepine, oxybutynin, pergolide, piroxicam, posaconazole, praziquantel, pregabalin, ranibizumab injection, repaglinide, ribavirin, risedronate, rituximab injection, Ramucirumab, Roflumilast, rosiglitazone, salsalate, saquinavir, sargramostim injection, selegiline, sibutramine, Sipuleucel-T, sirolimus, sodium oxybate, solifenacin, sulfinpyrazone, sulindac, sunitinib, tacrolimus topical, tadalafil, tamsulosin, tegaserod, telbivudine, telmisartan, temozolomide, terazosin, Travoprost, Valdecoxib, valganciclovir, valproic acid, valsartan, vancomycin hydrochloride, vardenafil, zolpidem, zonisamide

Ear Nose Throat No underlying causes
Endocrine

Addisons disease, Cushing’s Disease, hyperparathyroidism

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, ankylosing spondylitis, cervical fracture, coxarthrosis, cramp, degenerative disc disease, disc space infection, dorsopathy, gonarthrosis, lumbar disc disease, muscle strain, 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, cauda equina syndrome, 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

Urinary 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

Urologic Acute prostatitis
Miscellaneous

Fibromyalgia, chronic fatigue syndrome, dysraphia, facet Syndrome, mediastinitis, retroperitoneal fibrosis, retroperitoneal hematoma, Scheuermann’s disease

Causes in Alphabetical Order


References

  1. ↑ Jandrić S, Antić B (2006). “[Low back pain and degenerative disc disease]”. Med Pregl. 59 (9–10): 456–61. doi:10.2298/mpns0610456j. PMID 17345822.
  2. ↑ Nowotny J, Nowotny-Czupryna O, Brzęk A, Kowalczyk A, Czupryna K (2011). “Body posture and syndromes of back pain”. Ortop Traumatol Rehabil. 13 (1): 59–71. doi:10.5604/15093492.933788. PMID 21393649.
  3. ↑ Oliveira DS, Vélia Ferreira Mendonça L, Sofia Monteiro Sampaio R, Manuel Pereira Dias de Castro-Lopes J, Ribeiro de Azevedo LF (2019). “The Impact of Anxiety and Depression on the Outcomes of Chronic Low Back Pain Multidisciplinary Pain Management-A Multicenter Prospective Cohort Study in Pain Clinics with One-Year Follow-up”. Pain Med. 20 (4): 736–746. doi:10.1093/pm/pny128. PMID 30010966.
  4. ↑ Katonis P, Kampouroglou A, Aggelopoulos A, Kakavelakis K, Lykoudis S, Makrigiannakis A; et al. (2011). “Pregnancy-related low back pain”. Hippokratia. 15 (3): 205–10. PMC 3306025. PMID 22435016.
  5. ↑ 5.0 5.1 5.2 Idris Z, Ghazali FH, Abdullah JM (2014). “Fibromyalgia and arachnoiditis presented as an acute spinal disorder”. Surg Neurol Int. 5: 151. doi:10.4103/2152-7806.143364. PMC 4228496. PMID 25396073.
  6. ↑ Gardner A, Gardner E, Morley T (2011). “Cauda equina syndrome: a review of the current clinical and medico-legal position”. Eur Spine J. 20 (5): 690–7. doi:10.1007/s00586-010-1668-3. PMC 3082683. PMID 21193933.
  7. ↑ 7.0 7.1 Kiser TS, Mauldin CC, Grant R (1997). “Acute low back pain secondary to retroperitoneal hemorrhage in an elderly man”. Arch Phys Med Rehabil. 78 (6): 664–5. doi:10.1016/s0003-9993(97)90434-2. PMID 9196476.
  8. ↑ Van Wyngaarden JJ, Ross MD, Hando BR (2014). “Abdominal aortic aneurysm in a patient with low back pain”. J Orthop Sports Phys Ther. 44 (7): 500–7. doi:10.2519/jospt.2014.4935. PMID 24766359.
  9. ↑ Marcon RM, Cristante AF, Teixeira WJ, Narasaki DK, Oliveira RP, de Barros Filho TE (2013). “Fractures of the cervical spine”. Clinics (Sao Paulo). 68 (11): 1455–61. doi:10.6061/clinics/2013(11)12. PMC 3812556. PMID 24270959.
  10. ↑ Bond A, Manian FA (2016). “Spinal Epidural Abscess: A Review with Special Emphasis on Earlier Diagnosis”. Biomed Res Int. 2016: 1614328. doi:10.1155/2016/1614328. PMC 5156786. PMID 28044125.
  11. ↑ Perrin A, Bergman C, Hart L (2013). “A 30-year-old industrial worker with upper back pain”. Adv Emerg Nurs J. 35 (2): 103–9. doi:10.1097/TME.0b013e3182948e73. PMID 23636041.

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