Types of Back Pain: What They Mean and When to See a Doctor

Your back includes the spine plus the ligaments, tendons and muscles that support it. The spine (backbone) has 24 movable vertebrae (bones) stacked on top of each other. Discs sit between most vertebrae to cushion movement and ligaments help hold everything in place.

The spine also protects the spinal cord, which carries signals between the brain and body and controls movement and feeling in the arms and legs.

The spine has three regions:

Cervical spine (neck): The uppermost section has seven vertebrae. It supports your head and lets you bend and turn your neck.

Thoracic spine: The upper and middle section of the spine has 12 vertebrae that attach to your ribs and provide stability for your upper body.

Lumbar spine: The lower spine has five vertebrae. It provides flexibility for bending and twisting. Because it carries more weight and moves more than the thoracic spine, it is also more vulnerable to strain and injury.

Here’s a look at some of the most common types and causes of back pain.

Tight or sore muscles can develop anywhere along the spine.

In the neck, stiffness in the muscle that supports the head and connects to the shoulder is common. This kind of muscle tension can lead to neck pain and even headaches. Overuse, poor posture or prolonged forward head position can make these muscles tight and tense. Certain activities, such as pull-ups or other upper body exercises, can also contribute to neck muscle pain.

“We see a lot of neck strain that occurs as a result of bending the neck forward or down for prolonged periods of time while working on a computer or using a mobile device,” notes Dr. Mundis. “It’s important to be aware of your posture when you’re using devices and take frequent breaks.”

In the middle and lower back, muscle pain often stems from a strain or sprain of the muscles and ligaments that provide stability. Sudden twisting, lifting something heavy or awkward movements can trigger pain. Extra pressure from pregnancy or weight gain, as well as weak core muscles or poor posture can force back muscles to overwork and become sore.

Lower back muscles are especially prone to injury from sports, accidents or overexertion. These muscles are also prone to spasms, which can cause sudden, sharp and sometimes debilitating pain that can limit movement.

Gentle stretching, massage, posture awareness and gradual return to activity help relieve muscle strain.

Sharp, burning or shooting pain, sometimes with a “pins and needles” sensation, often points to a pinched or irritated spinal nerve. This type of pain usually radiates along the path of the nerve, so irritation in the neck can cause pain that shoots into the shoulder, arm or hand.

Sciatica type pain is a common example. It is pain that begins in the lower back or buttock and travels down the legs or feet, usually caused by compression or irritation of the nerve roots in the lower spine that join to form the sciatic nerve.

Other causes of nerve pain include:

• Spinal stenosis: This is a narrowing of the spinal canal. In the neck, it can press on the spinal cord. In the lower back, it more often compresses nerve roots, causing pain, numbness or weakness in the legs.
• Arthritis: Can lead to bone spurs or other changes that press on nearby spinal nerves

A herniated disc, sometimes called a slipped or ruptured disc, happens when the cushioned part of a spinal disc pushes through a tear in its tough outer layer. If the disc presses on a nearby nerve, it can cause pain, weakness, tingling or numbness. Some herniated discs, however, cause little or no symptoms if they don’t touch a nerve.

Another source of back and leg pain is spondylolisthesis, a condition where one vertebra slips forward over the one below it. This can lead to nerve compression and muscle tightness, especially in the lower back and legs.

This type of back pain is caused by inflammation in the joints of the spine. Unlike muscle strain, it usually feels worse during rest or at night and improves with movement or exercise. Morning stiffness that lasts 30 minutes or more is a common sign.

Inflammatory back pain can be linked to other disorders such as ankylosing spondylitis, an inflammatory disease that can cause some vertebrae to gradually fuse together and limit flexibility.

Other possible causes include autoimmune diseases or arthritis and spinal infections.

Other causes of back pain

Sometimes back pain is linked to conditions outside the spine, such as:

• Kidney stones or infection
• Endometriosis
• Tumors
• Osteoporosis, which can lead to vertebral fractures

If your pain is mild or occasional, try these self-care tips:

• Use hot or cold packs to ease inflammation
• Stretch and strengthen your core muscles
• Take breaks from sitting or screen time
• Practice good posture at your desk or while using your phone
• Try over-the-counter anti-inflammatory medications (as directed)

While many people experience back pain that improves with rest or self-care, some symptoms deserve medical attention.

“There are so many potential reasons for back pain, and many ways to help relieve it,” says Dr. Mundis. “If your pain is severe or prolonged, see your doctor to rule out anything serious and find the right treatment.”

See your doctor if you have:

• Pain that doesn’t improve after a few weeks
• Weakness, numbness or tingling in your legs or arms
• Pain after an accident or injury

Your doctor will likely perform a physical exam and may order imaging to confirm the cause.

Seek emergency care right away if you notice new or sudden loss of bladder or bowel control.

Scripps offers expert care for back and spine conditions — from physical therapy and pain management to minimally invasive surgery.