The easy part is pointing to where it hurts. It’s a bit trickier terrain from there, but thinking about how your pain feels, when it hurts worst, and what activities trigger painful flare-ups can help you zero in on the cause of your pain. Keeping a pain diary can help. Read on to understand the causes of back, neck, and shoulder pain, from the more common causes to the more obscure. Why women have it worseAlthough men and women are at risk of developing back pain, a few lifestyle events or experiences unique to women can put them at risk. Here’s how to take these life challenges and prevent them from leading to the additional challenge of back pain.Pregnancy: Pregnant women may experience back pain not only because of the extra weight they are carrying, but also because the body produces hormones that relax the joints and ligaments and aggravate pain. Edna Ma, MD, an anesthesiologist in Santa Monica, California, suggests exercising; using massage, over-the-counter pain relief, and hot and cold compresses; and sleeping on your side. Using proper posture when bending and lifting will also help you avoid aggravating your back.Heavy bags: Toting around a heavy purse or bag can cause what is in essence an overuse injury. Gerard W. Clum, DC, the president of Life Chiropractic College West in Hayward, California, says that the best approach is to clean out your purse or briefcase frequently so that you are carrying a lighter load. Backpacks are also preferable to purses or briefcases as they distribute weight evenly on your back instead of over one shoulder.Being well-endowed: Women with large breasts may experience back pain resulting from altered posture and the pressure it puts directly on the upper back. Dr. Ma sees breast reduction surgery as a last resort. Losing weight will often have the added benefit of reducing your breast size to a more manageable level. Wearing a sports bra or strengthening your core with yoga and Pilates can also be helpful. 

  1. Low back painLow back pain costs about $100 billion a year in related health care costs and the costs have doubled since the 1990s, according to University of North Carolina researchers. The researchers aren’t sure of the cause, but they suspect that obesity and overweight are the main suspects. Many people have trouble figuring out why they hurt; they could have slipped and fallen, lifted something improperly, or twisted too fast. Poor muscle tone, chronic strain from poor posture, and excess weight, not to mention degenerating bones and disks in your back can all contribute to low back injury and pain. Low back pain is often caused by strain, sprain, other types of injury, and also by age. The disks in the low back break down over time and can cause nerve-related pain, and the bones of the spine itself can break or grow painful spurs that can irritate nerves. The spinal cord itself can become infected or the victim of disease. In very rare cases, your low back pain may be caused by cancer. Ruling out one in favor of another can be tricky because expensive scans aren’t always helpful. The American College of Physicians and the American Pain Society both recommend scans only if they feel a serious nerve pain or cancer is suspected.
  2. Neck painAs with low back pain, neck pain is an extremely common complaint and most of us can expect a bout of it at one time or another in our lives. If you have one bout of neck pain, you have a 50 to 85% chance of it occurring again anywhere from 1 to 5 years later. When it comes to your neck, pain is often a result of your occupation (athlete, writer, or computer technician) or your poor habits (slumping and slouching). Most people with neck pain don’t completely recover. It can also be tricky to distinguish between upper back pain and neck pain since they often occur together.
  3. Upper back painThe most telling clue that your pain originates in your upper back is a consistent feeling of tension and pain in the middle of your back that often encompasses most of the area around your upper back. Sometimes the pain can radiate to the chest area because the thoracic spine (a fancy term for the upper back) connects to your ribs. People with upper back pain may also feel an intense shooting pain if they try to twist toward the side of the pain. Often the cause is a strain or a sprain from day-to-day poor posture, a quick twist, or another injury (the upper back isn’t designed to twist much).
  4. Shoulder painMoving slightly outward from the back, the shoulders can be a source of pain for many people. The most common causes of shoulder pain are arthritis or an overuse injury such as tendinitis or bursitis.
  5. Strains and sprainsMost back, neck, and shoulder pain is caused by either strains involving trauma to muscles and tendons or sprains caused by pulled or stretched ligaments that attach bone to bone. Strains can develop from years of poor posture; sprains are more often caused by an injury or accident. A strain or sprain is characterized by stiffness and muscle spasms in which the pain is localized—that is, the pain doesn’t radiate down your arms or legs. MORE: 5 Yoga Fixes For Bad Posture
  6. Disk-related painThe disks that live between the bony vertebrae of the spine are oval-shaped, with a tough outer layer surrounding a soft center. Your disks act as shock absorbers for the spinal bones, but as a normal part of aging, they experience a lot of wear and tear. When the stress becomes too great, they can dry out and crack. If too much of a disk wears away, bone can rub on bone and cause pain. Or a disk can bulge or slip out of alignment and pinch a nerve. When low back pain is caused by bulging, slipped, or broken disks, the pain radiates down one or both legs (called sciatica). Disks can rupture in the neck area as well, but the radiating pain in this case would be felt down one or both arms. Because the upper back is stable and doesn’t do a lot of moving, disk issues are rare in this region.
  7. ArthritisJust like all the other joints in the body, the bones of the spine can become arthritic and this can cause narrowing of the spinal cord. (See 13 important questions about arthritis, and get the facts.)
  8. Fractured vertebraeA spinal fracture caused by an injury or accident will cause immediate and apparent back pain. But in other cases, such as when a person has osteoporosis, the fracture may occur gradually and cause no pain at all. If you have this condition, you should be under a doctor’s supervision to make sure a fractured vertebra has not occurred. In some instances the fracture may evolve into chronic back pain or a subtle curvature of the spine.
  9. Slipped vertebraIn this condition, also known as spondylolisthesis, a vertebra cracks or slips forward so that bone is touching bone. This can also cause a pinched nerve. Spondylolisthesis in children is often caused by a birth defect. In adults it’s usually related to arthritis. Slipped vertebrae are fairly rare, occurring in about 3 to 6% of people, and can impact the body anywhere along the spine from the neck to the low back. Symptoms often begin with low back pain and muscle aches or pain in your buttocks and down your leg.
  10. Other causesWhen the spinal column narrows as a result of damaged disks, arthritis, infection, spinal defects, an injury, or other reasons, the condition is known as spinal stenosis. Spinal stenosis does not always cause symptoms, but it can cause pain or numbness in the back and/or legs. Weakness or cramping in the legs may also occur. Rarely, bowel and/or bladder problems occur as well. Skeletal abnormalities such as scoliosis (a curvature in the spine) and kyphosis (dowager’s hump) can cause pain in the upper back. When to call the doctorGet medical help immediately if you or a loved one has any of the following symptoms.

Back, neck, or shoulder pain after an injury or accidentPain accompanied by extreme numbness or loss of strength in the arms or handsBack pain accompanied by problems urinating or having bowel movementsInability to touch your chin to your chestBack, neck, or shoulder pain that is constant, intense, and interferes with your day-to-day routinePain that intensifies when you lie downBack pain with weakness, numbness, or tingling that radiates down one or both legs, especially if the pain goes below your kneeBack or neck pain that’s accompanied by pain or throbbing in your bellyBack, neck, or shoulder pain with a feverA first back pain incident that occurs after the age of 50Back, neck, or shoulder pain paired with a history of cancer, osteoporosis, steroid use, or drug or alcohol use

MORE: Worst Habits That Hurt Your Back Discover how to manage chronic aches and pains—from back pain to migraines to joint pain and more—in Your New Pain Prescription (Rodale). Order your copy today!