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At some time in their lives, 80 percent of all Americans suffer back pain severe enough to interfere with their activities. Although pain can develop anywhere along the spinal column, the neck (cervical) and low-back (lumbar) areas are most commonly affected.

Some backaches are easily remedied through life-style modifications such as losing weight, improving posture, exercising regularly, or sleeping on a firm mattress. Others are more complex and serious, warranting medical treatment.

Causes of back pain

Arthritis
If back pain is worse in the morning, and if it occurs in conjunction with pain in other joints such as the hands, elbows, hips, knees, or ankles, it probably stems from some type of arthritis. In people over the age of 60, the problem is apt to be osteoarthritis, which is caused by deterioration of the joints. In young to middle aged adults, one of the inflammatory types of arthritis may be the culprit.

Cancer
Spinal cord tumors are uncommon, although they can cause back pain, as can tumors involving bone tissue. Cancer related back pain is usually the result of metastasis, or the spread of cancer from elsewhere in the body. Tumors that tend to metastasize to bone include those that originate in the prostate and in the breast.

Disk problems
Disks are spongy pads of cartilage that separate the vertebrae, or individual segments of the backbone. If these disks degenerate or slip out of their normal place and press on a nerve, you may experience sudden, sharp pain in your lower back and down

your leg. Disk problems can also cause persistent, disabling back pain.

Gynecological problems
A wide variety of gynecological problems, ranging in severity from minor to serious, can cause lower back pain. Many women who suffer menstrual cramps and premenstrual syndrome complain of back pain before and during their periods, but this discomfort can usually be alleviated with nonsteroidal anti-inflammatory medications such as ibuprofen. At the other end of the spectrum, severe structural problems in the female reproductive tract can lead to back pain, as can endometriosis, a condition in which tissue that normally lines the uterus develops elsewhere in the pelvic cavity.

Infection
If back pain occurs in conjunction with fever and painful urination, the source may be some type of infection. Although a severe bout of influenza can cause such discomfort, it is more likely to derive from direct inflammation of the kidney.

Muscle and ligament problems
Muscle injury and misuse are perhaps the most common causes of back pain, especially lower back pain. A strain, also called a pulled muscle, involves overextending a muscle and tearing some of its fibers. Lifting heavy objects, exercising too strenuously, or maintaining poor posture at work can all lead to muscle strains. In a sprain, a joint is wrenched beyond its normal range of motion, tearing the ligament that holds it in position. The same movements that cause strains can also lead to sprains, but sprains are usually more painful. Obesity also strains the back muscles, since the spine must support excess abdominal weight. In addition, intense

psychological stress can cause muscles to go into spasm.

Osteoporosis
A sudden upper backache in a woman over 60 may signify the presence of osteoporosis, a condition marked by loss of bone strength. Osteoporosis also entails a gradual shrinking in height, chronic pain, and development of a stooped posture.