U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Back pain

MedGen UID:
2530
Concept ID:
C0004604
Sign or Symptom
Synonyms: Ache, Back; Aches, Back; Back Ache; Back Aches; Back Pain; Back Pains; Backache; Backaches; Pain, Back; Pains, Back
SNOMED CT: Backache (161891005); Back ache (161891005); Pain in back (161891005); Back pain (161891005)
 
HPO: HP:0003418

Definition

An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) localized to the back. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVBack pain

Conditions with this feature

Nail-patella syndrome
MedGen UID:
10257
Concept ID:
C0027341
Disease or Syndrome
Nail-patella syndrome (NPS) (previously referred to as Fong's disease), encompasses the classic clinical tetrad of changes in the nails, knees, and elbows, and the presence of iliac horns. Nail changes are the most constant feature of NPS. Nails may be absent, hypoplastic, or dystrophic; ridged longitudinally or horizontally; pitted; discolored; separated into two halves by a longitudinal cleft or ridge of skin; and thin or (less often) thickened. The patellae may be small, irregularly shaped, or absent. Elbow abnormalities may include limitation of extension, pronation, and supination; cubitus valgus; and antecubital pterygia. Iliac horns are bilateral, conical, bony processes that project posteriorly and laterally from the central part of the iliac bones of the pelvis. Renal involvement, first manifest as proteinuria with or without hematuria, occurs in 30%-50% of affected individuals; end-stage renal disease occurs up to 15% of affected individuals. Primary open-angle glaucoma and ocular hypertension occur at increased frequency and at a younger age than in the general population.
Spondylocostal dysostosis
MedGen UID:
82707
Concept ID:
C0265343
Disease or Syndrome
Spondylocostal dysostosis (SCDO), defined radiographically as multiple segmentation defects of the vertebrae (M-SDV) in combination with abnormalities of the ribs, is characterized clinically by: a short trunk in proportion to height; short neck; non-progressive mild scoliosis in most affected individuals, and occasionally, more significant scoliosis. Respiratory function in neonates may be compromised by reduced size of the thorax. By age two years lung growth may improve sufficiently to support relatively normal growth and development; however, even then life-threatening complications can occur, especially pulmonary hypertension in children with severely restricted lung capacity from birth. Males with SCDO appear to be at increased risk for inguinal hernia.
Polycystic liver disease 1
MedGen UID:
165781
Concept ID:
C0887850
Congenital Abnormality
Polycystic liver disease-1 is an autosomal dominant condition characterized by the presence of multiple liver cysts of biliary epithelial origin. Although the clinical presentation and histologic features of polycystic liver disease in the presence or absence of autosomal dominant polycystic kidney disease (see, e.g., PKD1, 173900) are indistinguishable, PCLD1 is a genetically distinct form of isolated polycystic liver disease (summary by Reynolds et al., 2000). A subset of patients (28-35%) may develop kidney cysts that are usually incidental findings and do not result in clinically significant renal disease (review by Cnossen and Drenth, 2014). Genetic Heterogeneity of Polycystic Liver Disease See also PCLD2 (617004), caused by mutation in the SEC63 gene (608648) on chromosome 6q21; PCLD3 (617874), caused by mutation in the ALG8 gene (608103) on chromosome 11p; and PCLD4 (617875), causes by mutation in the LRP5 gene (603506) on chromosome 11q13.
Sacral defect with anterior meningocele
MedGen UID:
325455
Concept ID:
C1838568
Disease or Syndrome
