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Muscle spasms, disc herniation, and degenerative disc disease are among the most common causes of the back pain experienced by 80 percent of the population at one time or another. While it’s understandable for an orthopedic surgeon to consider these potential causes first, there are times when back pain is linked to an uncommon source. Finding the true origin of back pain is the key to experiencing positive results with treatment recommendations, and exploring some other potential causes of spine-related discomfort may lead to an accurate diagnosis and, ultimately, meaningful relief.

Paget’s Disease

Occurring more often in people over age fifty, Paget’s disease affecting bones interferes with the natural process of replacing older bone tissues with new bone. It may weaken the spine and result in localized back pain. If bony areas in the lumbar (lower) spine become thicker due to this condition, it may result in radiating pain similar to sciatica. Diagnosis may involve a bone scan, a bone biopsy, and a blood test. Treatment includes medications to manage inflammation and control the rate of bone recycling to minimize abnormal growth.

Pelvic Bleeding or Infection

Patients taking blood thinners are at an increased risk of developing a pelvic bleeding, which may trigger sciatica symptoms. A pelvic infection may develop as a result of conditions like Crohn’s disease or pelvic inflammatory disease affecting the reproductive organs in women. Lower back pain is sometimes experienced as a symptom of a pelvic infection. Antibiotics are typically recommended to treat this type of infection.

Spinal Disc and Bone Infections

Sometimes caused by staph bacteria, infections of the bone (osteomyelitis) can produce localized back pain. The same is true of infections of the discs that cushion the spine (septic discitis). Tuberculosis inflection of spine (Pott’s disease) is another rare source of back pain. In some instances, sacroiliac (SI) joints may be affected by a bacterial infection. Treatment usually involves the long-term use of antibiotics.


Believed to be caused by a dormant version of the herpes virus in spinal nerve roots, shingles (herpes zoster) is a nerve infection that affects the skin. Prior to the breakout of blisters, back pain is sometimes experienced. After an outbreak has occurred, patients may develop chronic nerve pain that’s more noticeable. Treatment includes medications and skin patches.

Aortic Aneurysm

Weakening of the aorta in the abdomen sometimes occurs in older adults who have atherosclerosis. This weakening may cause the wall of the aorta to bulge, which is referred to as an aneurysm. While rare, sharp or throbbing lower back pain may be felt when an aneurysm occurs. Surgical repair of the damaged wall is the most common treatment option.

Neuropathic pain originating from the spine can also be difficult to diagnose since discomfort is felt away from the actual source. Symptoms often attributed to sciatica (pain felt in the legs, thighs, buttocks, or hips) may be due to sacroiliac joint dysfunction or piriformis syndrome. All of these potential sources of localized or radiating back pain emphasize the importance of getting an accurate diagnosis, a goal often achieved with methods such as injecting a contrast dye during image testing and using epidural injections or nerve blocks to confirm or rule out potential pain sources.