by Melissa Yuan-Innes, M.D. and author of The Emergency Doctor’s Guide to a Pain-Free Back: Fast Tips and Exercises for Healing and Relief.
What is back pain a symptom of?
- Muscle strain: : the most common culprit. You strained or even tore the muscles in your back. Happens to athletes, couch potatoes, weekend warriors…we all hurt muscles at one point or another.
- Soft tissue injury, like ligaments (which hold two bones together) and tendons (which connect muscle to bone) can get inflamed, pulled, or sheared off.
Together, muscle and soft tissue injuries probably account for 70 percent of pain. - Bone (vertebrae) problem. About 4 percent of back pain comes from osteoporotic fractures.
4. Discs
Ah, the intervertebral discs. The cushiony discs between the bones that can squish like a jelly doughnut. Everyone always asks, “Is it my disc?” But actually, only 4 percent of back pain patients have a disc herniation.
5. Facet Joints: If you think of the vertebrae like Lego bricks locking into each other, the facet joints are the hook-ups in the back.
When the discs start to wear down, these joints wear down, too, and get osteoarthritis[1]. It’s estimated that degeneration of facet and discs together account for about 10 percent of back pain patients.
Neural means nerve, and stenosis means the bone is narrowing down, but which nerve and which bone are you talking about?
6a. Foraminal stenosis: narrowing of the little tunnels where your nerve roots exit your spinal cord.
6b. Spinal stenosis: narrowing of the canal for the actual spinal cord. About 3 percent of people have spinal stenosis.
In other words, your spinal cord or spinal nerve roots are being squeezed by bone. Sounds scary, but usually it just means that the bone hole is a bit smaller, yet not pressing on the spinal cord or roots, which is really the end point we’re interested in. This is something that happens over time, gradually. Arthritis, basically.
So there you have it. Six causes of back pain.

Preorder ebook now at $5.99 (regular price $9.99). Trade paperback also available. Both launch April 21st.
Remember, I’m a doctor, but I’m not your doctor, so you’ll have to consult your own health care practitioner.
For more details, preorder The Emergency Doctor’s Guide to a Pain-Free Back: Fast Tips and Exercises for Healing and Relief at 40% off, as well as Jack Stern’s book, Ending Back Pain.
You may also want to join my back pain site for free worksheets and videos that supplement the book.
[1] Harris RI, Macnab I. Structural changes in the lumbar intervertebral discs; their relationship to low back pain and sciatica. J Bone Joint Surg Br. 1954 May. 36-B(2):304-22.

Dr. Melissa Yuan-Innes is an emergency physician with a special interest in back pain and health education. Her publications include lead authorship of a paper on healing spinal wounds in the journal Spine.
Upcoming appearances:
OTTAWA: Chapters Rideau April 21 @ 7 p.m. with Crime Writers of Canada
CORNWALL: Cornwall and Area Pop Event, April 23-24
BRANTFORD: Mystery Guest of Honour, Brantford Library, May 11
Temporary note:
For my newsletter subscribers, I created a thank you page with the opening of HUMAN REMAINS, the fifth Hope Sze novel, which was supposed to be hidden, but was accidentally broadcast to my blog followers and perhaps to the world at large. So now the page is password-protected.
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Louise, it’ll *inspire* you to make your back pain go away. Although if you keep popping out babies, that’s an extra challenge. 😉
P.S. for everyone: Amazon.ca http://amzn.to/1RLCUFK lists it as unavailable, but if you click on either the Kindle or paperback, you can add it to your cart.
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Ooh! Happy to hear “must read,” but sorry to hear that you need it, Dave McSween. I suspect catching enormous fish must weigh on your back.
It was the years of full time snowboarding, lol, including one compression fracture…oh well, you only live once, lol, but I should have treated my back better for sure
Dang! You must’ve had some good tricks. My son makes fun of my cautious snowboarding. But yeah, it’s never too late to look after your back.
I taught snowboarding for 15 years including 5 seasons at Whistler
Repeat: dang!
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My Kindle copy arrived in the night. As it happpens, I don’t currently suffer from back pain but the advice is good and the book is entertaining to read. Well done!
Hooray! Thanks for reading it, Pierre. I know you literally have a thousand books to read, so I appreciate your support and praise even though you don’t currently have back pain. Well done, you!
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