Randy Shelerud, M.D., Mayo Clinic specialist in physical medicine and rehabilitation

The common causes of low back pain include the joints and the soft tissues of the low back. The common medical terms that we use to describe these structures include the disks, the set joints, sacroiliac joints and the associated ligaments. In addition to that, the back support muscles that are near these structures can get involved in the pain cycle. In other words, if there's a painful structure underneath these muscles, they tend to spasm and the spasm can then be a secondary cause of pain as well.

Now when we talk about painful structures in the low back, I don't want to imply that the low back is somehow weak or fragile. It's quite the contrary. The spine and low back are some of the strongest structures in the entire body. And as it turns out, just through normal wear and tear, just like getting gray hair or wrinkles, we all, for the most part, will develop low back pain at some point in our adult life. Now, there are some risk factors that we've identified that are associated with an increased risk of low back pain, and those include:

• Taller height
• Overweight or obesity
• Patients who smoke
• Poor low back muscle strength and conditioning
• Poor general aerobic conditioning

And in addition, patients who tend to have an associated increased stress in their life tend to have increased risk of low back pain.

Now, if you look specifically at work-related factors, there are several that also are linked to increased risk of low back pain and those include:

• Demanding physical work.
• Repetitive heavy lifting.
• Repetitive work of other kinds that includes a lot of bending or twisting, specifically. Also, patients who have a lot of static positioning as part of their job, such as long-term sitting or long-term bending.

And then finally those who perceive that their work is physically demanding and have low work satisfaction are also at increased risk.

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