Back pain is a common musculoskeletal complaint. According to the American Chiropractic Association, Americans spend about $50 billion each year on back pain treatments, and up to 80 percent of Americans will experience a back problem at some point in their lives. The intensity of back pain ranges considerably between individuals. Back pain may be mild or severe and debilitating. Common causes of severe back pain include compression fractures, herniated lumbar discs and facet syndrome.
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Lumbar spine compression fractures may cause severe back pain. According to the Merck Manuals website, vertebral compression fractures--which involve a collapse and flattening of the spinal bones, and are especially common in older people with osteoporosis--may cause sudden, sharp pain, or pain may develop gradually. In some cases, notes the Merck Manuals website, people feel no pain at all. However, the American Association of Neurological Surgeons or AANS states that the main clinical symptoms of vertebral compression fractures include sudden onset of back pain, along with an increase in pain while walking, standing, coughing or sneezing. According to the AANS, vertebral compression fractures are the most common fracture in people with osteoporosis, affecting approximately 750,000 people each year. The pain associated with vertebral compression fractures typically lasts for several months before gradually subsiding.
Herniated Lumbar Disc
A herniated lumbar intervertebral disc is a relatively common cause of severe back pain. The Spine Universe website states that a herniated disc can occur gradually over time, sometimes taking weeks or months to manifest. The website also notes that lumbar disc herniations can cause sudden, crippling pain, which is often precipitated by a lifting or twisting maneuver. In the latter scenario, it's often suspected that the provocative lifting movement aggravated an already weak disc. If the herniated disc material impinges on a spinal nerve root as the nerve root exits the spine, it can cause radiating pain down the back of the thigh and possibly into the calf or foot on one side of the body. There may be associated muscle weakness as well. Herniated lumber intervertebral discs typically respond well to conservative care, although in some cases--especially where there is diminished motor function--surgical intervention may be required to decompress the involved nerve root.
Lumbar Facet Syndrome
Lumbar facet syndrome can cause back pain ranging from mild and annoying to severe and debilitating. According to Dr. Michael Carnes, a chiropractic physician and the author of "Quick Reference Conservative Care Conditions Manual," lumbar facet syndrome involves pain that's generated by a lumbar vertebra's facet or zygapophyseal joint or joint capsule. Carnes notes that the pain associated with lumbar facet syndrome may be caused by the following problems: a sprain of the facet joints' surrounding ligaments and joint capsule, synovial fold or meniscoid entrapment or degenerative joint disease of the zygapophyseal joint. According to the Cleveland Clinic--one of the top four hospitals in the United States--symptoms of facet joint syndrome in the lower back include focal pain or tenderness made worse with twisting or arching of the lower back, a deep, dull and achy pain that radiates to the buttocks or the back of the thighs and stiffness or difficulty standing up straight or getting out of a chair.