The Main Causes Of Lower Back Pain


With 65 million Americans reporting a recent episode of back pain, most of us know what it’s like to experience the agony of a sore lower back. And it’s no surprise that this kind of pain can significantly interfere with our day-to-day lives, making even simple tasks like getting out of bed in the morning a struggle.

As it turns out, the causes of lower back pain is a particularly common (16 million adults annually) and often debilitating issue. Your lower back is one of the most important parts of your body – it’s what keeps you upright, supports your posture, and helps you move.

It is the pillar of your body and preserving its structural integrity is key to your overall health. Knowing what causes lower back pain and what to do if you experience it is vital to keeping your body healthy.

Nociceptive vs Neuropathic Pain: What’s The Difference

Nociceptive or mechanical pain is caused by the stimulation of nociceptors, which are nerve endings found throughout the body. Nociceptive pain is initiated by an event or trauma such as a muscle strain, joint sprain, or surgery. Neuropathic pain, on the other hand, is caused by injury or impairment of the nervous system itself, such as sciatica, herniated disc, and facet joint damage.

Knowing what type of pain you are experiencing can help your doctor accurately diagnose the source of your pain and formulate a treatment plan that is tailored to you.

What Causes Lower Back Pain?

There are many causes for lower back pain, from muscle strain to a herniated disc. Here are the ten most common causes:

1. Muscle or Ligament Strain

Strained muscles and ligaments are one of the most common causes of lower back pain. The strain can be caused by any number of activities such as lifting heavy objects, repetitive motion, a sudden wrong move, or even poor posture and sneezing.

2. Bulging or Ruptured Discs

Discs are the soft cushioning between your vertebrae (small spinal bones), and when they are bulging or ruptured, the vital peripheral nerves that run from the spinal cord can become impinged, causing pain, numbness, and tingling. The root cause of this condition is often caused by wear and tear over time, but can also be caused by sudden trauma.

3. Herniated Disc

While bulging discs can cause painful symptoms, they may not be as serious as a herniated disc. A herniated disc is a condition where a tear in the outer layer of the disc causes it to bulge and leak its gel-like center, the nucleus pulposus, into the spinal canal. Again, the discs between the vertebrae bulge and impinge on the spinal cord or surrounding nerves, leading to inflammation and severe pain in the lower back, numbness, and tingling.

4. Facet Joint Damage

Facet joint damage occurs when the cartilage between the joints of your spine degenerates or is injured, causing pain in the lower back. This joint damage can be caused by a traumatic injury, osteoarthritis, or wear and tear over time.

5. Compression Fracture

One of the primary causes of lower back pain is a vertebral compression fracture, which occurs when the vertebrae break cracks under a compressive force. It predominantly affects people with osteoporosis, where weakened bones are more susceptible to fracture. With 1 to 1.5 million VCFs occurring annually in the United States (US) alone, it is no wonder that compression fractures are one of the leading causes of lower back pain.

6. Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal that can cause increased pressure on the nerves in your lower back. This condition is most often caused by age-related wear and tear, but can also be caused by trauma. Symptoms of spinal stenosis include numbness, tingling, and shooting pain in the lower back and legs. However, the manifestation of these symptoms can vary depending on the spinal level affected.

7. Spondylolisthesis

Spondylolisthesis, pronounced spon-dee-lo-lis-thee-sis, is a condition in which one vertebra slips out of position and onto the vertebra below it. This misalignment can cause nerve impingement, leading to lower back pain.

8. Arthritis

A more common cause of lower back pain is arthritis. The most common type of arthritis in the lower back is osteoarthritis, a degenerative joint disease caused by the age-related breakdown of the cartilaginous tissue between your vertebrae. Osteoarthritis’ counterpart, rheumatoid arthritis, is a chronic autoimmune condition that tends not to target axial joints such as your lower back. It presents itself as an inflammation of the finger, elbows, knees, and toe joints and is more common in younger individuals.

9. Osteoporosis

The weakening of bones due to a lack of calcium and other minerals is another common cause of lower back pain. Osteoporosis affects the majority of adults over the age of 50, especially postmenopausal women, leading to an increased risk of fractures and even painful lower back.

10. Scoliosis

Scoliosis is an abnormal curvature of the spine that can cause lower back pain and another symptom due to the misalignment of the vertebrae. Scoliosis is most common in young adults and adolescents but can affect people at any age. It is most commonly seen in children, adolescents, and young adults, but can affect people of all ages.

The Link Between Lumbar Multifidus Dysfunction and Lower Back Pain

In addition to the causes of lower back pain listed above, a condition called lumbar multifidus muscle dysfunction (LMMD) is increasingly becoming a factor in lower back pain. LMMD is a dysfunction of the multifidus muscles, which are deep stabilizing muscles located around your spine. When these skeletal muscles atrophy (weaken and shrink), with intramuscular fat deposits, there is dysfunction in pain inhibition. This leads to increased sensitivity to pain and reduced stability of the lumbar spine, resulting in lower back pain.

