Stiff Back: What's Causing Your Stiff Back & How to Get Relief
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Stiff back can be caused by muscular causes such as muscle strain, muscle spasms, and poor posture. Arthritis of the lumbar spine and spinal cord pressure that compresses the sciatic nerve - the nerve that runs from the lower back to the legs - can also cause back pain and stiffness.
Hallmark stiff back symptoms
Back stiffness is a common symptom that may start suddenly or develop slowly over time. Severe back stiffness can interfere with daily activities, such as movements required for work. Back stiffness can be particularly debilitating for elderly adults, but some conditions associated with back stiffness can occur at younger ages. The stiffness can occur due to problems with back muscles, joints in the spine, or the spinal cord itself.
Common characteristics of a stiff back
If you're experiencing a stiff back, it can likely be described by:
- Pain and stiffness in other joints or muscles
- Stiffness that is worse in the morning
- Specific tender points in the back muscles
- Intermittent muscle spasms
Common accompanying symptoms
It's also likely to experience the following symptoms with a stiff back.
6 stiff back causes
Arthritis may lead to a stiff back
- Inflammatory arthritis: Some types of arthritis are characterized by inflammation within the joints. Inflammatory arthritis often leads to stiffness in the back, particularly in a condition called ankylosing spondylitis. This type of arthritis most commonly affects young men. Other parts of the body can be affected, particularly the eyes.
- Osteoarthritis: Older people are often affected by osteoarthritis, resulting from accumulated damage to the joints due to wear-and-tear over a lifetime. Osteoarthritis in the spine can result in back pain and stiffness.
Your back stiffness may be due to certain muscular conditions.
- Muscle strain: Excessive force on the muscles in the back can cause stiffness and pain. Muscle strain can occur suddenly, such as from lifting a heavy object. It can also occur due to repetitive forces on the muscle over time during occupational or athletic activities.
- Pain syndromes: Back muscles can be involved in musculoskeletal pain syndromes such as fibromyalgia. In this case, there will be chronic pain throughout the body, typically accompanied by stiffness. Back muscles are often involved and may be more stiff in the morning. Fibromyalgia is most common in young women.
- Polymyalgia rheumatica: This inflammatory condition affects muscles close to the middle of the body, including the shoulders, hips, and back. Muscle pain is commonly accompanied by stiffness, particularly in the morning. This disorder is sometimes associated with inflammation of the temporal artery, which can lead to blindness if left untreated.
Injury to the spine or spinal cord can result in a stiff back.
- Fracture: A fracture of part of a vertebra can lead to back pain and stiffness. Depending on the type of fracture, either young athletes or older adults are most commonly affected. Osteoporosis or bone thinning is a risk factor.
- Spinal cord compression: Back pain and neurological abnormalities are the dominant symptoms of compression in the area of the spinal cord. Back stiffness can also occur, however. The spinal cord can be compressed by bony abnormalities or injury, infection, or a herniated disc. Immediate medical evaluation is recommended.
Diffuse idiopathic skeletal hyperostosis
Diffuse idiopathic skeletal hyperostosis (DISH) is calcification or a bony hardening of ligaments in areas where they attach to the spine. Ligaments are supposed to be flexible, so DISH can cause symptoms such as pain, stiffness, and restricted movement.
Top Symptoms: joint pain, upper back pain, stiff neck, stiff back, trouble swallowing
Urgency: Primary care doctor
"Ankylosing" means a joint has become stiffened and fixed in one position due to injury or disease. "Spondylitis" means inflammation in the joints of the spine. In ankylosing spondylitis, inflammation has damaged the vertebrae of the low back and caused a form of arthrit...
Lower back arthritis
Osteoarthritis, most often simply called arthritis, is a disease of cartilage. In joints, where bones touch and move against one another, cartilage helps provide lubrication for smooth movement, and acts as a shock absorber. Cartilage is also present in between vertebrae, which are the bones comprising the spine. Osteoarthritis of the spine, also known as degenerative joint disease, happens when the cartilage between vertebrae dries out and shrinks. The vertebrae are thus not as able to move smoothly against one another. The ability to walk and perform normal daily activities can be impaired due to inflammation and pain in the lower back.
Top Symptoms: lower back pain, spontaneous back pain, back pain that gets worse when straightening it, back pain from overuse
Urgency: Primary care doctor
Psoriatic arthritis is a condition which causes inflammation of the joints. In most circumstances, psoriatic arthritis presents between the ages of 30 and 50 years and occurs after the manifestation of the symptoms of psoriasis, which is a disease of the skin. Psoriatic arthritis...
Herniated (slipped) disk in the lower back
The backbone, or spine, is made up of 26 bones called vertebrae. In between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. Although people talk about a slipped disk, nothing actually slips out of place. The outer shell of the disk ruptures, and the jelly-like substance bulges out. It may be pressing on a nerve, which is what causes the pain.A slipped disk is more likely to happen due to strain on the back, such as during heavy lifting, and older individuals are at higher risk.
Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness
Urgency: Primary care doctor
Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness throughout the body. Rheumatoid arthritis (RA) is a chronic condition that is autoimmune in nature, meaning that the body's immune system which normally protects the body by att..
Stiff back treatments and relief
Back stiffness alone is unlikely to require emergency treatment. However, it can indicate a serious injury or infection when accompanied by other symptoms.
When it is an emergency
You should seek emergency treatment for the following.
- The stiffness and pain after an acute injury are so severe that you are unable to move
- Changes in vision or eye pain
- Weakness in your legs, sensation changes in your legs or groin, and/or loss of control over bowel and bladder function
- Systemic symptoms such as fever and fatigue along with severe back pain
When to see a doctor
In some cases, even though emergency treatment isn't necessary, you may need medical evaluation and treatment. Make an appointment with a doctor for the following.
- Your back stiffness lasts more than two weeks
- You are unable to carry out your usual activities
- Your back stiffness is particularly severe in the mornings
- You have pain and stiffness in other joints and/or muscles
- You have been diagnosed with arthritis or a pain syndrome previously and your symptoms are worsening
Your doctor may recommend one or more of the following treatments, depending on the cause of your stiff back:
- Physical therapy
- Anti-inflammatory medications
- Steroid injections into joints affected by arthritis
- Antidepressant medications: These can help improve pain, stiffness, and sleep if a pain syndrome is a cause.
- Referral for surgical management
Some home treatments may help with a stiff back, such as the following.
- Heat for muscle pain: A heating pad can help with muscle stiffness and pain.
- Ice for injury: If your stiffness occurs after an acute back injury, applying ice can help prevent swelling.
- Continue light activity as much as possible: Bedrest can worsen back pain and stiffness.
- Pain medication: Ibuprofen (Advil, Motrin) or other NSAIDs can help with pain and stiffness.
- Relaxation techniques: Meditation can help relax your back muscles, resulting in decreased stiffness and discomfort.
- Massage: This can help make back muscles less stiff.
FAQs about stiff back
Can back stiffness in a young person be caused by arthritis?
Yes, certain types of arthritis associated with back stiffness typically occur in young people. These conditions are associated with inflammation in the joints of the spine. Ankylosing spondylitis is strongly associated with back stiffness and typically occurs in young men. Rheumatoid arthritis is often diagnosed in children and young adults; like ankylosing spondylitis, it can cause back stiffness and pain.
Is my back stiffness likely to improve?
Many causes of back stiffness will resolve over time without treatment, or with simple home treatments such as heating pads and massage. For example, a muscle strain will likely get better within weeks to months. However, back stiffness caused by a chronic medical condition such as arthritis may persist or worsen over time. See your physician if your back stiffness has not improved after a few weeks.
Do I need imaging to diagnose the cause of my stiff back?
Imaging is not typically the first step in evaluating a stiff back. Often, back stiffness will resolve without treatment and is not caused by a serious underlying medical condition. However, in some cases, it is a good idea to get imaging. If back stiffness occurs along with sudden pain and other worrying symptoms such as leg weakness or fevers, imaging of the back should be performed to see if spinal cord compression or infection is the cause. If arthritis is suspected, imaging can be helpful to establish a diagnosis and determine disease severity.
Why is my back particularly stiff in the morning?
Several conditions cause back pain and stiffness that are particularly severe in the morning. These include inflammatory arthritis, such as ankylosing spondylitis or rheumatoid arthritis, and the musculoskeletal inflammatory disorder polymyalgia rheumatica. If you have one of these conditions, you will likely notice stiffness lasting an hour or more after waking up in the morning, and stiffness may recur if you spend a long time in one position.
Why am I having visual changes in addition to back stiffness?
Uveitis is a common complication of ankylosing spondylitis and inflammatory arthritis. This condition involves inflammation of one of the layers of the eye, leading to eye pain, redness, and blurred vision. On the other hand, polymyalgia rheumatica, a musculoskeletal inflammatory condition, can be associated with temporal arteritis. Inflammation of the temporal artery can cause blood vessel damage that ultimately leads to vision loss. Any changes in vision occurring in association with back pain or stiffness should be evaluated immediately.
Questions your doctor may ask about stiff back
- Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
- Is your spinal stiffness worse in the morning?
- Does your back pain radiate anywhere?
- Do food or drinks get stuck when you swallow?
Lauren is a resident physician in family medicine at the University of Illinois at Chicago. She earned her medical degree at the University of Pennsylvania and her undergraduate degree at Oberlin College. Lauren also has an interest in teaching as well as experience with college tutoring and writing MCAT preparatory materials. She believes family medicine challenges her to maintain a broad field of medical knowledge and she hopes to work in an academic setting in the future. In her free time, Lauren enjoys running, reading, and visiting historic sites.