## Mechanical and Structural Causes
### Muscle and Ligament Issues
- Strains and sprains: Often resulting from acute injuries, lifting heavy objects, or repetitive movements[1][2]
- Poor posture: Prolonged periods of improper posture can lead to muscle fatigue and pain[1]
### Spinal Problems
- Herniated or bulging discs: When the inner gel of a spinal disc protrudes through the outer layer, potentially pressing on nerves[1][3]
- Degenerative disc disease: Natural wear and tear of spinal discs over time[1][3]
- Facet joint damage: Breakdown of cartilage in the joints connecting vertebrae, often due to osteoarthritis[1]
- Spinal stenosis: Narrowing of the spinal canal, putting pressure on nerve roots[1]
- Spondylolisthesis: Forward slippage of a vertebra over the one below it[1]
### Bone-related Issues
- Vertebral compression fractures: Often related to osteoporosis or trauma[2]
- Congenital conditions: Such as scoliosis or kyphosis[2]
[Degenerative disease
Discs (spondylosis)
Facet joints (osteoarthritis)]
## Medical Conditions
### Inflammatory Disorders
- Ankylosing spondylitis and other inflammatory spondyloarthropathies[2]
- Sacroiliitis: Inflammation of the sacroiliac joints[2]
### Infections
- Vertebral osteomyelitis, diskitis, or epidural abscesses[2]
### Tumors
- Primary or metastatic spinal tumors[2]
### Metabolic Issues
- Osteoporosis: Weakening of bones, increasing fracture risk[2]
## Lifestyle Factors
- Obesity: Excess weight putting additional stress on the spine[3]
- Sedentary lifestyle: Lack of physical activity weakening supporting muscles[3]
- Smoking: Associated with increased inflammation and reduced healing[3]
## Other Causes
- Referred pain: From internal organs such as the kidneys or lungs[2]
- Psychological factors: Stress, anxiety, or depression can exacerbate pain perception[2]
Citations:
[1] https://www.houstonmethodist.org/blog/articles/2021/may/lower-back-pain-causes-8-reasons-for-sudden-and-chronic-pain/
[2] https://www.ncbi.nlm.nih.gov/books/NBK538173/
[3] https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain/lower-back-pain-what-could-it-be
[4] https://www.niams.nih.gov/health-topics/back-pain
[5] https://www.webmd.com/back-pain/ss/slideshow-low-back-pain-overview
[6] https://www.mayoclinic.org/symptoms/back-pain/basics/causes/sym-20050878
[7] https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
[8] https://my.clevelandclinic.org/health/diseases/7936-lower-back-pain
++++++++++++++++++++++++++++
Spinal stenosis
Osteoporosis
Fractures
Congenital disease
Severe kyphosis
Severe scoliosis
Possible type II or type IV transitional vertebra*
Possible spondylolysis
Possible facet joint asymmetry
Nonmechanical spine disease
Neoplasia
Multiple myeloma
Metastatic carcinoma
Lymphoma and leukemia
Spinal cord tumors
Retroperitoneal tumors
Infection
Osteomyelitis
Septic discitis
Paraspinous abscess
Epidural abscess
Inflammatory arthritis (often HLA-B27-associated)
Ankylosing spondylitis
Psoriatic spondylitis
Reactive arthritis
Inflammatory bowel disease
Scheuermann disease (osteochondrosis)
Paget disease
Visceral disease
Pelvic organs
Prostatitis
Endometriosis
Chronic pelvic inflammatory disease
Renal disease
Nephrolithiasis
Pyelonephritis
Perinephric abscess
Aortic aneurysm
Gastrointestinal disease
Pancreatitis
Cholecystitis
Penetrating ulcer
Fat herniation of lumbar space
HLA: human leukocyte antigen.
* A transitional vertebra is a congenital anomaly in which there is a naturally occurring articulation or bony fusion between the transverse processes of L5 and the sacrum, but there is still a small remnant disc space between L5 and the sacrum. Type II means that one or both transverse processes appear to form a diarthrodial joint with the sacrum, but there is no bony fusion. Type IV means that there is a type II abnormality on one side and a complete bony fusion on the opposite side.