What Causes Back Pain? A Complete Guide
Medically reviewed by Kenneth Willeford, MD — Coastal Carolinas Interventional Spine
Back pain is one of the most common reasons people visit a doctor, and it can come from many different sources — muscles, discs, joints, nerves, or bone. Understanding what’s actually causing your pain is the first step toward finding the right treatment, rather than guessing with rest, over-the-counter medication, or generic stretches that may not address the real problem.
Below, we break down the most common causes of back pain, how each one typically feels, and what treatment approaches tend to help. If you’re in the North Myrtle Beach, SC or Supply, NC area and dealing with ongoing back pain, our team at Coastal Carolinas Interventional Spine can help pinpoint the exact source and build a plan to treat it.
Quick Answer: The Most Common Causes of Back Pain
- Muscle or ligament strain
- Herniated or bulging discs
- Degenerative disc disease
- Facet joint dysfunction (spinal arthritis)
- Sciatica (nerve compression)
- Spinal stenosis
- Osteoporosis and compression fractures
- Poor posture and prolonged sitting
- Scoliosis and other spinal deformities
- Injury or trauma
We’ll cover each of these in detail below.
1. Muscle or Ligament Strain
The most common cause of sudden back pain is a simple muscle or ligament strain, often from lifting something incorrectly, twisting awkwardly, or overexerting during exercise or yard work.
What it feels like: Localized soreness or stiffness, often worse with movement and better with rest. Pain usually stays in one area rather than radiating down the leg.
How it’s typically treated: Most muscle strains improve within a few weeks with activity modification, anti-inflammatory medication, and physical therapy. Pain that doesn’t improve after several weeks, or that keeps recurring, is worth having evaluated — it can be a sign that something more structural is contributing to the problem.
2. Herniated or Bulging Discs
The discs between your vertebrae act as cushions. When the outer layer of a disc weakens or tears, the soft inner material can bulge or leak out, sometimes pressing on nearby nerves.
What it feels like: Sharp or burning pain that often radiates from the lower back into the buttock and leg (or from the neck into the arm, for cervical disc issues). Numbness, tingling, or weakness in the leg or foot is common when a nerve is involved.
How it’s typically treated: Many disc issues respond well to non-surgical care, including epidural steroid injections, targeted physical therapy, and activity modification. Imaging such as an MRI is usually needed to confirm a disc herniation and its exact location.
3. Degenerative Disc Disease
As we age, spinal discs naturally lose hydration and elasticity, becoming thinner and less able to absorb shock. This is a normal part of aging, but it can still cause significant pain for some people.
What it feels like: A dull, chronic ache in the lower back, often worse with prolonged sitting or standing and somewhat relieved by changing positions. Pain may flare periodically rather than being constant.
How it’s typically treated: Because this is a structural, ongoing process rather than an acute injury, treatment often focuses on reducing inflammation and improving spinal stability through injections, physical therapy, and in some cases radiofrequency ablation for long-term relief.
4. Facet Joint Dysfunction (Spinal Arthritis)
The facet joints connect each vertebra to the ones above and below it, allowing the spine to bend and twist. Like any joint, they can develop arthritis over time.
What it feels like: Pain that is typically worse with standing or arching backward, and often improves when sitting or bending forward. This is one of the more distinctive patterns in back pain — pain that shows up with standing but not sitting often points specifically to the facet joints.
How it’s typically treated: Diagnostic facet joint injections can confirm the source of pain, and radiofrequency ablation is a common next step for longer-lasting relief when injections work but wear off.
5. Sciatica
Sciatica isn’t a condition on its own — it’s a symptom caused by irritation or compression of the sciatic nerve, most often from a herniated disc, spinal stenosis, or a tight piriformis muscle.
What it feels like: Pain that radiates from the lower back or buttock down the back of one leg, sometimes reaching the foot. It’s often accompanied by tingling, numbness, or a burning sensation.
How it’s typically treated: Treatment depends on the underlying cause, but often includes physical therapy, epidural steroid injections, and nerve-focused treatments to reduce inflammation around the nerve root.
6. Spinal Stenosis
Spinal stenosis is a narrowing of the spinal canal that can put pressure on the spinal cord or nerve roots. It’s most common in adults over 50 and often develops gradually from arthritis or disc degeneration.
