For patients with lower back pain that lasts longer than two weeks to three months, or with predominantly leg pain, a more specific and definable problem is often the source of pain. Several types of low back and leg pain tend to be more common in either younger or older adults.

Common types of lower back pain for young adults (< 60 years old)

1. Common symptoms: Leg pain (sciatica) and possible numbness
   Pain that radiates through the buttocks, as well as pain and possibly numbness that radiates down to the foot, is frequently caused by a disc herniation in the lumbar (lower) spine. This type of pain is usually worse after a long period of standing or sitting.

   • See also Lumbar disc herniation

2. Common symptoms: Pain with certain movement and positions
   Low back pain in young adults that is caused by certain positions and movements (such as bending forward, running) is commonly caused by a syndrome called degenerative disc disease. The low back pain symptoms of degenerative disc disease can become chronic and may tend to fluctuate and at times become significantly worse.

   • See also Degenerative disc disease

3. Common symptoms: Low back pain (and possibly leg pain) that worsens when standing or walking
   Sometimes a vertebral body in the low back slips forward, causing stress on the disc below it, which in turn may cause low back pain and may sometimes cause leg pain. These painful symptoms are sometimes caused by a stress fracture that occurs at a young age.

   • See also Isthmic spondylolisthesis

Common types of lower back pain for older adults (>60 years old)

1. Common symptoms: Lower back pain that is worse in the morning and in the evening, and stiffness
   Lower back pain that is most pronounced first thing in the morning and later in the day is often caused by facet joint osteoarthritis (degenerative arthritis), a condition that involves breakdown of the cartilage between the facet joints in the back. The pain and stiffness is a result of the lack of cartilage between the joints.

   • See also Facet joint osteoarthritis

2. Pain down the legs when walking and standing upright
   Leg pain (sciatica) that occurs when walking, and increases with more walking, can be caused by conditions such as lumbar spinal stenosis or degenerative spondylolisthesis. Both conditions place pressure on the nerves at the point where they exit the spine. Standing upright, such as in normal walking, increases pressure on the nerve and results in leg pain.

   • See also Lumbar spinal stenosis and Degenerative spondylolisthesis

While less common than the above listed conditions, a number of other conditions can cause low back pain as well, including but not limited to:

• Sacroiliac joint dysfunction

• Piriformis syndrome

• Infection or spinal tumor

• Vertebral fracture

• Fibromyalgia

• Ankylosing spondylitis

Finally, it is important to note that one’s attitude and situation also have an effect on pain levels and duration. For example, people who are depressed, under stress, unhappy in their work, or seeking money after an accident are more likely to have their pain become chronic, and vice-versa.

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