A burning sensation in the back is a distinctive symptom, often described as hot, electric, or tingling. This is generally termed neuropathic pain, indicating the source of the discomfort is the nervous system itself. Unlike a dull muscle ache, burning pain suggests irritation, compression, or damage to a nerve root or the nerve fibers branching from the spinal cord. Recognizing this specific sensation helps narrow the potential causes down to conditions affecting the spine’s delicate neural structures. Nerve damage, if left unaddressed, can lead to chronic pain and long-term functional impairment.
Burning Pain Caused by Mechanical Nerve Impingement
The most frequent causes of burning back pain involve structural issues within the spinal column that place physical pressure on a nerve root. This mechanical compression often leads to radiculopathy, a condition where pain radiates along the path of the irritated nerve. A common culprit is a herniated disc, where the soft, gel-like center pushes through the tougher outer layer. This extruded disc material can physically pinch a nearby nerve root, and also releases inflammatory chemical substances that irritate the nerve, contributing to the intense burning sensation.
Another widespread mechanical cause is spinal stenosis, which involves a progressive narrowing of the spinal canal or the small openings where nerve roots exit the spine. This narrowing, often due to age-related degeneration, reduces the space available for the nerves. The resulting compression typically causes burning pain that worsens with standing or walking. The pain often finds temporary relief when a person sits or leans forward, a posture that slightly flexes the spine and opens up the narrowed canal. Spondylolisthesis, where one vertebra slips forward over the one below it, can also compress the nerve roots, leading to a similar burning, radiating pain pattern.
Neuropathic and Infectious Conditions
Burning back pain can also arise when the nerves themselves are damaged or diseased, regardless of mechanical compression from spinal structures. A classic infectious cause is Shingles (herpes zoster), which is a reactivation of the varicella-zoster virus. This virus remains dormant in the sensory ganglia near the spine after a chickenpox infection. It can travel down a nerve path to the skin, causing a painful, blistering rash that typically wraps around one side of the torso or back. The acute burning and electric pain experienced during the outbreak is caused by the direct inflammation and destruction of the nerve fibers.
A long-lasting complication of Shingles is postherpetic neuralgia (PHN), where the intense burning pain persists for months or even years after the visible skin rash has healed. PHN results from permanent damage inflicted on the sensory nerve fibers, causing them to send abnormal pain signals to the brain. Systemic conditions like diabetes can also cause this type of nerve damage, known as diabetic neuropathy. While it most often affects the hands and feet, diabetes can also lead to proximal or focal neuropathy, causing burning pain, numbness, or weakness in the trunk or lower back area. This damage occurs because chronically high blood sugar levels impair nerve function and injure the small blood vessels that supply the nerves.
Referred Pain from Internal Structures
Sometimes, intense burning or aching back pain originates not from the spine or the nervous system, but from diseased internal organs, a phenomenon called referred pain. This misdirection of pain occurs because the visceral nerves supplying the internal organs and the somatic nerves supplying the back share common pathways within the spinal cord. The brain misinterprets the organ pain signal as originating from the back, rather than the organ itself.
A common source of referred back pain is the kidney, which sits high in the flank area between the ribs and the hips. Conditions like kidney stones or pyelonephritis, a severe kidney infection, can cause intense, constant pain that radiates into the back. Similarly, the pancreas, situated behind the stomach, can cause severe upper to mid-back pain when inflamed. Acute pancreatitis frequently causes pain that radiates straight through the abdomen to the back, often described as intense and sometimes burning.
Recognizing Urgent Symptoms and Seeking Diagnosis
While most burning back pain is treatable, certain accompanying symptoms act as “red flags” that signal a potentially severe, time-sensitive medical problem requiring immediate attention. A loss of bladder or bowel control, difficulty initiating urination, or an inability to control a bowel movement are the most concerning signs, as they may indicate Cauda Equina Syndrome. This condition involves massive compression of the nerve bundle at the base of the spinal cord, which can lead to permanent paralysis or incontinence if not promptly treated.
Other urgent symptoms include a sudden, progressive weakness in the legs, or a severe numbness in the “saddle area.” Systemic signs like unexplained fever, drenching night sweats, or unintentional weight loss accompanying the back pain also warrant immediate evaluation, as they may point toward an infection in the spine or an underlying malignancy. Seeking a professional diagnosis promptly is the only way to accurately determine the source of the burning pain and begin appropriate treatment before any potential nerve damage becomes irreversible.