Sacral defect with anterior meningocele (SDAM) is a form of caudal dysgenesis. It is present at birth and becomes symptomatic later in life, usually because of obstructive labor in females, chronic constipation, or meningitis. Inheritance is autosomal dominant (Chatkupt et al., 1994). Welch and Aterman (1984) gave a population frequency of 0.14%. Caudal dysgenesis syndrome and caudal regression syndrome are broad terms that refer to a heterogeneous constellation of congenital caudal anomalies affecting the caudal spine and spinal cord, the hindgut, the urogenital system, and the lower limbs. Approximately 15 to 25% of mothers of children with caudal dysgenesis have insulin-dependent diabetes mellitus (222100) (Lynch et al., 2000). See also Currarino syndrome (176450), a similar disorder caused by mutation in the HLXB9 gene (142994) on chromosome 7q36. Currarino syndrome classically comprises the triad of hemisacrum, anorectal malformation, and presacral mass. However, Currarino syndrome also shows phenotypic variability: Lynch et al. (2000) stated that there is variable expressivity of clinical features and that some patients with Currarino syndrome are asymptomatic. Kochling et al. (2001) found the complete triad of Currarino syndrome in only 8 of 23 patients with mutations in the HLXB9 gene, These reports suggest that some patients previously reported as having forms of sacral agenesis, including SDAM, may have had Currarino syndrome and vice versa. See also spina bifida (182940), which can be seen in some patients with sacral agenesis or caudal regression syndrome and may be etiologically related.
Brachyolmia type 1, toledo type
MedGen UID:
376504
Concept ID:
C1849048
Disease or Syndrome
Brachyolmia type 1, Hobaek type
MedGen UID:
338605
Concept ID:
C1849055
Disease or Syndrome
Rock et al. (2008) provided an overview of the brachyolmias, a heterogeneous group of skeletal dysplasias that affect primarily the spine. Type 1 brachyolmia includes the Hobaek and Toledo (BCYM1B; 271630) forms, which are inherited in an autosomal recessive fashion. Both forms of type 1 are characterized by scoliosis, platyspondyly with rectangular and elongated vertebral bodies, overfaced pedicles, and irregular, narrow intervertebral spaces. The Toledo form is distinguished by the presence of corneal opacities and precocious calcification of the costal cartilage. Type 2 brachyolmia (BCYM2; 613678), sometimes referred to as the Maroteaux type, is also an autosomal recessive disorder, primarily distinguished from type 1 by rounded vertebral bodies and less overfaced pedicles. Some cases are associated with precocious calcification of the falx cerebri. Type 3 brachyolmia (BCYM3; 113500) is an autosomal dominant form, caused by mutation in the TRPV4 gene (605427), with severe kyphoscoliosis and flattened, irregular cervical vertebrae. Paradoxically, although the limbs are mildly shortened in all types of brachyolmia, they show minimal epiphyseal and metaphyseal abnormalities on radiographs. Type 4 brachyolmia (BCYM4; 612847) is an autosomal recessive form, caused by mutation in the PAPSS2 gene (603005), with mild epiphyseal and metaphyseal changes.
Spondyloarthropathy, susceptibility to, 1
MedGen UID:
400145
Concept ID:
C1862852
Finding
Spondyloarthropathy (SpA), one of the commonest chronic rheumatic diseases, includes a spectrum of related disorders comprising the prototype ankylosing spondylitis (AS), a subset of psoriatic arthritis (PsA), reactive arthritis (ReA), arthritis associated with inflammatory bowel disease, and undifferentiated spondyloarthropathy (Miceli-Richard et al., 2004). These phenotypes are difficult to differentiate because they may occur simultaneously or sequentially in the same patient. Studies have suggested that a predominant shared component, including HLA-B27, predisposes to all phenotypic subsets, and that these subsets should be considered as various phenotypic expressions of the same disease (Said-Nahal et al., 2000, Said-Nahal et al., 2001). Braun and Sieper (2007) provided a detailed review of ankylosing spondylitis, including clinical features, pathogenesis, and management. Genetic Heterogeneity of Susceptibility to Spondyloarthropathy Additional susceptibility loci for spondyloarthropathy have been identified on chromosome 9q31-q34 (SPDA2; 183840) and chromosome 2q36 (SPDA3; 613238).
Pelvis-shoulder dysplasia
