Low Back Pain Causes


Low Back Pain Causes, Differential Diagnosis of Low Back Pain

  • Causes
  • Mechanical (90%)
  1. Lumbosacral strain (70-90% of Acute Low Back Pain)
    1. Isolated Trauma or repetitive overuse
  2. Lumbar Spondylosis (10%)
    1. Chronic disc degeneration and secondary foraminal narrowing in over age 40 years old
  3. Lumbar Disc Herniation (5%)
    1. Occurs at L4-5 or L5-S1 in 90-95% of cases
  4. Spondylolysis (<5%)
    1. Young athletes with frequent lumbar hyperextension (e.g. gymnastics, football)
  5. Vertebral Compression Fracture (4%)
    1. Vertebral Fracture and collapse, typically due to Osteoporosis, and most commonly at L1 and L4
  6. Spondylolisthesis (3-4%)
    1. Vertebral slippage anteriorly, at L5 in 90% of cases, with Leg Pain, Paresthesias and weakness
  7. Lumbar Spinal Stenosis (3%)
    1. Narrowing of lumbar spinal canal with back pain and leg numbness, weakness better with rest
    2. Includes Cauda Equina Syndrome (requiring emergent intervention)
  8. Spondylosis
    1. Chronic disk degeneration
    2. Facet joint Arthropathy
  9. Sacroiliac Joint
    1. Sacroiliac Joint Dysfunction
    2. Spondyloarthropathy