Over the past 32 years of caring for many thousands of patients, I have heard many explanations for how their low back pain began.
In general, most lower back pain originates from the following five causes.
1. An acute accident or injury. For this type of case, the diagnosis is typically very straightforward. A slip and fall, muscle strain, vehicle accident, sprain from lifting or similar event often causes immediate pain.
2. Sub-acute accident or injury. This type of case can be a little more difficult to solve. Patients will tell me that they just began having pain recently but cannot recall any specific reason for it. In many situations, the event was so mild that they did not notice the injury.
3. Chronic pain from ongoing mechanical stress. An example of this type of problem might be a patient that has a desk job that involves hours of sitting each day.
4. Degenerative discs or joints. This condition is usually the result of an injury long ago or the result of genetics. Degenerative joint conditions often develop silently for years and are not revealed until patients realize that their back pain is getting worse over time. Degenerative disc processes also include bulging or herniated discs that can result in pinched nerves
5. Other disease processes such as arthritis. Although patients are often told that their condition is the result of