Editing Low back pain (section)

==Causes==
[[File:Lagehernia.png|thumb|A herniated disc as seen on MRI, one possible cause of low back pain]]
Low back pain is not a specific disease but rather a complaint that may be caused by a large number of underlying problems of varying levels of seriousness.<ref name=borczuk_2013>{{cite journal | vauthors = Borczuk P | title = An evidence-based approach to the evaluation and treatment of low back pain in the emergency department | journal = Emergency Medicine Practice | volume = 15 | issue = 7 | pages = 1–23; Quiz 23–24 | date = July 2013 | pmid = 24044786 | url = http://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=371 | url-status = live | archive-url = https://web.archive.org/web/20130814141409/http://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=371 | archive-date = 14 August 2013 }}</ref> The majority of low back pain does not have a clear cause<ref name=casazza_2012/> but is believed to be the result of non-serious muscle or skeletal issues such as [[sprain]]s or [[Strain (injury)|strain]]s.<ref name=NIH_2013>{{cite web |url=http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm |title=Low Back Pain Fact Sheet |work=National Institute of Neurological Disorders and Stroke |publisher=National Institute of Health |access-date=12 July 2013 |url-status=live |archive-url=https://web.archive.org/web/20130719200618/http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm |archive-date=19 July 2013 }}</ref> Obesity, smoking, weight gain during pregnancy, [[Psychological stress|stress]], poor physical condition, and poor sleeping position may also contribute to low back pain.<!-- This sentence is copied verbatim from the NIH website, which is public domain --><ref name=NIH_2013/> There is no consensus as to whether [[spinal posture]] or certain physical activities are causal factors.<ref>{{cite journal | vauthors = Swain CT, Pan F, Owen PJ, Schmidt H, Belavy DL | title = No consensus on causality of spine postures or physical exposure and low back pain: A systematic review of systematic reviews | journal = Journal of Biomechanics | volume = 102 | page = 109312 | date = March 2020 | pmid = 31451200 | doi = 10.1016/j.jbiomech.2019.08.006 | s2cid = 201756091 }}</ref> A full [[differential diagnosis|list of possible causes]] includes many less common conditions.<ref name=manusov_2012_diag/> Physical causes may include [[osteoarthritis]], [[degenerative disc disease|degeneration of the discs]] between the [[vertebrae]] or a [[spinal disc herniation]], [[vertebral fracture|broken vertebra(e)]] (such as from [[osteoporosis]]) or, rarely, an infection or tumor of the spine.<ref name=NIH_2009>{{cite web |url=http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.asp#b |title=Fast Facts About Back Pain |author=<!--Staff writer(s); no by-line.--> |date=September 2009 |website=National Institute of Arthritis and Musculoskeletal and Skin Diseases |publisher=National Institute of Health |access-date=10 June 2013 |url-status=live |archive-url=https://web.archive.org/web/20130605004734/http://www.niams.nih.gov/health_info/Back_Pain/back_pain_ff.asp#b |archive-date=5 June 2013 }}</ref>

Women may have acute low back pain from medical conditions affecting the female reproductive system, including [[endometriosis]], [[ovarian cyst]]s, [[ovarian cancer]], or [[uterine fibroid]]s.<ref name=medline_lbp_acute_2012>{{cite web |title=Low back pain – acute |url=https://www.nlm.nih.gov/medlineplus/ency/article/007425.htm |publisher=U.S. Department of Health and Human Services – National Institutes of Health |access-date=1 April 2013 |url-status=live |archive-url=https://web.archive.org/web/20130401120321/http://www.nlm.nih.gov/medlineplus/ency/article/007425.htm |archive-date=1 April 2013 }}</ref> Nearly half of all pregnant women report pain in the low back during pregnancy, which is attributed to changes in posture and the relocation of the center of gravity, leading to strain on the musculoskeletal system, including muscles, ligaments, and joints.<ref name=majchrzycki_2010>{{cite journal | vauthors = Majchrzycki M, Mrozikiewicz PM, Kocur P, Bartkowiak-Wieczorek J, Hoffmann M, Stryła W, Seremak-Mrozikiewicz A, Grześkowiak E | display-authors = 6 | title = [Low back pain in pregnant women] | language = pl | journal = Ginekologia Polska | volume = 81 | issue = 11 | pages = 851–855 | date = November 2010 | pmid = 21365902 }}</ref>

Low back pain can be broadly classified into four main categories:
*Musculoskeletal – mechanical (including [[muscle strain]], [[muscle spasm]], or [[osteoarthritis]]); herniated nucleus pulposus, [[Spinal disc herniation|herniated disc]]; [[spinal stenosis]]; or [[compression fracture]]
*Inflammatory – HLA-B27 associated arthritis including [[ankylosing spondylitis]], [[reactive arthritis]], [[psoriatic arthritis]], inflammation within the reproductive system, and [[inflammatory bowel disease]]
*Malignancy – [[bone metastasis]] from lung, breast, prostate, thyroid, among others
*Infectious – [[osteomyelitis]], abscess, [[urinary tract infection]].<ref name="EM2011">{{cite journal | vauthors = Lane DR, Takhar SS | title = Diagnosis and management of urinary tract infection and pyelonephritis | journal = Emergency Medicine Clinics of North America | volume = 29 | issue = 3 | pages = 539–552 | date = August 2011 | pmid = 21782073 | doi = 10.1016/j.emc.2011.04.001 }}</ref>