Why Does My Back Hurt?

Why Does My Back Hurt?

You twist to grab something, or wake up one morning, and there it is:

Back pain.

It might feel like a dull ache, a sharp stab, or pain that shoots down your leg. You may start asking yourself:

• Did I pull a muscle?
• Is this my spine?
• Could it be something serious?

Back pain is very common. Most people will have it at some point in their lives.
The good news: many causes are not dangerous and get better with time.
Still, back pain can be scary, and some symptoms do need quick medical care.

This article explains common reasons your back might hurt, how to spot red flags, and when it’s time to see a doctor.

This information is for general education and is not a substitute for medical advice for your specific situation.

How Your Back Works (In Simple Terms)

Your back is built to be strong and flexible, but that also means it has a lot of parts that can hurt.

Key pieces include:

• Vertebrae – the small bones stacked on top of each other to form your spine
• Discs – soft, gel-like cushions between the vertebrae that act like shock absorbers
• Muscles and ligaments – support the spine and help you move, twist, and bend
• Nerves – carry signals to and from your brain; the largest in the lower back is the sciatic nerve

Because so many structures work together, pain can come from:

• Muscles
• Joints
• Discs
• Nerves
• Or even from organs near your spine

Understanding the basics makes it easier to see what might be going wrong.

Common Everyday Causes of Back Pain

1. Muscle Strain or Sprain

This is one of the most common causes of back pain.

It can happen when you:

• Lift something heavy (especially with poor form)
• Twist suddenly
• Do a new or intense activity your body isn’t used to

Typical features:

• Sore, achy muscles in the back
• Pain that gets worse when you move in certain ways
• Stiffness, especially after sitting or waking up
• Tenderness if you press on the muscles

Most muscle strains improve within days to a few weeks with rest, gentle movement, and basic care.

2. Poor Posture

Spending long hours hunched over:

• A computer
• A phone
• A steering wheel

can strain muscles and joints in your neck, upper back, and lower back.

Typical features:

• Slow, gradual onset of pain
• Dull, aching discomfort
• Worse after long periods of sitting or looking down
• May improve with stretching, posture changes, or standing up

3. Overuse and Weak Core Muscles

If your core and back muscles are weak, they tire easily and can’t support your spine well.

You might notice:

• Soreness after “weekend warrior” activities (yard work, sports, heavy cleaning)
• Stiffness and tightness after new workouts
• Pain that improves as your muscles get stronger and used to the activity

Spine-Related Causes: Discs, Joints, and Nerves

Sometimes pain comes from deeper structures in the spine itself.

1. Herniated (“Slipped”) Disc

A disc herniates when its soft center pushes out through a tear in the outer ring.

This can press on nearby nerves and cause:

• Sharp or burning pain in the lower back
• Pain that travels down the buttock and leg (sciatica)
• Numbness, tingling, or weakness in the leg or foot
• Pain that worsens when coughing, sneezing, or bending

Not all herniated discs cause severe pain, but when they do, symptoms can be intense.

2. Sciatica

Sciatica is not a diagnosis by itself, but a pattern of pain that follows the sciatic nerve.

It usually:

• Starts in the lower back or buttock
• Travels down the back of the leg
• May reach the calf or foot

You might also feel:

• Numbness
• Pins-and-needles sensations
• Weakness in the leg

Sciatica can be caused by a herniated disc or other conditions that pinch the nerve.

3. Arthritis and Wear-and-Tear (Degenerative Changes)

As we age, the joints and discs in the spine can wear down.

This can lead to:

• Osteoarthritis – breakdown of cartilage in the joints
• Degenerative disc disease – discs lose height and flexibility over time

Typical features:

• Stiffness, especially in the morning or after inactivity
• Pain that may improve somewhat with gentle movement
• Chronic, on-and-off pain rather than one brief episode

4. Spinal Stenosis

Spinal stenosis means the spaces inside the spine become more narrow, putting pressure on nerves.

Common features:

• Pain, numbness, or heaviness in the legs when walking or standing
• Relief when bending forward or sitting down
• More common in older adults

When Back Pain Comes from Somewhere Else

Not all back pain starts in the spine or muscles.

Sometimes pain is referred from other organs:

• Kidney problems
  • Kidney stones or infections can cause pain in the side of your back (flank), often on one side
  • May come with fever, blood in the urine, or burning when you pee
• Gynecologic or pelvic conditions (in people with a uterus)
  • Certain conditions can cause low back or pelvic pain, often related to the menstrual cycle or other symptoms
• Abdominal or digestive issues
  • Some stomach, liver, or pancreas problems can cause pain felt in the back

If back pain comes with other strong symptoms—like fever, vomiting, severe abdominal pain, or urinary changes—it’s important to see a doctor.

Back Pain: Normal Strain vs Red-Flag Symptoms

Most back pain from strain or overuse improves with time and simple care.

But some symptoms need urgent medical attention.

