Many people who suffer recurrent back pain say that fear is as big a problem as the pain. Their fear stems from the notion that the pain is a sign of permanent damage to the spine or a manifestation of a grave illness. In fact, recurrent back pain can have many different causes, and the overwhelming majority of people with this problem do not have a medically serious condition. That is, the pain is not a sign that something serious is wrong with the back. Nevertheless, the first step in managing your back pain is to rule out the possibility that it is caused by a serious medical problem such as a fracture, pinched nerve, tumor, or infection. Most people with back pain will have none of these signs. For them, the discomfort may come from any number or causes, which rarely involve progressive illness or harmful injury. Just about every part of the back â “ muscles, tendons, disks, ligaments, joints, and bones â “ can cause this type of pain.

The causes of recurrent back pain may be difficult to identify. In most cases, physicians cannot find any specific injury or condition in the muscles, joints, ligaments, or nerves of the back to explain the pain. Even if the onset of pain can be linked to an identifiable injury, why the pain recurs may remain unknown.

One theory is that recurrent back pain is caused by a vicious cycle that begins after an injury to the back. If you are in pain after an injury, you may hold your muscles tense, move in careful ways, or limit your movement and become inactive. These behaviors will cause your muscles and ligaments to shorten, resulting in more pain. Lack of activity may also weaken your back muscles, making them prone to fatigue and spasm. Chronic muscle tension and guarding can lead to a similar outcome. Or perhaps an initial injury causes a flare-up of pain, which triggers tension and more discomfort in the nearby muscle. Another explanation is that recurrent back pain is linked to the sensitization of nerves. After repeated episodes of pain or a single period of severe pain, a nerve may require less simulation than before to send a pain signal to the brain. Because so many factors can be involved, few back pain conditions are definitively diagnosed.

Even when the cause of back pain cannot be determined, as long as there are no red flag symptoms, the condition is not serious or dangerous. Whether pain is caused by tight muscles, weakness, nerve sensitization, or a bulging disk, it is time to focus on managing the serious problem of your pain rather than being concerned that it is a symptom of something worse.