7 Unexpected Causes of Back Pain

Back Pain

For most people, back pain is caused by common things like pulled muscles, disc injuries, and muscle spasms. These are usually related to overuse, falls, lifting injuries, or other types of trauma. Back pain can also be caused by more unexpected things, some that may surprise you.

1. Clothes and Accessories

Rocking tight pants may make that booty look good, but that compression isn’t good for everything—it can cause back pain or sciatic-nerve related pain or symptoms. Keeping your wallet in your back pocket is another no-no. Your pelvis will not be level when sitting, which can compress your sciatic nerve, causing buttock, back, or nerve pain. Try switching your wallet to your front pants pocket or shirt pocket (or try bringing the fanny pack back in fashion). If you’re required to wear a tool belt or other utility belt for work (we’re looking at you, Batman) that extra weight around your hips can also cause back pain over time.

2. Internal Organ Referral


Because of the way our nerve systems are set up, our internal organs can refer pain to another body part, like the back.. While not every organ will refer pain, so
me referral patterns are typical and common. For example, kidney stones can cause pain in the low back and/or the buttocks; the uterus can refer to the low back and hips; the liver and gallbladder can refer to the right back or the right shoulder and neck.

3. Medication

Sometimes we’re trying to fix one thing, and end up creating additional issues. Some medications can have side effects; some are more likely to cause muscle pain, joint pain or back pain. Here are a few examples medications with muscle and joint pain side effects and please talk to your prescribing doctor if any of your medications are causing undesirable side effects:


Statins are a group of medications used to lower cholesterol. Statins have a high likelihood of causing muscle and joint pain–they’re the most common joint-pain-causing medication on our list. Statins include Rosuvastatin (Crestor), Atorvastatin (Lipitor) and Lovastatin (Altoprev).

Levofloxacin (Levoquin)

This antibiotic is often prescribed for sinus infections and pneumonia. Regardless of age, 25% of patients report muscle and joint pain while taking this antibiotic.

Boniva (Ibandronate)

This medication is used to treat and prevent osteoporosis in post-menopausal women. Back pain is the most common reaction to this medication.

Tamsulosin Hydrochloride (Flomax)

This medication is used to treat the symptoms of benign prostate hypertrophy (BPH), or enlarged prostate. Back pain can be a side effect of this prostate-relaxing medication.

There are other medications that may cause back pain as a side effect. It’s important to let your doctor know all of your medication that you take or if anything changes with your medication—dosage or frequency.


This habit is associated with many adverse health effects and conditions—back pain is one more thing to add to that list. Adult smokers are 30% more likely to report low back pain than non-smokers. Smoking alters blood flow, which means it can speed up degenerative changes and lowers disc nutrition, resulting in possible back pain.

Spinal Tumors

There are two types of spinal tumors: primary and secondary. Primary spinal tumors start in the spine. These are often non-cancerous and generally have a better outcome. Secondary tumors are those that metastasize, or spread from cancer in another body part. About 30-70% of cancer patients will develop metastatic spinal tumors. The following is the list (in order of ones most likely to attack the spine) of metastatic spinal tumors: breast (21%), lung (19%), prostate (7.5%), renal (5%), gastrointestinal (4.5%), and thyroid (2.5%). Pain is the most common symptom for spinal tumors.


Spinal infections can be bacterial or fungal and often travel through the bloodstream from another part of the body.

Vertebral Osteomyelitis

Vertebral Osteomyelitis is the most common type of spinal infection and is usually caused by Staphlococcus aureus bacteria. It spreads to the spinal column from an open spinal trauma like a broken bone or from another infection like from bed sores or even urinary tract infections.

Intervertebral Disc Space Infections

These infections occur in the disc and adjacent vertebra. They can be spontaneous infections, or can happen during childhood or after an operation/procedure. Childhood infections (discitis) typically occur in children ages 4-10 and are often from an infection that traveled to the spine from another area of the body. Postoperative spinal infection is a possible complication of surgery and usually present 3 days to 3 months after a surgical procedure.

Spinal Canal Abscess

This is a type of infection that develops in the spinal canal, or the area where the spinal cord goes through the vertebrae. This type of infection is very unlikely.

Long-term intravenous antibiotics or antifungal therapy are used to treat these infections, depending on what kind of problem it is. Sometimes surgery is required to repair the damage from the infection. Spinal infections are more common in older persons, diabetics, immune-compromised persons, IV drug users, and those with a history of long-term steroid use.


There is one more infection that may cause back pain. This infection is less severe, but more common – Shingles: If you’ve ever had chicken pox, then you still have this virus lying dormant in your body. Shingles is the name for the viral infection that occurs later in life from the same virus that caused chicken pox. Because this dormant virus lies in wait along the dorsal root ganglion (spinal nerve root) a shingles infection will follow the spinal nerve affected. This will often be one side of the body, often along the torso or back and typically presents as a painful rash. Treatment includes a week-long antiviral medicine.

Abdominal Aortic Aneurysm (AAA)

Your aorta, the large artery that runs from your heart down through your body and has several arterial branches that supply blood to your organs and lower extremities. In a small percentage (2-5%) of people 45 years old or older, the aorta can enlarge or balloon—this is an aneurysm. Abdominal pain is the most common sign of an abdominal aortic aneurysm, but low back pain can also be a symptom of the same condition; it should not be ignored, and medical attention should be sought immediately.

The last three causes of back pain listed above (tumors, infections, and aneurysms) may be able to be caught via x-ray in your initial evaluation at our office. An inside look helps us determine underlying causes, whether poor posture, or something that requires immediate medical attention.

Beyond the typical run-of-the-mill back pain causes, these causes range from an easy fix (just find looser pants) to more complex issues. Keep track of what you believe may be causing your pain, and seek out chiropractic care to determine what can be done to address it and get back in your element