I have lots of friends and family who have back pain that seems to go away with time. Most of these people never see a doctor, so they don’t know what’s causing the problem. Is there a common problem that causes so much back trouble for so many people?

Problems with low back pain (LBP) affect up to 80 per cent of the adult population sometime in their lives. Older adults are subject to degenerative changes from wear and tear. The discs, joints, and ligaments can be involved.

Narrowing of the spinal canal from age-related changes can cause a condition called spinal stenosis. Pressure on the spinal cord inside the canal leads to LBP that can travel down the legs. People with this problem have trouble walking and standing up straight.

Tumors, fractures, and infection are other causes of LBP. These are fairly rare and require treatment to get better. The majority of patients suffer from what’s called mechanical LBP. This means the moving parts and soft tissue structures are most likely the problem. We don’t always know exactly what those are for each person. These are the folks who seem to get better with time no matter what they do (or don’t do) to treat it.

Doctors and physical therapists are working together to find ways to classify back pain. The goal is to put patients into subgroups based on common features. Subgroups of people with LBP would help guide treatment based on each contributing factor. In the future we expect to see better ways to diagnose, classify, and treat LBP.