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.
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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 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.
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.
Narrowing of the exit channels for nerve roots, causing radicular leg symptoms.
A fissure in the outer disc wall that can cause significant pain without full herniation.
Excessive movement at a spinal segment, causing instability-pattern back pain.
Protective lateral lean caused by significant disc irritation. Looks alarming but is well understood.
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.
Thickening of the spinal ligament — often the most significant contributor to central canal stenosis.
Adult-onset lateral spinal curvature from asymmetric degeneration.
Reactive changes at the vertebral endplate adjacent to a degenerated disc.
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 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.
Hip joint impingement causing groin and anterior hip pain, often in younger active adults.
The combined presentation where both hip and spine contribute to back pain.
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.
Inflammatory spinal disease associated with psoriasis. Similar pattern to AxSpA.
Inflammatory joint disease triggered by infection. Usually self-limiting.
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.
Bone softening from vitamin D deficiency. Causes widespread aching often attributed to fibromyalgia.
Serious conditions requiring urgent assessment
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 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.
Renal pain closely mimics back pain. Urinary symptoms alongside back pain always warrants investigation.
Kidney infection. Fever, loin pain, and urinary symptoms alongside back pain needs same-day assessment.
Inflammatory condition causing severe hip and shoulder girdle pain in over 50s. Responds rapidly to steroids.
Gynaecological causes of lower back and pelvic pain in women.
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 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.
Want to understand how the assessment works? Read the full explanation →
Browse individual condition pages: Back pain conditions → • Treatments →