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Doctors have many ideas about what causes low back pain, but no explanation applies to everyone. It may be related to damage to or aging of the disc, muscular problems, arthritis of the spine, problems with tendons or ligaments in and around the spine or malpositioning of vertebrae. Low back pain is sometimes caused by:

• Excessive stress to the back, such as lifting something heavy
• Minimal movement, such as bending or reaching for something

Occasionally, it happens with no cause.

Low back pain can happen after an injury, especially if there is a fracture of the spine. Some other factors associated with low back pain are smoking and long term exposure to vibration.

Obesity may also be related. The symptoms of low back pain vary in some ways and are similar in others. Most people find that reclining or lying down will improve their pain and after their initial severe episode, many will be able to rest at night without severe pain. Most people are worse when they bend over to pick something up. Some get relief from arching backward (extending the back). Leg pain also can be part of the problem. The pain is most common in the back or outer side of the thigh, and can go all the way to the foot. Pain that goes to the foot is called sciatica because it is pain that follows the course of the sciatic nerve. Sciatica is often made worse by coughing or sneezing.

With an acute episode, back pain can be very severe for a few days or a week, and then will often improve. By 2 weeks to 4 weeks, the large majority of people are much better. Individuals vary greatly in length of time between episodes, length of each episode and intensity of each episode, and how they cope with the pain.