The Common Causes of Low Back Pain
Low back pain is one of the most common reasons people see a doctor, with the large majority of us experiencing it at some point. The reassuring reality is that most low back pain is mechanical and not caused by anything serious, and most episodes improve.
The Most Common Causes
- Muscle and ligament strain from lifting, twisting, or sudden movements
- Sustained postures and prolonged sitting
- Deconditioning and weak supporting muscles
- Age-related disc and joint changes, which are common and often painless
- Stress, poor sleep, and low activity levels, which all influence back pain
What Usually Is Not the Cause
Imaging often reveals disc bulges and degeneration in people with no pain at all, so these findings do not always explain symptoms. This is why modern guidelines discourage routine imaging for ordinary low back pain and emphasize staying active (Ann Intern Med, 2021, PMID 34370518).
What Helps Most
For most low back pain, the evidence favors staying active, gradually returning to normal movement, and conservative care such as exercise and manual therapy over rest and medication (J Pain Res, 2022, PMID 36510616).
- Keep moving rather than resting in bed
- Stay at or return to work and activity as able
- Build core and hip strength over time
- Address stress and sleep, which influence recovery
When to Get Checked
Seek assessment for back pain that follows significant trauma, comes with leg weakness or numbness, affects bladder or bowel control, or is accompanied by fever or unexplained weight loss. Otherwise, persistent or recurring back pain benefits from a plan to build resilience and prevent flare-ups.
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