There are many causes of<unk> , including blood vessels, internal organs, infections, mechanical, and autoimmune causes. Approximately 90 percent of people with<unk>  are diagnosed with nonspecific acute<unk>  in which there is no identifiable underlying pathology. In approximately 10 percent of people, a cause can be identified through diagnostic imaging. Less than 2 percent of cases are attributed to secondary factors, with metastatic cancers and serious infections, such as spinal osteomyelitis and epidural abscesses, accounting for around 1 percent. +Common causes Cause % of people with<unk>  Nonspecific 90% Vertebral compression fracture 4% Metastatic cancer 0.7% Infection 0.01% Cauda equina 0.04% Nonspecific In as many as 90 percent of cases, no physiological causes or abnormalities on diagnostic tests can be found. Nonspecific<unk>  can be due to<unk>  strain/sprain. The cause is peripheral injury to muscle or ligaments. The patient may or may not recall the cause. The pain can present acutely but in some cases can persist, leading to chronic pain. Chronic<unk>  in people with otherwise normal scans can result from central sensitization, where an initial injury causes a longer-lasting state of heightened sensitivity to pain. This persistent state maintains pain even after the initial injury has healed. Treatment of sensitization may involve low doses of anti-depressants and directed rehabilitation such as physical therapy. Spinal disc disease Spinal disc disease occurs when the nucleus pulposus, a gel-like material in the inner core of the vertebral disc, ruptures. Rupturing of the nucleus pulposus can lead to compression of nerve roots. Symptoms may be unilateral or bilateral, and correlate to the region of the spine affected. The most common region for spinal disk disease is at L4–L5 or L5–S1. The risk for lumbar disc disease is increased in overweight individuals due to the increased compressive force on the nucleus pulposus, and is twice as likely to occur in men. A 2002 study found that lifestyle factors such as night shift work and lack of sporting activity can also increase the risk of lumbar disk disease. Lumbar disc herniation Severe spinal cord compression is considered a surgical emergency and requires decompression to preserve motor and sensory function. Cauda equina syndrome refers to severe compression of the cauda equina and presents initially with pain followed by motor and sensory. Bladder incontinence is seen in later stages of the cauda equina syndrome. Degenerative disease Spondylosis, or degenerative arthritis of the spine, occurs when the intervertebral disc undergoes degenerative changes, causing the disc to fail at cushioning the vertebrae. There is an association between intervertebral disc space narrowing and lumbar spine pain. The space between the vertebrae becomes more narrow, resulting in compression and irritation of the nerves. Spondylolithesis is the anterior shift of one vertebra compared to the neighboring vertebra. It is associated with age-related degenerative changes as well as trauma and congenital anomalies. Spinal stenosis can occur in cases of severe spondylosis, spondylotheisis and age associated thickening of the ligamentum flavum. Spinal stenosis involves narrowing of the spinal canal and typically presents in patients greater than 60 years of age. Neurogenic claudication can occur in cases of severe lumbar spinal stenosis and presents with symptoms of pain in the lower<unk> , buttock or leg that is worsened by standing and relieved by sitting. Vertebral compression fractures occurs in 4 percent of patients presenting to primary care with low<unk> . Risk factors include age, female gender, history of osteoporosis, and chronic glucocorticoid use. Fractures can occur due to trauma but in many cases can be asymptomatic. Infection Common infectious causes of<unk>  include osteomyelitis, septic diskitis, paraspinal abscess, and epidural abscess. Infectious causes that lead to<unk>  involve various structures surrounding the spine. Osteomyelitis is the bacterial infection of the bone. Vertebral osteomyelitis is most commonly caused by staphylococci. Risk factors include skin infection, urinary tract infection, IV catheter use, IV drug use, previous endocarditis, and lung disease. Spinal epidural abscess is also commonly caused by severe infection with bacteremia. Risk factors include recent epidural, IV drug use, or recent infection. Cancer Spread of cancer to the bone or spinal cord can lead to<unk> . Bone is one of the most common sites of metastatic lesions. Patients typically have a history of malignancy. Common types of cancer that present with<unk>  include multiple myeloma, lymphoma, leukemia, spinal cord tumors, primary vertebral tumors, and prostate cancer.<unk>  is present in 29% of patients with systemic cancer. Unlike other causes of<unk>  which commonly affect the lumbar spine, the thoracic spine is most commonly affected. The pain can be associated with systemic symptoms such as weight loss, chills, fever, nausea and vomiting. Unlike other causes of<unk> , neoplasm-associated<unk>  is constant, dull, poorly localized, and worst with rest. Metastasis to the bone also increases the risk of spinal cord compression or vertebral fractures which requires emergent surgical treatment. Autoimmune<unk>  can be caused by the vertebrae compressing the intervertebral discs. Inflammatory arthritides such as ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, and systemic lupus erythematosus can all cause varying levels of joint destruction. Among the inflammatory arthritides, ankylosing spondylitis is most closely associated with<unk>  due to the inflammatory destruction of the bony components of the spine. Ankylosing spondylitis is common in young men and presents with a range of possible symptoms such as uveitis, psoriasis, and inflammatory bowel disease. Referred pain<unk>  can also be due to referred pain from another source. Referred pain occurs when pain is felt at a location different from the source of the pain. Disease processes that can present with<unk>  include pancreatitis, kidney stones, severe urinary tract infections, and abdominal aortic aneurysms. Risk factors Heavy lifting, obesity, sedentary lifestyle, and lack of exercise can increase a person's risk of<unk> . People who smoke are more likely to experience<unk>  than others. Poor posture and weight gain in pregnancy are also risk factors for<unk> . In general, fatigue can worsen pain. A few studies suggest that psychosocial factors such as on-the-job stress and dysfunctional family relationships may correlate more closely with<unk>  than structural abnormalities revealed in X-rays and other medical imaging scans.
Back pain
Low back pain
Radicular pain
Pelvic pain
Xiphodynia
Pelvic girdle pain
Knee pain
Middle back pain