Few injuries are more dreaded than back injuries. Back pain is often misunderstood. People associate it with old age or see it as a symptom of long-lasting health conditions. Aging men may see any back pain as the first sign of ill health and a warning signal of upcoming years of less and less activity. But what really causes back pain? How can you tell the difference between a simple backache and something more serious?

Types of back injuries

To find out more about back pain, I interviewed Dr. Timothy Keenen, an orthopedic spine surgeon at Pacific Spine Specialists in Tualatin, Oregon. Dr. Keenen outlined the main types of back injuries that men get, what causes them and how to know when to see a doctor.

  • Muscle strain or lumbar sprain: "Two of the most common causes of low back pain are muscle strain and lumbar sprain injuries," Dr. Keenen explains. You get a strain when muscle fibers are stretched or torn. Sprains happen when ligaments are torn from where they are attached. Both strains and sprains have similar symptoms, so figuring out one from the other can be hard.
  • Disk injury: As our spines age, they get less flexible. A disk injury (or herniated disk) is caused when part of a disk (one of the spine's "shock absorbers") pushes out from where it belongs or gets out of alignment. A sudden fall or long-term repetitive motion can cause this type of injury.
  • Spinal fracture: A spinal fracture, or vertebral compression fracture, happens when the bones in the spine get so weak they collapse and break. Depending on the strength of your back and how strong your bones are, this kind of injury can be caused by anything from a car accident to a cough or sneeze.

Causes of back pain

Dr. Keenen says several things cause most back pain:

  • Improper lifting: "Lifting objects that are too heavy or lifting with improper technique may be the single most common cause of temporary back pain and more serious back injuries," Dr. Keenen says. "Getting out of position during a lift or placing too much demand on your back muscles by lifting an object that's too heavy can cause muscle strain and herniated disks [disk injuries]," he adds. Men are vulnerable to improper lifting. They may be embarrassed to ask for help or may have jobs that involve short bursts of extreme effort.
  • Sports injuries: Nearly 20 percent of all sports-related injuries are to the lower back or neck. Repetitive activities like running or weightlifting often affect the lower back. Classically male-dominated sports like football often cause injuries to the neck.
  • Work-related injuries: The job you do can also put your back at risk, and even the safest work environments can't prevent every injury. According to Dr. Keenen, on-the-job back injuries usually go something like this: Three workers lift an object, and one person slips. The slip causes an injury to the first person and the increased strain causes injuries to the remaining two. Improper posture and putting too much effort on the back muscles strain the back.


According to Dr. Keenen, the best thing you can do to prevent back pain and injury is to strengthen your core. "Strengthening the abdominal wall and lower back muscles is essential to maintaining a healthy back as we age," he says. "Also, men and women should learn and practice proper lifting techniques to avoid common back problems. When lifting a heavy object, it's always better to keep the object as close to your body as possible to leverage core muscle strength. Lifting something at arm's length is riskier—not only because of the potential for back strain—but because of the greater likelihood of losing balance and falling," he says.

When to see a doctor

With so many ways to injure your back to different degrees, how can you know when it's time to man up and see a doctor? According to Dr. Keenen, here's what to keep in mind.

  • Injuries with a clear cause: "If there was ... a clear cause, like a car accident or a fall, then the safest bet is to always get checked out by a doctor," Dr. Keenen says.
  • Nagging or spreading pain: If you have pain that wasn't clearly caused by something and doesn't go away after a week or so, or pain that begins to move to your calf, thighs, feet, or other extremities, see a doctor. Pain that spreads to your lower extremities may indicate nerve and spinal problems.
  • Pain with fever, chills or weight loss: "Any back injury that presents with a fever, chills or weight loss may point to an infection and should be checked out by a physician immediately," Dr. Keenen says.

If you need to see a doctor about an injury, keep in mind that physical therapy, visiting a chiropractor and rest can often treat back pain. Even more serious back injuries, such as disk injuries, can usually be treated without surgery.

As men age, back and spinal problems are almost impossible to avoid completely. But if you focus on good health, strength-building and behaving safely to prevent problems, you don't have to be afraid of keeping up an active lifestyle. Just know your body's warning signs, take proper precautions and, when in doubt, see a doctor.

Published on Jan. 4, 2012; updated on May 7, 2014.