MedGen UID:
356991
Concept ID:
C1868508
Disease or Syndrome
A rare focal skeletal dysostosis with characteristics of symmetrical hypoplasia of the scapulae and the iliac wings of the pelvis. Approximately 10 patients have been reported so far. Additional skeletal abnormalities may include hypoplasia of the clavicles, ribs, femora and fibula, together with spina bifida and prominent lumbar lordosis. Eye anomalies (coloboma of iris and retina) have occasionally been reported. Intelligence is described as normal. Pelvis-shoulder dysplasia seems to be a genetically heterogeneous disorder but no causative genes have been identified so far.
X-linked myopathy with postural muscle atrophy
MedGen UID:
395525
Concept ID:
C2678055
Disease or Syndrome
Emery-Dreifuss muscular dystrophy (EDMD) is characterized by the clinical triad of: joint contractures that begin in early childhood; slowly progressive muscle weakness and wasting initially in a humero-peroneal distribution that later extends to the scapular and pelvic girdle muscles; and cardiac involvement that may manifest as palpitations, presyncope and syncope, poor exercise tolerance, and congestive heart failure along with variable cardiac rhythm disturbances. Age of onset, severity, and progression of muscle and cardiac involvement demonstrate both inter- and intrafamilial variability. Clinical variability ranges from early onset with severe presentation in childhood to late onset with slow progression in adulthood. In general, joint contractures appear during the first two decades, followed by muscle weakness and wasting. Cardiac involvement usually occurs after the second decade and respiratory function may be impaired in some individuals.
Spondylo-megaepiphyseal-metaphyseal dysplasia
MedGen UID:
412869
Concept ID:
C2750066
Disease or Syndrome
Spondylo-megaepiphyseal-metaphyseal dysplasia is a rare autosomal recessive skeletal dysplasia characterized by disproportionate short stature with a short and stiff neck and trunk; relatively long limbs that may show flexion contractures of the distal joints; delayed and impaired ossification of the vertebral bodies and the presence of large epiphyseal ossification centers and wide growth plates in the long tubular bones; and numerous pseudoepiphyses of the short tubular bones in hands and feet (summary by Hellemans et al., 2009).
Hereditary spastic paraplegia 25
MedGen UID:
424835
Concept ID:
C2936860
Disease or Syndrome
A rare complex type of hereditary spastic paraplegia with characteristics of adult-onset spastic paraplegia associated with spinal pain that radiates to the upper or lower limbs and is related to disk herniation (with minor spondylosis), as well as mild sensorimotor neuropathy. The phenotype has been mapped to a locus on chromosome 6q23-q24.1.
Spondyloepiphyseal dysplasia tarda, X-linked
MedGen UID:
762085
Concept ID:
C3541456
Congenital Abnormality
X-linked spondyloepiphyseal dysplasia tarda is a condition that impairs bone growth and occurs almost exclusively in males. The name of the condition indicates that it affects the bones of the spine (spondylo-) and the ends of long bones (epiphyses) in the arms and legs. "Tarda" indicates that signs and symptoms of this condition are not present at birth, but appear later in childhood, typically between ages 6 and 10.\n\nMales with X-linked spondyloepiphyseal dysplasia tarda have skeletal abnormalities and short stature. Affected boys grow steadily until late childhood, when their growth slows. Their adult height ranges from 4 feet 6 inches (137 cm) to 5 feet 4 inches (163 cm). Impaired growth of the spinal bones (vertebrae) primarily causes the short stature. Spinal abnormalities include flattened vertebrae (platyspondyly) with hump-shaped bulges, progressive thinning of the discs between vertebrae, and an abnormal curvature of the spine (scoliosis or kyphosis). These spinal problems also cause back pain in people with this condition. Individuals with X-linked spondyloepiphyseal dysplasia tarda have a short torso and neck, and their arms are disproportionately long compared to their height.