Here’s a side-by-side look:

Feature / Symptom	Typical Strain or Mild Back Pain	Red-Flag Symptoms – Call a Doctor Right Away
Onset	After lifting, bending, or new activity	Sudden and severe with no clear cause, or after a major accident
Pain pattern	Achy, sore, may improve slightly day by day	Getting much worse, especially at night or when resting
Location	Mostly in back muscles	Back pain with pain, numbness, or weakness in one or both legs
Other symptoms	Stiffness, mild muscle soreness	Fever, chills, unexplained weight loss, or feeling very unwell
Bladder/bowel changes	None	Trouble controlling urine or stool, or trouble starting to pee
Duration	Improves over 1–2 weeks with self-care	Lasts more than a month or keeps returning
History / risk factors	Healthy person, recent known strain	History of cancer, serious infection, IV drug use, or major trauma

If you fall into the “red-flag” column, you should contact a doctor right away or go to urgent care/ER, depending on how severe the symptoms are.

How to Think About Your Back Pain

Ask yourself a few questions:

• When did the pain start?
  • After lifting, twisting, or a long day of work?
  • Out of the blue?
• Where is the pain?
  • Only in the back?
  • Does it travel into your buttock, leg, or groin?
• What makes it better or worse?
  • Does it feel better with gentle movement or rest?
  • Worse with certain positions, coughing, or sneezing?
• Are there other symptoms?
  • Fever, chills, weight loss
  • Numbness, tingling, or weakness
  • Difficulty controlling your bladder or bowels

Your answers can give clues, but they don’t replace a medical exam.
If you are worried or unsure, it’s always okay to call a doctor.

When to See a Doctor or Get Urgent Help

Call or See a Doctor Soon (Within Days) If:

• Your back pain lasts more than 2–4 weeks
• The pain keeps coming back
• Pain is strong enough to interfere with sleep or daily activities
• You have a history of osteoporosis and develop sudden pain after a minor strain or fall
• Over-the-counter pain methods (rest, gentle movement, basic medications) are not helping at all

Go to Urgent Care or the ER Right Away If:

• You suddenly cannot feel or move one or both legs normally
• You lose control of your bladder or bowel, or cannot pee at all
• The pain is severe and comes with fever, chills, or unexplained weight loss
• You’ve had a serious fall, car accident, or other major injury
• You have back pain plus a history of cancer, serious infection, or IV drug use and feel very unwell

These may be signs of serious conditions that need rapid treatment.

At-Home Care: What Often Helps Mild Back Pain

For mild to moderate back pain from muscle strain or overuse, many people find relief with simple steps, as long as they are medically safe for them.

Always follow your own doctor’s instructions first.

Helpful strategies may include:

• Short-term rest
  • Avoid heavy lifting and twisting for a few days
  • But try not to stay in bed all day; too much rest can slow recovery
• Gentle movement
  • Short walks
  • Light stretching that does not increase pain
  • Changing positions often (don’t sit for hours without getting up)
• Ice or heat
  • Ice may help in the first 1–2 days after an injury
  • Heat (warm shower, heating pad) can relax tight muscles later on
  • Use a barrier (like a towel) to protect your skin
• Over-the-counter pain relievers
  • Some people use non-prescription pain medication
  • Follow the label and any guidance from your doctor or pharmacist
  • Not everyone can safely take these (for example, due to kidney, liver, or stomach issues), so check if you’re unsure

If home care is not helping, or your pain is getting worse, talk with a medical professional.

What Doctors Might Do for Back Pain

When you see a doctor, they will usually:

1. Take a detailed history
   • When did the pain start?
   • What makes it better or worse?
   • Any injuries or other health problems?
2. Do a physical exam
   • Check your range of motion
   • Press on different areas to find tender spots
   • Test your reflexes, strength, and sensation in your legs
3. Decide if you need imaging
   • Many people with back pain do not need X-rays or MRIs right away
   • Imaging is often reserved for red-flag symptoms or pain that doesn’t improve over time
4. Recommend a plan
   • Physical therapy to improve strength, flexibility, and posture
   • Medications if appropriate
   • Advice on activity, work, and exercise
   • In some cases, referral to a spine specialist or pain management doctor

Only a small percentage of people with back pain ever need surgery.

Preventing Future Back Pain

You may not be able to prevent every episode of back pain, but you can lower your risk.

Helpful habits include:

• Strengthen your core and back muscles
  • Regular, gentle exercises for your abdomen, hips, and back
  • Physical therapy or guided programs if needed
• Move regularly
  • Avoid sitting for long periods without breaks
  • Stand, stretch, or walk for a few minutes every hour
• Use good posture
  • Adjust your chair, desk, and screen so you’re not hunching
  • Keep your phone at eye level instead of looking down
• Lift safely
  • Bend at your hips and knees, not your waist
  • Keep the object close to your body
  • Avoid twisting while lifting
• Sleep smart
  • Use a mattress that supports your spine comfortably
  • Try sleeping on your side with a pillow between your knees, or on your back with a pillow under your knees
• Take care of overall health
  • Manage weight, stress, and chronic conditions
  • Stay active in ways your doctor approves

Small changes over time can make a big difference.

Key Takeaways

• Back pain is very common and often comes from muscle strain, posture, or age-related changes in the spine.
• Many cases improve with time, gentle movement, and simple care, without needing surgery.
• Some symptoms—like weakness, numbness, fever, weight loss, or bladder/bowel problems—are red flags and need urgent medical attention.
• Paying attention to how the pain started, where it goes, and what makes it better or worse can give useful clues, but a doctor’s exam is still important when you’re unsure.
• Healthy habits—like regular movement, core strength, good posture, and safe lifting—can help prevent or lessen future back pain.
• When in doubt, or if your pain is strong, unusual, or lasting, it’s always reasonable to talk with a healthcare professional.