Most people with short-term back pain recover without ever finding out exactly what went wrong. But especially when pain lingers, discovering the underlying source of the pain can help guide treatment. And understanding what can cause your back to hurt is key to preventing a recurrence.

The following are the most common causes of back pain. 

Muscle Injuries

Overstretched or injured muscles, tendons, or ligaments can result in strains, sprains, or spasms. Poor posture, prolonged sitting, strenuous work, and repetitive action such as throwing a ball or weeding a garden can stress so-called soft tissues in your back. In our survey, this was the most common cause of back pain, affecting more than one-third of respondents.

Degenerative Changes

As you age, the gel-like disks cushioning the bones of your spine and the cartilage lining the joints can begin to wear. That allows the bones to rub against one another, causing osteoarthritis. Some degeneration of this kind is harmless and unavoidable. Imaging studies show that almost everyone older than 60 has signs of spinal wear and tear. But most never report significant pain.

Herniated, or Slipped, Disks

Lifting, pulling, bending, or twisting puts pressure on the disks. That pressure can cause them to bulge or slip. When a bulging disk in the lower spine irritates the sciatic nerve, the sharp pain, called sciatica, is often excruciating and can radiate down a leg even when there’s no back pain. Slouching at the waist can worsen symptoms.

Spinal Stenosis

The spine responds to degenerative changes by growing new bone in the joints and thickening the ligaments to provide better support. But over time those bone spurs and thickened ligaments narrow the space around the spinal cord and can irritate nerves. Symptoms include numbness, weakness, or cramping in the back, buttocks, arms, or legs. Walking usually worsens symptoms; rest or leaning forward tends to offer relief.

Spinal Instability

When disks and joints wear, they don’t do as good a job supporting the spine. As a result, vertebrae move more than they should. In some cases a bone slides forward, causing a condition called spondylolisthesis. Symptoms often come and go suddenly, sometimes shifting from one side of the body to the other, and can include a feeling of weakness in the legs with prolonged standing or walking.

Editor's Note: This article also appeared in the June 2017 issue of Consumer Reports magazine. This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).