\n\nOther skeletal features of X-linked spondyloepiphyseal dysplasia tarda include an abnormality of the hip joint that causes the upper leg bones to turn inward (coxa vara); multiple abnormalities of the epiphyses, including a short upper end of the thigh bone (femoral neck); and a broad, barrel-shaped chest. A painful joint condition called osteoarthritis that typically occurs in older adults often develops in early adulthood in people with X-linked spondyloepiphyseal dysplasia tarda and worsens over time, most often affecting the hips, knees, and shoulders.
Inclusion body myopathy with Paget disease of bone and frontotemporal dementia type 1
MedGen UID:
1641069
Concept ID:
C4551951
Disease or Syndrome
Inclusion body myopathy associated with Paget disease of bone (PDB) and/or frontotemporal dementia (IBMPFD) is characterized by adult-onset proximal and distal muscle weakness (clinically resembling a limb-girdle muscular dystrophy syndrome), early-onset PDB, and premature frontotemporal dementia (FTD). Muscle weakness progresses to involve other limb and respiratory muscles. PDB involves focal areas of increased bone turnover that typically lead to spine and/or hip pain and localized enlargement and deformity of the long bones; pathologic fractures occur on occasion. Early stages of FTD are characterized by dysnomia, dyscalculia, comprehension deficits, and paraphasic errors, with minimal impairment of episodic memory; later stages are characterized by inability to speak, auditory comprehension deficits for even one-step commands, alexia, and agraphia. Mean age at diagnosis for muscle disease and PDB is 42 years; for FTD, 56 years. Dilated cardiomyopathy, amyotrophic lateral sclerosis, and Parkinson disease are now known to be part of the spectrum of findings associated with IBMPFD.
Muscular dystrophy, limb-girdle, autosomal dominant 4
MedGen UID:
1648316
Concept ID:
C4748295
Disease or Syndrome
Autosomal dominant limb-girdle muscular dystrophy-4 (LGMDD4) is characterized by onset of proximal muscle weakness in young adulthood. Affected individuals often have gait difficulties; some may have upper limb involvement. Other features include variably increased serum creatine kinase, myalgia, and back pain. The severity and expressivity of the disorder is highly variable, even within families (summary by Vissing et al., 2016). For a discussion of genetic heterogeneity of autosomal dominant limb-girdle muscular dystrophy, see 603511.
Short stature, oligodontia, dysmorphic facies, and motor delay
MedGen UID:
1787876
Concept ID:
C5543206
Disease or Syndrome
SOFM is characterized by marked short stature, oligodontia, mild facial dysmorphism, and motor delay. Endosteal hyperostosis has also been observed, and patients may exhibit some features of progeria (Terhal et al., 2020; Beauregard-Lacroix et al., 2020).
Developmental delay, impaired speech, and behavioral abnormalities
MedGen UID:
1794167
Concept ID:
C5561957
Disease or Syndrome
Developmental delay, impaired speech, and behavioral abnormalities (DDISBA) is characterized by global developmental delay apparent from early childhood. Intellectual disability can range from mild to severe. Additional variable features may include dysmorphic facial features, seizures, hypotonia, motor abnormalities such as Tourette syndrome or dystonia, and hearing loss (summary by Cousin et al., 2021).
Congenital anomalies of kidney and urinary tract 2
MedGen UID:
1804316
Concept ID:
C5574705
Disease or Syndrome
Congenital anomalies of the kidneys and urinary tract (CAKUT) encompasses a spectrum of developmental disorders of the urinary tract that can range from mild vesicoureteral reflux to severe renal agenesis. Other phenotypes include renal duplication, small kidneys, ureteropelvic junction obstruction, hydronephrosis, and renal dysplasia. These abnormalities can result in kidney damage, and possibly renal failure (summary by Vivante et al., 2015). For a discussion of genetic heterogeneity of CAKUT, see 610805.

