Some back pain is due to medical conditions that affect the spine
Some of the less common medical conditions that can affect the spine and lead to back pain include ankylosing spondylitis, osteomalacia, spondylolysis, spondylolisthesis, and vertebral osteomyelitis.
Ankylosing Spondylitis
This condition is a chronic inflammation of the facet joints and the joints located between the back wall of the pelvis and the hip (the sacroiliac joints). Inflammation may also involve locations where ligaments and tendons attach to bone. In severe cases of ankylosing spondylitis, the vertebrae may become fused together, resulting in rigidity and a stooped posture.
Osteomalacia
Bone is mostly composed of collagen but requires the minerals calcium and phosphorus for strength. Osteomalacia develops when the bones soften because of a lack of these minerals.
The most common cause of osteomalacia is vitamin D deficiency. Many older people suffer from a vitamin D deficiency. Vitamin D is essential for absorption of calcium and phosphorus. Fractures due to osteomalacia are more common in the pelvis and ribs but may also involve the spine.
Spondylolysis
Spondylolysis is a defect and weakness in a portion of the spine called the pars interarticularis, a small segment of bone joining the facet joints in the back of the spine. The condition is basically a stress fracture in the pars interarticularis and is either congenital (present at birth) or may be caused later in life by trauma.
Spondylolisthesis
Spondylolisthesis, in which one of the vertebrae slips forward onto an adjacent vertebra, causes a gradual deformity of the lower spine and narrowing of the vertebral canal. It may develop in people with spondylolysis (see above), can be congenital, or may develop later in life because of disk degeneration associated with abnormal facet joints.
Vertebral Osteomyelitis
This disorder is a serious and increasingly common bacterial infection of the spine that causes pain in the neck or back and may or may not be accompanied by fever. It is often associated with autoimmune disorders such as type 1 diabetes.
Cancer
In rare instances, back pain is caused by cancer in the spine. Malignant tumors of the spine account for far less than 1% of all cases of back pain and occur more frequently in older people. Cancer can originate in the vertebrae, as in the case of multiple myeloma (cancer cells that move from the bone marrow to the bones at numerous sites). It can also spread to the spine from other sites in the body, most often from the breast, prostate, lung, kidney, or thyroid gland.
Other Causes of Back Pain
Not all back pain is caused by problems with the spine or back muscles. In some cases, pain originates in the abdominal organs and radiates to the back. Conditions such as pancreatitis (inflammation of the pancreas), peptic ulcers (lesions in the stomach or small intestine), or an abdominal aortic aneurysm (a ballooning of the wall of the body’s largest artery, which carries blood from the heart to the rest of the body) also may cause back pain.
In addition, back pain may originate from gallstones, kidney stones, kidney infections, and endometriosis (a growth of the tissue lining a woman’s uterus in places other than the uterus). Last, but certainly not least, emotional stress may induce back pain.
