A burning sensation in the back points to irritation or damage within three main tissue systems: deep spinal nerves, superficial skin layers, or underlying muscle tissue. This feeling, which can manifest as searing heat, an electric shock, or an intense sting, requires understanding the source of the irritation—from spinal compression to a simple skin reaction—to find relief.
Deep Nerve Irritation and Neuropathic Pain
Intense burning pain in the back is often neuropathic pain, originating from the deep spinal nerves. This occurs when a nerve root is compressed, trapped, or inflamed as it exits the spinal column, a condition known as radiculopathy. The damaged nerve misfires, sending signals interpreted as a burning, tingling, or electric shock sensation.
A common cause is a herniated disc, where the inner material pushes out through a tear in the disc’s outer layer. This bulging material directly presses upon a nerve root and releases inflammatory chemicals that further irritate the nerve. This combination of mechanical pressure and chemical inflammation creates burning pain that often radiates away from the spine.
When nerve root compression occurs in the lower back, it frequently causes sciatica, characterized by sharp, shooting, or burning pain traveling down the buttock and into the leg. This sensation follows the specific pathway of the affected nerve, differentiating it from generalized muscle soreness. The pain may worsen with actions that increase pressure on the disc, such as coughing, sneezing, or prolonged sitting.
Spinal stenosis involves the narrowing of the spinal canal or the small openings where nerve roots exit. This narrowing typically develops gradually due to age-related changes, such as bone spur formation or thickening of ligaments. The reduced space puts pressure on the nerve roots, causing burning pain that worsens when standing or walking. Relief is often found when sitting or leaning forward, indicating mechanical compression is the primary cause.
Superficial Skin Conditions and Localized Burning
A burning sensation confined to the skin’s surface suggests a problem with the skin or the small, superficial nerves beneath it. Unlike deep nerve pain, these conditions are often localized to a specific patch or band and may include visible skin changes.
Shingles, caused by the reactivation of the varicella-zoster virus, is a frequent culprit for localized burning back pain. The virus travels along a single nerve pathway, or dermatome, causing intense burning, itching, or tingling that often precedes the characteristic red, blistering rash. This pain typically appears on only one side of the body, following a distinct band-like pattern around the torso or back.
Notalgia Paresthetica is a localized sensory neuropathy primarily affecting the skin between the shoulder blades or in the mid-back. It is characterized by a persistent, localized itch, tingling, or burning sensation, often without an initial rash. This condition is thought to be caused by the entrapment or irritation of small nerves passing through the back muscles. Constant rubbing or scratching of the area can eventually lead to a patch of darkened or thickened skin.
Contact dermatitis can cause a superficial burning or stinging sensation where the skin has reacted to an irritant or allergen. This reaction may be caused by a new detergent, a specific fabric, or a topical cream. The burning results directly from inflammation in the skin’s outer layers, which can also lead to redness, dryness, or small blisters.
Muscular Strain and Inflammatory Hot Spots
When the burning sensation is deep but does not radiate or follow a nerve path, it may be linked to severe muscle strain or localized inflammation in the surrounding support structures. This type of pain is generally mechanical or inflammatory in origin, rather than purely neuropathic.
A severe muscle strain or tear, particularly in the lower back, can create a deep, searing pain often described as a hot spot. Damage to the muscle tissue causes an immediate inflammatory response. Localized swelling and the release of pain-signaling chemicals irritate nerve endings within the muscle, mimicking a burning sensation.
Deep muscle trigger points are hyper-irritable spots within a taut band of muscle that can cause a referred burning sensation. These points are believed to be areas of sustained muscle contraction that restrict blood flow and create a toxic chemical environment. The referred pain generated by a trigger point can manifest as a burning, stinging, or deep aching sensation in a nearby area.
Inflammation of the facet joints, the small joints located on the back of the spine that enable movement, can also produce a burning discomfort. Degeneration or injury can cause these joints to become arthritic and inflamed, and the irritation of the nerve endings within the joint capsule is felt as a deep, burning ache. The pain from facet joint issues often worsens with backward bending or twisting movements, which compress the irritated joint surfaces.
Warning Signs and When to Contact a Doctor
While most causes of burning back pain are manageable with conservative care, certain symptoms require immediate medical attention. Any sudden and severe loss of bladder or bowel control is a red flag suggesting serious compression of the spinal cord nerves. This is often associated with Cauda Equina Syndrome, which requires emergency treatment to prevent permanent damage.
The sudden onset of significant weakness in one or both legs, or a rapidly increasing numbness in the “saddle area” around the groin and buttocks, are also urgent warning signs. These neurological deficits indicate a potential loss of nerve function that necessitates an immediate medical evaluation.
Pain accompanied by a high fever, chills, or unexplained weight loss, especially if constant and not improving with rest, may indicate a spinal infection or other systemic issue. If the burning pain results from significant trauma, such as a fall or car accident, a prompt assessment is needed to rule out spinal fracture or serious internal injury.