Professional guidelines

PubMed

Gibbs D, McGahan BG, Ropper AE, Xu DS
Neurol Clin 2023 Feb;41(1):61-76. Epub 2022 Oct 29 doi: 10.1016/j.ncl.2022.07.002. PMID: 36400559
Corp N, Mansell G, Stynes S, Wynne-Jones G, Morsø L, Hill JC, van der Windt DA
Eur J Pain 2021 Feb;25(2):275-295. Epub 2020 Nov 12 doi: 10.1002/ejp.1679. PMID: 33064878Free PMC Article
Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CC, Chenot JF, van Tulder M, Koes BW
Eur Spine J 2018 Nov;27(11):2791-2803. Epub 2018 Jul 3 doi: 10.1007/s00586-018-5673-2. PMID: 29971708

Recent clinical studies

Etiology

Chou R
Ann Intern Med 2021 Aug;174(8):ITC113-ITC128. Epub 2021 Aug 10 doi: 10.7326/AITC202108170. PMID: 34370518
Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP
Lancet 2021 Jul 3;398(10294):78-92. Epub 2021 Jun 8 doi: 10.1016/S0140-6736(21)00733-9. PMID: 34115979
Maher C, Underwood M, Buchbinder R
Lancet 2017 Feb 18;389(10070):736-747. Epub 2016 Oct 11 doi: 10.1016/S0140-6736(16)30970-9. PMID: 27745712
Balagué F, Mannion AF, Pellisé F, Cedraschi C
Lancet 2012 Feb 4;379(9814):482-91. Epub 2011 Oct 6 doi: 10.1016/S0140-6736(11)60610-7. PMID: 21982256
Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel
Ann Intern Med 2007 Oct 2;147(7):478-91. doi: 10.7326/0003-4819-147-7-200710020-00006. PMID: 17909209

Diagnosis

Gibbs D, McGahan BG, Ropper AE, Xu DS
Neurol Clin 2023 Feb;41(1):61-76. Epub 2022 Oct 29 doi: 10.1016/j.ncl.2022.07.002. PMID: 36400559
Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP
Lancet 2021 Jul 3;398(10294):78-92. Epub 2021 Jun 8 doi: 10.1016/S0140-6736(21)00733-9. PMID: 34115979
Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, Viswanath O, Jones MR, Sidransky MA, Spektor B, Kaye AD
Curr Pain Headache Rep 2019 Mar 11;23(3):23. doi: 10.1007/s11916-019-0757-1. PMID: 30854609
Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ; Orthopaedic Section of the American Physical Therapy Association
J Orthop Sports Phys Ther 2012 Apr;42(4):A1-57. Epub 2012 Mar 30 doi: 10.2519/jospt.2012.42.4.A1. PMID: 22466247Free PMC Article
Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel
Ann Intern Med 2007 Oct 2;147(7):478-91. doi: 10.7326/0003-4819-147-7-200710020-00006. PMID: 17909209

Therapy

Chen Z, Wu J, Wang X, Wu J, Ren Z
Complement Ther Med 2021 Jun;59:102737. Epub 2021 May 10 doi: 10.1016/j.ctim.2021.102737. PMID: 33984499
O'Keeffe M, O'Sullivan P, Purtill H, Bargary N, O'Sullivan K
Br J Sports Med 2020 Jul;54(13):782-789. Epub 2019 Oct 19 doi: 10.1136/bjsports-2019-100780. PMID: 31630089Free PMC Article
Cherkin DC, Sherman KJ, Balderson BH, Cook AJ, Anderson ML, Hawkes RJ, Hansen KE, Turner JA
JAMA 2016 Mar 22-29;315(12):1240-9. doi: 10.1001/jama.2016.2323. PMID: 27002445Free PMC Article
Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RW, Cabral CM, Menezes Costa LC, Costa LO
Cochrane Database Syst Rev 2015 Jul 2;2015(7):CD010265. doi: 10.1002/14651858.CD010265.pub2. PMID: 26133923Free PMC Article
Rubinstein SM, Terwee CB, Assendelft WJ, de Boer MR, van Tulder MW
Cochrane Database Syst Rev 2012 Sep 12;2012(9):CD008880. doi: 10.1002/14651858.CD008880.pub2. PMID: 22972127Free PMC Article