What it feels like: Pain, numbness, or cramping in the legs that worsens with walking or standing and improves with sitting or leaning forward (often described as needing to “lean on a shopping cart” for relief).
How it’s typically treated: Epidural injections, physical therapy, and activity modification are common first steps. More advanced cases may require minimally invasive procedures to relieve pressure on the nerves.
7. Osteoporosis and Compression Fractures
Osteoporosis weakens bone density over time, making the vertebrae more susceptible to compression fractures — sometimes from something as minor as bending, coughing, or a small fall.
What it feels like: Sudden, sharp back pain, often in the mid-to-lower back, that can worsen with standing or walking. Some compression fractures cause a noticeable loss of height or a forward-curving posture over time.
How it’s typically treated: Treatment focuses on both pain relief and bone health, and may include bracing, minimally invasive procedures like kyphoplasty, and medication or lifestyle changes to slow further bone loss.
8. Poor Posture and Prolonged Sitting
Extended periods of sitting, especially with poor ergonomic support, place ongoing strain on the lower back and can accelerate wear on the discs and joints.
What it feels like: A dull, generalized ache that builds throughout the day and tends to improve with movement, stretching, or changing position.
How it’s typically treated: Ergonomic adjustments, regular movement breaks, and core-strengthening exercises are usually the first line of defense. Persistent pain despite these changes may point to an underlying structural cause worth evaluating.
9. Scoliosis and Spinal Deformities
An abnormal curvature of the spine — whether present from adolescence or developing later in life (degenerative scoliosis) — can create uneven stress on the muscles, discs, and joints.
What it feels like: Asymmetric pain, muscle fatigue, and sometimes visible unevenness in the shoulders or hips.
How it’s typically treated: Mild cases may only need monitoring and physical therapy, while more significant curves may benefit from bracing or, in select cases, surgical evaluation.
10. Injury or Trauma
Falls, car accidents, and sports injuries can cause anything from soft tissue damage to fractures or disc injuries, and pain may not always appear immediately after the event.
What it feels like: Varies widely depending on the injury, from localized soreness to sharp, severe pain with movement.
How it’s typically treated: Any back pain following a trauma should be evaluated promptly, since imaging is often needed to rule out fractures or significant disc or nerve involvement.
When Should You See a Specialist for Back Pain?
Most minor back pain improves within a few weeks with rest and self-care. It’s time to see a specialist if you experience:
- Pain lasting longer than 2–4 weeks
- Pain that radiates into the arms or legs
- Numbness, tingling, or weakness
- Pain that disrupts sleep or daily activities
- Pain following a fall or injury
- A history of osteoporosis with new or worsening back pain
How Coastal Carolinas Interventional Spine Can Help
Identifying the true source of back pain requires more than guesswork — it takes a careful evaluation of your symptoms, movement patterns, and, when needed, diagnostic imaging. At Coastal Carolinas Interventional Spine, we specialize in pinpointing the exact cause of your pain and building a personalized, non-surgical treatment plan designed for lasting relief.
If you’re experiencing ongoing back pain in North Myrtle Beach, SC or Supply, NC, schedule a consultation with our team to find out what’s really causing your pain — and what we can do about it.
Schedule a Consultation | Call (910) 755-6060
Frequently Asked Questions
What is the most common cause of back pain? Muscle and ligament strain is the most common cause of sudden back pain, though chronic or recurring back pain is more often related to disc degeneration, arthritis of the facet joints, or nerve compression.
Can stress cause back pain? Yes. Stress can cause muscles in the back to tense up, which may contribute to or worsen existing back pain, especially in the neck and lower back.
When is back pain a sign of something serious? Back pain accompanied by numbness, leg weakness, loss of bladder or bowel control, unexplained weight loss, or fever should be evaluated promptly, as these can indicate a more serious underlying condition.
Why does my back hurt more when I stand than when I sit? This pattern often points to facet joint dysfunction or spinal stenosis, both of which tend to worsen with standing or walking and improve with sitting or leaning forward.
Call today to schedule a consultation and take the first step toward lasting relief.
Coastal Carolinas Interventional Spine
416 Main Street
North Myrtle Beach, SC 29582
(910) 755-6060
https://www.coastalcarolinasinterventionalspine.com/
[email protected]
Coastal Carolinas Integrated
10 Doctor Circle
Suite #2
Supply, NC 28462