Not all back pain comes from daily habits or posture. For some people, underlying medical conditions play a role. Herniated discs, arthritis, and spinal stenosis are some of the most common causes of persistent low back discomfort. Understanding these conditions doesn’t mean you need to diagnose yourself — but knowing the basics can help you have better conversations with your healthcare provider and take practical steps toward relief.

Why Knowing the Cause Matters

Low back pain is one of the most common health problems worldwide, but it’s not a single condition. It’s a symptom that can come from different sources: muscles, joints, discs, or nerves [1].

While most cases improve with lifestyle changes and simple care, certain conditions need more attention. By learning about the most common ones, you’ll know what to look out for and when to seek medical help. For a full overview of other contributors, see our main guide on low back pain: causes, symptoms, and prevention.

Herniated or Bulging Discs

The spine is made of bones (vertebrae) cushioned by discs — soft, gel-like pads that act as shock absorbers. Sometimes, these discs can bulge or rupture, pressing on nearby nerves. This is known as a herniated disc.

What it feels like:

• Pain that radiates down the leg (sciatica).

• Tingling or numbness in the legs or feet.

• Pain that worsens with sitting or bending forward.

Most herniated discs occur in the lower back, especially between the L4-L5 or L5-S1 vertebrae [2].

Why it happens:

• Natural aging and wear (degenerative disc changes).

• Heavy lifting or twisting injuries.

• Prolonged sitting with poor posture.

For more on leg pain linked to discs, see understanding sciatica: signs & relief options.

Spinal Arthritis (Osteoarthritis of the Spine)

Just like knees and hips, the joints in your spine can develop arthritis over time. Spinal osteoarthritis occurs when cartilage between the facet joints breaks down, leading to stiffness, inflammation, and pain.

What it feels like:

• Aching pain in the lower back.

• Stiffness, especially in the morning or after sitting.

• Pain that improves with gentle activity but worsens with overuse.

Spinal arthritis becomes more common with age, but lifestyle factors like obesity and inactivity can also play a role [3].

Why it matters: Arthritis can sometimes contribute to another condition called spinal stenosis, where spaces in the spine narrow and put pressure on nerves.

If you’re unsure whether stiffness is from daily habits or arthritis, see when to see a doctor for back pain.

Spinal Stenosis

Spinal stenosis means the spinal canal (the space nerves travel through) becomes narrower. This narrowing can pinch nerves, leading to pain, numbness, or weakness.

What it feels like:

• Pain or cramping in the legs when walking or standing.

• Relief when bending forward or sitting (sometimes called the “shopping cart sign”).

• Numbness or weakness in the lower body.

Spinal stenosis is often linked to arthritis, herniated discs, or thickened ligaments that crowd the spinal canal [4].

Why it matters: It can significantly affect mobility. Physical therapy and posture-friendly exercise often help manage symptoms, while severe cases may require medical procedures.

For gentle ways to keep moving, see best exercises for a healthy spine.

Osteoporosis and Compression Fractures

Osteoporosis makes bones weaker and more likely to fracture. In the spine, this can lead to compression fractures, where a vertebra partially collapses.

What it feels like:

• Sudden, sharp back pain (often from a minor movement).

• Loss of height over time.

• Curved or hunched posture.

Women after menopause and older adults are at higher risk [5].

Why it matters: Compression fractures can severely affect quality of life, but early detection and treatment of osteoporosis can help prevent them.

If you’ve noticed new height loss or posture changes, it’s worth checking with a doctor.

Other Possible Causes

While the conditions above are the most common, other factors can contribute to back pain:

• Scoliosis: Abnormal spinal curvature.

• Sacroiliac joint dysfunction: Pain where the spine meets the pelvis.

• Inflammatory conditions: Such as ankylosing spondylitis, which typically starts in younger adults.

Though less common, these conditions highlight why persistent pain deserves a proper evaluation.

When to Seek Medical Help

Most back pain improves with lifestyle changes, posture adjustments, and gentle exercise. But some red flags mean you should check in with a doctor:

• Pain lasting longer than a few weeks.

• Numbness, tingling, or weakness in the legs.

• Pain accompanied by weight loss, fever, or unexplained fatigue.

• Loss of bladder or bowel control (seek immediate care).

See our post on when to see a doctor for back pain for more guidance.

Managing Conditions Day to Day

Even if a medical condition contributes to your back pain, there are many ways to manage it:

• Exercise regularly: Core strengthening and gentle aerobic activity help stabilize the spine. Learn more in best exercises for a healthy spine.

• Ergonomic adjustments: A supportive workstation and smart movement habits reduce daily strain. See ergonomic hacks for home and office.

• Improve sleep posture: The right mattress and pillow support recovery. Explore the role of sleep in back health.

• Address stress: Stress can amplify pain perception and muscle tension. See the mind-body connection between stress and low back pain.

Bringing It All Together

Back pain can have many causes, but herniated discs, arthritis, spinal stenosis, and osteoporosis are among the most common medical contributors. Understanding these conditions can help you recognize patterns, make lifestyle changes, and know when to seek professional advice.

You don’t need to figure everything out on your own. By combining medical guidance with everyday strategies — like good posture, smart ergonomics, exercise, and stress management — you can often keep pain under control and stay active.

For the bigger picture, return to our main article on low back pain: causes, symptoms, and prevention.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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References

1. Hartvigsen J, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–2367. doi:10.1016/S0140-6736(18)30480-X

2. Jordan J, et al. Herniated lumbar disc. BMJ Clin Evid. 2011;2011:1118. PMID: 21711958

3. Kalichman L, Hunter DJ. Diagnosis and conservative management of degenerative lumbar spondylolisthesis. Eur Spine J. 2008;17(3):327–335. doi:10.1007/s00586-007-0543-3

4. Katz JN, Harris MB. Lumbar spinal stenosis. N Engl J Med. 2008;358(8):818–825. doi:10.1056/NEJMcp0708097

5. Lindsay R, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001;285(3):320–323. doi:10.1001/jama.285.3.320