Additional causes of back pain

Ankylosing spondylitis. Ankylosing spondylitis is a chronic inflammation of the facet joints and the joints between the back wall of the pelvis and the hip (the sacroiliac joints). Inflammation may also involve locations where ligaments and tendons attach to bone. In severe cases, the vertebrae may become fused together, resulting in rigidity. Because fusion can be painful, the person tends to lean forward and develop a stooped posture.

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Osteomalacia. Bone is mostly made up of collagen but requires the minerals calcium and phosphorus for strength. Osteomalacia is a softening of bone that results from a lack of these minerals. The most common cause of osteomalacia is vitamin D deficiency, which is prevalent in older individuals. Vitamin D is essential for absorption of calcium and phosphorus.

Spondylolysis. Spondylolysis refers to a weak area in the bone that connects the facet joints to the vertebral body.

Spondylolisthesis. Spondylolisthesis, in which one of the vertebrae slips forward, may develop in people with spondylolysis.

Vertebral osteomyelitis. Vertebral osteomyelitis is a serious and increasingly common bacterial infection of the spine. It can cause pain in the neck or back and may be accompanied by fever. It is often associated with autoimmune disorders such as Type I diabetes.

Cancer. In rare instances, back pain is caused by cancer in the spine. Although malignant tumors of the spine account for far less than 1 percent of all cases of back pain, they occur more frequently in older people. Cancer can originate in the vertebrae, as in the case of multiple myeloma (cancer cells that move from the bone marrow to the bones at numerous sites). Alternately, it can spread to the spine from other sites in the body, most often from the breast, prostate, lung, kidney, or thyroid gland.

Other causes. Not all back pain is caused by problems with the spine or muscles involving the back. In some cases, pain originates in the abdominal organs and radiates to the back. Conditions such as pancreatitis (inflammation of the pancreas), peptic ulcers (nonhealing defects in the stomach or small intestine), or an abdominal aortic aneurysm (a ballooning of the wall of the body's largest artery) may also cause back pain.

In addition, back pain may originate from disorders at other body sites. Such disorders include gallstones, kidney stones and infections, and endometriosis (a benign growth of endometrial tissue outside of the uterus).