The spine is a column of bones held together by muscles, tendons and ligaments. The spinal bones are cushioned by shock-absorbing disks. A problem in any part of the spine can cause back pain. For some people, back pain is simply an annoyance. For others, it can be excruciating and disabling.

Most back pain, even severe back pain, goes away on its own within six weeks ­— especially for people under age 60. Surgery usually isn't suggested for back pain. Generally, surgery is considered only if other treatments aren't effective.

A common cause of back pain is injury to a muscle or ligament. These strains and sprains can occur for many reasons, including improper lifting, poor posture and lack of regular exercise. Being overweight may increase the risk of back strains and sprains.

Back pain may also be caused by more-serious injuries, such as a spinal fracture or ruptured disk. It can also result from arthritis and other age-related changes in the spine. Certain infections can cause back pain.

Possible causes of back pain include:

• Ankylosing spondylitis
• Endometriosis
• Fibromyalgia
• Herniated disk
• Kidney infection (also called pyelonephritis)
• Kidney stones (Hard buildups of minerals and salt that form inside the kidneys.)
• Muscle strains (An injury to a muscle or to tissue that connects muscles to bones, called a tendon.)
• Obesity
• Osteoarthritis (the most common type of arthritis)
• Osteomyelitis
• Osteoporosis
• Poor posture
• Pregnancy
• Sacroiliitis
• Sciatica (Pain that travels along the path of a nerve that runs from the lower back down to each leg.)
• Scoliosis
• Spinal cord tumor
• Spinal fractures
• Spinal stenosis
• Spondylolisthesis
• Sprains (Stretching or tearing of a tissue band called a ligament, which connects two bones together in a joint.)

Most back pain gets better within a few weeks without treatment. Bed rest isn't recommended. Over-the-counter pain medications often help reduce back pain. So might applying cold or heat to the painful area.

Schedule an office visit

Call your health care provider if your back pain hasn't improved after a week of home treatment or if your back pain:

• Is constant or intense, especially at night or when lying down
• Spreads down one or both legs, especially if the pain extends below the knee
• Causes weakness, numbness or tingling in one or both legs
• Occurs with unintended weight loss
• Occurs with swelling or redness on the back

Seek emergency medical care

Call 911 or emergency medical help or have someone drive you to the emergency room if your back pain:

• Occurs after a trauma, such as a car crash, bad fall or sports injury
• Causes new bowel or bladder control problems
• Occurs with a fever