Back pain conditions the myBackPain assessment considers

Back pain is not a single condition. It is a symptom that can arise from over 80 distinct causes — ranging from simple muscle strain to inflammatory disease, nerve compression, vascular emergencies, and cancer. Getting the right diagnosis matters, because the most effective management for each cause is different.

The myBackPain assessment applies structured clinical reasoning to identify which of these conditions is most likely based on your specific pattern of symptoms. Here is a complete overview of every condition the assessment considers.

80+
conditions considered across 7 clinical categories
31
detailed condition pages with clinical explanations
7
clinical domains from mechanical to systemic and serious
Teal border = dedicated condition page available
Red border = urgent safety content
Grey = assessed in tool, page coming soon
How to use this page

Click any teal-bordered condition to read the full plain-language explanation. If you recognise your pattern in one of these descriptions, the assessment will tell you how likely it is that this condition is driving your symptoms — based on your specific answers.

Mechanical & Structural

Mechanical and structural spine conditions

These represent the majority of back pain presentations. Most respond well to the right conservative management once correctly identified.

Lumbar Muscle and Ligament Strain The most common cause of acute back pain. Does not damage the spine. Activity is the treatment. Disc Herniation (Slipped Disc) 90% resolve without surgery. The disc material reabsorbs naturally over weeks to months.
Disc Bulge / Protrusion The disc weakens and bulges without the inner material leaking. Often asymptomatic.
Degenerative Disc Disease Normal ageing — not a disease. Found on most MRI scans over 40. Doesn’t always cause pain. Facet Joint Syndrome Causes up to 40% of chronic back pain. Frequently missed. Highly treatment-responsive. Lumbar Spinal Stenosis Canal narrowing causing leg pain with walking. Leading cause of walking difficulty over 60. Spondylolisthesis One vertebra slips forward on another. Grade I and II usually manage well without surgery. Spondylolysis (Pars Stress Fracture) Missed in up to 30% of cases on X-ray. Common in young athletes. Extension aggravation is the key sign.
Foraminal Stenosis Narrowing of the exit channels for nerve roots, causing radicular leg symptoms.
Annular Tear A fissure in the outer disc wall that can cause significant pain without full herniation.
Lumbar Instability Excessive movement at a spinal segment, causing instability-pattern back pain.
Acute Lateral Shift Protective lateral lean caused by significant disc irritation. Looks alarming but is well understood.
Degenerative & Age-Related

Degenerative age-related conditions

Common after 50. Often overlap with mechanical conditions and coexist in the same patient.

Facet Joint Osteoarthritis Age-related wear on the facet joint cartilage. Extension-dominant pain pattern.
Ligamentum Flavum Hypertrophy Thickening of the spinal ligament — often the most significant contributor to central canal stenosis.
Degenerative Scoliosis Adult-onset lateral spinal curvature from asymmetric degeneration.
Modic Endplate Changes Reactive changes at the vertebral endplate adjacent to a degenerated disc.
Nerve & Neurological

Nerve root and neurological conditions

Sciatica Shooting or burning leg pain from nerve root irritation. 90% resolve without surgery. Lumbar Radiculopathy Nerve root compression causing dermatomal pain, tingling, and weakness. ⚠ Cauda Equina Syndrome Spinal emergency. Bladder/bowel changes + back pain = A&E now. Do not wait. Meralgia Paraesthetica Burning, tingling outer thigh from lateral femoral cutaneous nerve entrapment. Not a spinal cause.
Hip & Pelvic

Hip and pelvic conditions

The hip is one of the most commonly overlooked causes of back pain. The assessment specifically identifies hip-referred and hip-driven patterns.

Hip Osteoarthritis Frequently causes back pain through altered lumbopelvic mechanics. Groin pain is the key sign. Sacroiliac Joint Dysfunction Common and frequently missed. Often mistaken for lumbar spine problems or sciatica. Greater Trochanteric Pain Syndrome Gluteal tendinopathy causing outer hip pain. Often misdiagnosed as hip OA or L5 nerve root pain. Pelvic Girdle Pain Pregnancy and postpartum SIJ hypermobility causing pelvic pain. Affects 1 in 5 pregnant women.
Femoroacetabular Impingement Hip joint impingement causing groin and anterior hip pain, often in younger active adults.
Hip–Spine Syndrome The combined presentation where both hip and spine contribute to back pain.
Inflammatory

Inflammatory spine disease

Inflammatory back pain has a characteristic pattern — morning stiffness over 30 minutes that improves with movement. It is frequently missed for years. Average diagnostic delay for ankylosing spondylitis is 7–8 years.