Palliative vs Restorative Treatment: Which is Better?

The question of what type of treatment is best for lower back pain is a difficult one to answer. While both palliative and restorative treatments are effective in relieving lower back pain, they serve different purposes.

Palliative treatments improve your quality of life by providing temporary pain relief. However, they do not treat the underlying condition that is causing the pain. On the other hand, restorative treatments have the goal of addressing and correcting the underlying condition causing the pain thus improving function and providing relatively longer-term relief.

The most effective treatment for lower back pain is one that combines both palliative and restorative treatments.

Introducing ReActiv8® – The First FDA-Approved Restorative Neurostimulation

While most current treatment options are palliative in nature, ReActiv8 is a revolutionary new restorative neurostimulation therapy that is FDA-approved and clinically proven to provide long-term relief for lower back pain.

ReActiv8 uses a patented technology to target the multifidus muscles, which are responsible for stabilizing the lumbar spine. By stimulating these muscles, ReActiv8 helps to restore normal function resulting in lasting lower back pain relief.

In the ReActiv8-B  clinical trial, after one year of use, 78% of patients were “definitely satisfied” with the treatment.

While ReActiv8 is making strides for lower back pain, it is not recommended for use with neuropathic pain or leg pain resulting from sciatica or other nerve-related conditions. Rather, it targets mechanical or nociceptive pain by stimulating the nerves innervating the multifidus muscles via a motor response, instead of sensory stimulation.

ReActiv8 is a safe and effective option for those suffering from chronic lower back pain and allows you to return to the quality of life you deserve. In an internal study, 

Signs You Should See a Doctor

While the majority of lower back pain can be managed conservatively, that is not always the case. If you recognize the following signs, it is important to make an appointment with our trained medical team:

Lasts Longer Than A Few Weeks

Lower back pain that lasts longer than a few weeks should be taken seriously as it could be an indication of a more serious underlying condition.

Is Severe And Doesn’t Improve With Rest

If your back pain is severe and doesn’t improve with rest or conservative treatment, you must seek medical help as soon as possible to rule out any possible serious complications.

Spreads Down One Or Both Legs

Lower back pain that spreads down one or both legs is often a sign of a herniated disc or spinal stenosis that is impinging on the peripheral nerve and needs to be evaluated by a doctor.

Causes Weakness, Numbness Or Tingling In One Or Both Legs

Peripheral nerve impingement manifests as muscle weakness, numbness, or tingling in the legs. Consulting with a doctor can eliminate any serious complications and help manage your symptoms.

Is Paired With Unexplained Weight Loss

Unexplained weight loss tends to reflect a more malignant cause of lower back pain. You must seek medical advice to rule out any underlying causes.

Lower Back Pain Risk Factors

Lower back pain can affect anyone, but certain people are at an increased risk of developing it. Knowing these risk factors can help you take preventive measures to avoid back pain in the future.


The older you get, the higher your risk of developing lower back pain due to age-related wear and tear.

Lack of Exercise

People who are inactive or have poor posture tend to be more prone to back pain than those who exercise regularly and maintain good posture.

Excess Weight

Carrying excess weight can put additional compressive stress on your back, leading to lower back pain.


The New England Journal of Medicine outlines a few visceral and non-mechanical causes such as endometriosis, chronic pelvic inflammatory disease, osteomyelitis, and various neoplastic diseases. Investigating the underlying causes of these diseases can help identify the source of your lower back pain.

Improper Lifting

Lifting heavy objects with incorrect form or technique increases the risk of back strain or injury.

Psychological Conditions

The International Association for the Study of Pain highlights psychological conditions as a risk factor for chronic lower back pain. From depression and anxiety to post-traumatic stress disorder, any kind of psychological condition can increase the risk of lower back pain resulting in an impaired quality of life.


Smoking is associated with a decrease in blood flow to the spine and can contribute to lower back pain. It is also linked to osteoporosis and spine fractures.

ReActive8 Paves the Way for Chronic Lower Back Pain Relief

Lower back pain is one of the most common ailments out there, but knowing what causes lower back pain and taking preventive measures can reduce your chances of developing it. Incorporating exercise, maintaining good posture, and making sure you lift properly can help protect your back and prevent lower back pain.

In cases where lower back pain is chronic with no relief in sight, ReActiv8® – an FDA-approved restorative neurostimulation therapy – may be the answer. It is safe, minimally invasive, and has been proven to provide long-lasting relief from chronic lower back pain.

Ready to live without the restrictions of lower back pain?

Learn More About ReActiv8® For Chronic Lower Back Pain Relief Today!

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