Prognosis

Wong CK, Mak RY, Kwok TS, Tsang JS, Leung MY, Funabashi M, Macedo LG, Dennett L, Wong AY
J Pain 2022 Apr;23(4):509-534. Epub 2021 Aug 24 doi: 10.1016/j.jpain.2021.07.012. PMID: 34450274
Maselli F, Storari L, Barbari V, Colombi A, Turolla A, Gianola S, Rossettini G, Testa M
BMC Musculoskelet Disord 2020 Jun 3;21(1):343. doi: 10.1186/s12891-020-03357-4. PMID: 32493481Free PMC Article
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators
Lancet 2017 Sep 16;390(10100):1211-1259. doi: 10.1016/S0140-6736(17)32154-2. PMID: 28919117Free PMC Article
Hoy D, Brooks P, Blyth F, Buchbinder R
Best Pract Res Clin Rheumatol 2010 Dec;24(6):769-81. doi: 10.1016/j.berh.2010.10.002. PMID: 21665125
Andersson GB
Lancet 1999 Aug 14;354(9178):581-5. doi: 10.1016/S0140-6736(99)01312-4. PMID: 10470716

Clinical prediction guides

Steffens D, Hancock MJ, Maher CG, Williams C, Jensen TS, Latimer J
Eur J Pain 2014 Jul;18(6):755-65. Epub 2013 Nov 26 doi: 10.1002/j.1532-2149.2013.00427.x. PMID: 24276945
Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, Baker P, Smith E, Buchbinder R
J Clin Epidemiol 2012 Sep;65(9):934-9. Epub 2012 Jun 27 doi: 10.1016/j.jclinepi.2011.11.014. PMID: 22742910
Haskins R, Rivett DA, Osmotherly PG
Man Ther 2012 Feb;17(1):9-21. Epub 2011 Jun 8 doi: 10.1016/j.math.2011.05.001. PMID: 21641849
Woby SR, Roach NK, Urmston M, Watson PJ
Pain 2005 Sep;117(1-2):137-44. doi: 10.1016/j.pain.2005.05.029. PMID: 16055269
Laslett M, Aprill CN, McDonald B, Young SB
Man Ther 2005 Aug;10(3):207-18. doi: 10.1016/j.math.2005.01.003. PMID: 16038856

Recent systematic reviews

Hayden JA, Ellis J, Ogilvie R, Stewart SA, Bagg MK, Stanojevic S, Yamato TP, Saragiotto BT
J Physiother 2021 Oct;67(4):252-262. Epub 2021 Sep 16 doi: 10.1016/j.jphys.2021.09.004. PMID: 34538747
Chen Z, Wu J, Wang X, Wu J, Ren Z
Complement Ther Med 2021 Jun;59:102737. Epub 2021 May 10 doi: 10.1016/j.ctim.2021.102737. PMID: 33984499
Corp N, Mansell G, Stynes S, Wynne-Jones G, Morsø L, Hill JC, van der Windt DA
Eur J Pain 2021 Feb;25(2):275-295. Epub 2020 Nov 12 doi: 10.1002/ejp.1679. PMID: 33064878Free PMC Article
Meucci RD, Fassa AG, Faria NM
Rev Saude Publica 2015;49:1. Epub 2015 Oct 20 doi: 10.1590/S0034-8910.2015049005874. PMID: 26487293Free PMC Article
Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, Woolf A, Vos T, Buchbinder R
Arthritis Rheum 2012 Jun;64(6):2028-37. Epub 2012 Jan 9 doi: 10.1002/art.34347. PMID: 22231424

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Consumer resources

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...