Step 4: Are you at risk?

Many things can make you more likely to develop back pain. Such risk factors include:

• Age. After age 30, the disks between your vertebrae begin to deteriorate and grow thinner, which puts you at greater risk for disk herniation. The disks also lose water, which puts you at risk for spinal stenosis.
• Genes. You may inherit certain structural abnormalities in your spine or a have a genetic predisposition for back problems (for example, many people in your family may have problems with back pain after a certain age).
• Lower pain threshold. Lots of people have spine problems, like bulging disks. But not everyone experiences pain from them.
• Arthritis. The kind of arthritis that happens with age, called osteoarthritis, can often affect the joints of the lower spine. Another common kind of arthritis, called rheumatoid arthritis, can affect vertebrae, but usually in the neck, rarely the lower back.
• Depression, stress, and unhappiness at home or work. These all make you more likely to experience back pain. Depression also makes it more likely for your back pain to become a long-term, ongoing problem. Depression and stress may lower your pain threshold or magnify the pain you already have.
• Pregnancy. The changes that happen in your body when you are pregnant make you very susceptible to back pain. First, your weight redistributes. Also, the ligaments in your pelvis purposefully loosen to get your body ready to deliver a baby. Having a loose pelvis can last for weeks to months following the delivery.
• Osteoporosis. A decrease in bone density (called osteoporosis) happens as you age, especially in women after menopause. As you lose bone density, the bone weakens and fractures become more likely. Tiny fractures in the vertebrae from osteoporosis can cause back pain. Another possible outcome from loss of bone strength is sudden collapse of a vertebra. This may be very painful.

• Certain occupations. Jobs that involve heavy lifting, forceful movements, lots of bending or twisting, and whole body vibration (for example, long-distance truck driving) place you at greater risk for low back pain.
• Lack of exercise. If you do not exercise regularly, you are more likely to develop low back pain. This is especially true if you suddenly attempt an activity that you haven't done in a long time. Shoveling snow and moving furniture are common examples.
• Being overweight. Carrying around extra pounds puts additional stress on your spine.
• Smoking. Cigarettes may put you at increased risk for back problems. This may be because tobacco causes poor blood circulation. Or it may be because when you smoke, you are more likely to have other bad habits, like not exercising.

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