Ankylosing Spondylitis / AxSpA The most important inflammatory cause of back pain to identify. Responds to NSAIDs and biologics.
Psoriatic Arthritis (spinal) Inflammatory spinal disease associated with psoriasis. Similar pattern to AxSpA.
Reactive Arthritis (spinal) Inflammatory joint disease triggered by infection. Usually self-limiting.
Bone & Metabolic

Bone and metabolic disorders

Osteoporosis and Vertebral Fracture 3 million people in the UK. Vertebral fractures can occur without a fall. Often missed as muscle strain. Paget’s Disease of Bone Affects 1 in 20 over 55s. Highly treatable once identified. Often misdiagnosed for years.
Osteomalacia Bone softening from vitamin D deficiency. Causes widespread aching often attributed to fibromyalgia.
Serious Conditions

Serious conditions requiring urgent assessment

These conditions are rare — but the assessment screens for them in every report

The features that suggest serious pathology are well defined. The assessment identifies them systematically and directs you toward the right level of care when they are present. Most back pain is not serious. But the minority that is needs to be found.

⚠ Spinal Metastases Secondary cancer in the spine. Constant pain at rest and night pain are key indicators. ⚠ Multiple Myeloma Blood cancer presenting as back and rib pain. Over 60s. Fatigue and recurrent infections alongside pain. ⚠ Spinal Infection Discitis, osteomyelitis, epidural abscess. Fever with constant back pain needs same-day assessment. ⚠ Abdominal Aortic Aneurysm Tearing back pain + pulsating abdomen = 999 immediately. NHS screening for men at 65. ⚠ Prostate Cancer Spine is the most common metastasis site. Urinary symptoms + back pain = GP this week. ⚠ Cauda Equina Syndrome Bladder or bowel changes + back pain = A&E now. Do not wait to see if it improves.
Systemic & Referred

Systemic and referred causes

Back pain can originate from organs rather than the spine. The assessment screens for features that suggest a systemic rather than musculoskeletal cause.

Endometriosis Cyclical back pain worsening with periods. Average 7–8 year diagnostic delay. Affects 1 in 10 women. Diabetes and Back Pain Neuropathy mimics sciatica. Accelerated disc degeneration. Increased spinal infection risk.
Kidney Stones / Kidney Disease Renal pain closely mimics back pain. Urinary symptoms alongside back pain always warrants investigation.
Pyelonephritis Kidney infection. Fever, loin pain, and urinary symptoms alongside back pain needs same-day assessment.
Polymyalgia Rheumatica Inflammatory condition causing severe hip and shoulder girdle pain in over 50s. Responds rapidly to steroids.
Ovarian Cysts / Pelvic Inflammatory Disease Gynaecological causes of lower back and pelvic pain in women.
Central & Psychological

Central and psychological contributors

These are not imagined or exaggerated conditions. Central sensitisation reflects real neurological changes. The assessment identifies their contribution so that management is directed appropriately.

Central Sensitisation Why pain persists after tissue healing. The nervous system remains amplified. Real pain, different driver. Fibromyalgia Widespread pain, fatigue, poor sleep. Not psychological — reflects real changes in pain processing. Fear-Avoidance The strongest predictor of chronic back pain disability. More powerful than structural findings on imaging. Sleep and Back Pain Bidirectional relationship. Poor sleep amplifies pain; pain disrupts sleep. Treating sleep is treating pain.
Age-Specific

Age-specific and population conditions

Back Pain in Older Men Broader differential over 60. Stenosis, hip OA, prostate cancer, AAA, osteoporosis all considered. Back Pain in Adolescents More likely to have a specific cause than adults. Spondylolysis, AxSpA, Scheuermann’s, scoliosis. Osteoporosis (Post-menopausal Women) 1 in 2 women over 50 will have an osteoporosis-related fracture. DEXA scan guidance included.

Not sure which of these applies to you?

The assessment identifies which of these conditions best fits your specific pattern of symptoms — and tells you what to do next. Safety screening included. Results in minutes.

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