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Back Pain

Low back pain affects 4 out of 5 adults during their lifetime. Nearly half of all patients who suffer from an episode of low back pain will have a recurrence within a year.

Back pain is the second most common reason people see a physician and the third most frequent reason for surgery. Thirty percent of adults over the age of 30 have degenerative disc disease and this plays a significant role in making the spine susceptible to back pain. Low back pain is the second most frequent reason (after the common cold) that people under the age of 45 miss work. The vast majority of back problems get better on their own or with non-surgical treatment.


Danger Signals of Back Pain

There are a few signs, however, that may indicate serious spinal problems. If you experience any of these symptoms, seek medical attention immediately.

  • Loss of control of the bowel or bladder, or retention of urine, may indicate potentially dangerous damage to the spine's cauda equina nerves. The cauda equina is a bundle of nerves in the low back where the spinal cord ends. Damage to these nerves can be permanent if not treated aggressively. This problem should be seen the same day by a spine specialist, or in an emergency room.
  • Weakness or numbness in a leg or arm, especially if it is severe-and it is getting worse-also points to nerve damage. This includes "foot drop", a condition where the muscles of the leg and foot are too weak to raise the foot up as the individual attempts to walk. Again, nerve damage associated with these symptoms can be permanent if not treated immediately. This problem should be seen within 24 hours by a spine specialist.
  • Any numbness, pain or tingling that radiates into an arm or leg is also a source for immediate concern and should be seen within 24 hours by a spine specialist.
  • High fever accompanied by back pain, may indicate a possible infection of the spine and should be seen within 24 hours.

Possible Causes of Back Pain

MRI SpineSoft Tissue Injury

Strain occurs with a sudden, stressful injury causing stretching or tearing of the muscles, tendons and/or ligaments in and around the spine. Injury to these soft tissue areas can result in intense back and neck pain, headaches, and/or arm or leg pain.

Muscle Strain

Some research studies note that 80 percent of back and neck pain is caused by muscle strain. Unlike muscles in the legs, which are long and resistant to spasm, the back is composed of short extensor muscles that bridge from vertebra to vertebra. Because these muscles are shorter, they are more prone to spasm. The muscles of the back can be strained with heavy lifting, and discs may herniate, causing inflammation of adjacent nerve roots. Gentle stretching and moderate exercise are recommended to strengthen the muscles of the back to prevent injury. If you have to lift, learn to use proper body mechanics. Use the navigation bar on the left and click on "Lifting without Pain" to see a description of how to safely lift objects.

Lumbar Disc Changes

Many back pain problems could be the result of bulging discs, fissuring, ruptured or herniated discs, or degenerative disc disease.

Bulging Discs

The Annulus and Nucleus exert pressure on nearby nerves.


The Nucleus is squeezed through the opening in the Annulus causing pressure on nearby nerves.

Bone Spurs

Bone spurs and overgrowth of the Ligamentum Flavum cause compression on the nerves.

Spondylolysis & Spondylolisthesis

These problems relate to instability in the joints in the low back. Either from a fall, or a defect, a vertebral bone segment may be in a position to slip out of position, causing back pain.


Scoliosis is a curvature of the spine that can first appear in childhood. It is not known why scoliosis occurs, but it does tend to affect women more than men. The curvature of the spine needs to be assessed because in some cases, extreme curves can place pressure on internal organs - which can shorten lifespan if not treated.

Coccygeal Pain

In rare cases, back pain can originate in the coccyx, the small section of fused bones at the base of the spine. This pain usually results from a direct fall onto the buttocks or pressure from sitting.


A hard fall or severe jolt to the spine as the result of vigorous physical activity or an accident can crack or fracture vertebrae. A cracked vertebrae may put the delicate spinal cord at risk. In some cases, surgery may be required to repair the vertebrae.

Facet Joint

There are joints in your spine just like there are joints in your finger. These joints, called facet joints, allow you to bend forward, backward and from side to side. Spurring at the facet joint can cause the nerve, which exits between the two bones to be pinched. Arthritis of the facet joint may result in back or leg pain.

Sacro-Iliac Joint

The facet joint between the sacrum and ilium is called the sacro-iliac joint. Arthritis of the sacro-iliac joint may result in back or leg pain.

Other Causes

Many other changes in your body can cause back and neck pain. Some of these include menstruation, abnormal tumors, aortic aneurysms and arthritic conditions.

1 American Association of Neurological Surgeons 2 National Health and Nutrition Examination Survery III 3 4 American Association of Orthopaedic Surgeons

Book Resources




Exercise Library neurosurgery and spine center in north dakota, wyoming and nebraska

These stretches and exercises can relieve pain symptoms, strengthen the back and neck, and increase flexibility and resistence to future strain. Learn more.

anatomy library  neurosurgery and spine center in north dakota, wyoming and nebraska

Learn what causes your back or neck pain with medical illustrations and narrated animations. Click here.


Numerous patients have shared their life-changing experiences with the physicians at Black Hills Neurosurgery & Spine. Read more.

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