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. Age - Back pain usually begins between the ages of 30 and 50 years, and is more common among older adults.
. Fitness - Back pain occurs in people who are not physically fit, as weak muscle cannot properly support the spine.
. Weight - Excessive weight can put stress and strain on the structures of the back, resulting in pain.
. Heredity - Certain back conditions that cause pain are inherited, such as ankylosing spondylitis.
. Occupation - Jobs that require heavy lifting, pulling, pushing, and twisting can lead to back pain. In addition, any job that vibrates the spine can injure the structures of the back.

Most patients with acute (short-term) back pain only suffer with discomfort for a few days or weeks. The pain usually resolves on its own or with minimal self-care measures. Acute back pain is defined as pain that lasts from 4-12 weeks.

Chronic back pain is pain that persists for 12 weeks or more, even after the initial trauma, damage, or injury has been treated and resolved. Approximately 20% of people with acute back pain go on to develop the chronic form.

The majority of back pain is mechanical in nature. For many patients, back pain is associated with spondylosis, which is general degeneration of the spine. Other causes of back pain include:
Degenerative disc disease - The rubber disc between the vertebrae lose integrity as they age and with wear and tear. Degenerative discs cause problems with mobility and flexibility of the spine.

Herniated disc - This occurs when a disc becomes compressed and the inner, soft material protrudes through the outer disc layer.

Radiculopathy - This condition is caused by inflammation, compression, and/or injury to one or more spinal nerve roots. This pressure causes pain, tingling, and numbness that travels down the nerve root and into the arms or legs.

Spinal stenosis - Narrowing of the spinal column will put pressure on the spinal cord and nerves, which produces pain and leg weakness.

Spondylolisthesis - With this condition, one or more of the vertebrae of the spine slips out of place and pinches the nerves exiting the spinal cord and column.

Scoliosis - TAbnormal curvature of the spine can cause pain when nerve roots are compressed.

The treatment of back pain usually depends on the cause. Treatment options include:

Physical therapy - For strengthening core muscles that support the back, the doctor may recommend physical therapy. The therapist works with the patient to improve mobility and flexibility of the spine. Pain relief measures offered by the therapist include heat and cold therapy, massage, and electrical stimulation.

Medications - For relief of pain and inflammation, the doctor may prescribe prescription strength NSAIDs, such as ketoprofen or naproxen sodium. In addition, certain analgesic medications are prescribed short-term, such as oxycodone and hydrocodone. Other drugs used include anticonvulsants, antidepressants, and topical counter-irritants, which stimulate the nerves to reduce the sensation of pain.

Chiropractic care - The chiropractor can perform spinal manipulation and mobilization using his/her hands. This therapy involves massage, adjustments, and manipulation of the spine to improve pain.

Nerve blocks - To block nerve condition from specific body areas, this approach involves injecting long-acting anesthetics, with or without steroids, near the nerve root. Nerve blocks have a 75-80% success rate, based on recent clinical reports.

Epidural steroid injection (ESI) - For short-term pain relief, the doctor can inject a corticosteroid, with or without an anesthetic agent, into the epidural space (right outside the spinal cord). A recent clinical study found the efficacy rate of ESI to be 80-90%.

Radiofrequency Ablation - This has been a revolutionary procedure for back pain, as it can provide 6-24 months of consistent pain relief. If the pain comes back, studies show a repeat radiofrequency lesioning can be just as effective.

Facet Blocks/Medial Branch Blocks - These are outpatient procedures involving the injection of numbing medicine plus/minus steroid. In addition to offering pain relief for months at a time, they also perform as a diagnostic procedure.

Regenerative Medicine - Procedures for back pain include stem cell therapy with bone marrow or amniotic derived stem cells. These procedures are showing excellent benefits in small studies so far.