lower back pain : Common conditions that cause lower back pain

For patients with low back pain that lasts longer than two weeks to three months, or with predominantly leg pain, a more specific and definable problem is often the source of pain. Several types of low back and leg pain tend to be more common in either younger or older adults.

Common types of low back pain for young adults (< 60 years old)

Leg pain and possible numbness
Pain that radiates through the buttocks, as well as pain and possibly numbness that radiates down to the foot, is frequently caused by a disc herniation in the lumbar (lower) spine. This type of pain is usually worse after a long period of standing or sitting.

• See also Lumbar disc herniation

Mechanical low back pain
Low back pain in young adults that is caused by movement (such as bending forward, running) is commonly caused by a syndrome called degenerative disc disease. This condition can result from a twisting injury that weakens the disc. The low back pain symptoms of degenerative disc disease can become chronic and may tend to fluctuate and at times become significantly worse.

• See also Degenerative disc disease

Low back pain (and possibly leg pain) that worsens when standing or walking
Sometimes a vertebral body in the low back slips forward, causing stress on the disc, which in turn may cause low back pain and may sometimes cause leg pain. These painful symptoms are sometimes caused by a stress fracture that occurs at a young age.|

• See also Isthmic spondylolisthesis

Common types of low back pain for older adults (>60 years old)

Low back pain that is worse in the morning and in the evening, and stiffness
Low back pain that is most pronounced first thing in the morning and later in the day is often caused by facet joint osteoarthritis (degenerative arthritis), a condition that involves breakdown of the cartilage between the facet joints in the back. The pain and stiffness is a result of the lack of cartilage between the joints.

• See also Facet joint osteoarthritis

Pain down the legs when walking and standing upright
Leg pain that occurs when walking, and increases with more walking, can be caused by conditions such as lumbar spinal stenosis or degenerative spondylolisthesis. Both conditions place pressure on the nerves at the point where they exit the spine. Standing upright, such as in normal walking, increases pressure on the nerve and results in leg pain.

• See also Lumbar spinal stenosis and Degenerative spondylolisthesis

By: Peter F. Ullrich, Jr., MD
October 1999 (Updated January 3, 2002)