Back pain truly is an umbrella term for a myriad of things which can manifest as "back pain". It is no wonder that the back is host to a lot of pain manifestation, whether originating from the back itself or not. This is because as per the 'Rule of Nines' (a medical way of estimating coverage in burns patients), the back accounts for around a fifth of the whole body's surface area. And so, given the large area of the body that the back is, and given the complexity of the human body, there are a lot of things which may cause or contribute to the pain you may be experiencing.

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The back is a very complex formation which is made up of vertebral bones, intravertebral discs, large nerves, tendons, ligaments, soft tissue and others. Some of these structures span beyond just the back, and include areas such as the ribs and abdomen. These all work together in a biomechanical symphony, tasked with connecting the top with lower portion of the body, protecting the spinal nerve and keeping the body upright to navigate the world. Naturally, all these structures work together in synergy to execute these vital functions. However, when the body's effort to sustain this synergy slips up, it backfires (pun intended), and results in stress. This stress manifests as back irritation or even pain, meant as a signal by the body that something is not exactly as it should be. 

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Although very common, referred (not originating in source of pain) back pain (a result of such imbalances in the body) can be very aggravating and worrying for an individual. A frequent example of such referred back pain can (and does) start from sitting down for too long. Being sat down for too long e.g. when working in an office or not exercising regularly, can cause tightness in muscles lining your ribs called the intercostals. Such tightness throws the balance off between the front and the back of the body, which puts extra stress of the muscles and/or structures in the back. Another interesting example of referred  back pain is back pain which can be brought on by an episode of gastro-oesophageal reflux disease (GERD). Because nerves along the the food pipe use similar highways to communicate with the brain as the stomach and torso do, pain from GERD can be felt in the back and even jaw! This is precisely why back pain can be worrisome for people, let alone debilitating. 

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Aside from referred back pain direct back pain is also very common, and unlike referred pain, it can generally be pinpointed to a more localised issue within the structures of the back. There can be many reasons for direct back pain, some benign but also some which warrant a visit to the GP. Examples of conditions which may put pressure on, or cause pain altogether, are sciatica (compression of nerve which travels down your leg), arthritis (wear and tear of discs), osteoporosis (thinning of bones in the spine) or herniated (slipped) disc. There are other conditions which may further contribute to back pain, so it is important to speak to a healthcare professional if you experience back pain which gets progressively worse or stops you from your daily functions.

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Other less expected causes of back pain can manifest from mental states. Anxiety and depression have a strong link to back pain. There are also pre-dispositions and direct behaviours which can cause back pain, either acutely or over a longer span of time. These include a general state of inactivity, obesity, poor work habits such as poor posture, improper lifting and other chronic health conditions. 

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