II. Causes: Mechanical (90%)
- Lumbosacral strain (70-90% of Acute Low Back Pain)
- Isolated Trauma or repetitive overuse
-
Lumbar Spondylosis (10%)
- Chronic disc degeneration and secondary foraminal narrowing in over age 40 years old
-
Lumbar Disc Herniation (5%)
- Occurs at L4-5 or L5-S1 in 90-95% of cases
-
Spondylolysis (<5%)
- Young athletes with frequent lumbar hyperextension (e.g. gymnastics, football)
-
Vertebral Compression Fracture (4%)
- Vertebral Fracture and collapse, typically due to Osteoporosis, and most commonly at L1 and L4
-
Spondylolisthesis (3-4%)
- Vertebral slippage anteriorly, at L5 in 90% of cases, with Leg Pain, Paresthesias and weakness
-
Lumbar Spinal Stenosis (3%)
- Narrowing of lumbar spinal canal with back pain and leg numbness, weakness better with rest
- Includes Cauda Equina Syndrome (requiring emergent intervention)
-
Spondylosis
- Chronic disk degeneration
- Facet joint Arthropathy
- Sacroiliac Joint
III. Causes: Non-Mechanical
- See Low Back Pain Red Flags
- Spondyloarthropathy
- Spinal Infection
- Osteoporosis (Vertebral Compression Fracture)
- Cauda Equina Syndrome
- Spinal Neoplasm (Spine Metastases, Vertebral Metastases)
- Connective Tissue Disease
- Referred visceral pain
- Abdominal Aortic Aneurysm
- Pancreatic Cancer
- Genitourinary cancer
IV. Causes: Referred Pain
- Vascular
- Gastrointestinal
- Renal
- Genitourinary
- Skin