A burning sensation in the back is a distinctive form of pain, often described as hot, stinging, or like an electric shock. Unlike a dull ache or sharp, stabbing pain, this symptom typically points to irritation within the sensory system, specifically affecting the nerves or the superficial layers of the skin. Understanding the possible origins of this specific pain is the first step toward addressing the underlying cause.
Nerve-Related Conditions
The most common causes of a burning sensation in the back relate to the irritation or compression of spinal nerves. This is known as neuropathic pain, which results from damage or dysfunction within the nervous system itself, causing nerves to misfire and send spontaneous pain signals. The burning feeling originates at the nerve roots as they exit the spinal column. Radiculopathy occurs when a spinal nerve root is pinched or inflamed, frequently by a herniated disc or a bone spur. This pressure can cause the nerve to depolarize abnormally, leading to spontaneous pain that may radiate along the nerve’s path.
Sciatica is a specific form of radiculopathy where the burning pain travels along the sciatic nerve, running from the low back down the buttocks and leg. Spinal stenosis, which is a narrowing of the spinal canal, can also compress multiple nerve roots. This generates a burning discomfort that often worsens with movement or standing.
Skin and Surface Irritations
While deep nerve compression causes burning pain, a superficial burning sensation often points to conditions affecting the skin and the nerve endings just beneath the surface. The most distinct example is Herpes Zoster (Shingles), a reactivation of the varicella-zoster virus. The virus lies dormant in nerve roots and, upon reactivation, travels along a specific nerve pathway (dermatome) to the skin, causing inflammation and pain.
Shingles-related back pain is often described as sharp, burning, or tingling, and it can begin before any visible rash appears. When the rash develops, it typically presents as a painful band of fluid-filled blisters on one side of the body, corresponding to the inflamed nerve root. If this acute pain persists for months after the blisters heal, it is called postherpetic neuralgia, a chronic neuropathic complication.
Other common surface irritations can also produce a recognizable burning sensation. Severe sunburn causes localized burning due to thermal damage and inflammation of the skin’s outer layers. Contact dermatitis, an allergic reaction to products like laundry detergent, causes the skin to become inflamed and itchy, which can manifest as a superficial burning or stinging feeling.
Musculoskeletal and Inflammatory Sources
Structural and muscular issues can result in a burning sensation, typically due to intense localized inflammation rather than direct nerve root compression. Severe muscle strains or sprains involve microscopic tearing of muscle fibers or ligaments, triggering a significant inflammatory response. This process irritates the fine nerve endings located within the muscle tissue, leading to a sensation that feels like a burn.
Myofascial pain syndrome involves the development of trigger points, which are hyper-irritable spots in the fascia surrounding muscles. These localized points of tension and inflammation can cause a referred pain pattern that includes a focused burning sensation in the back. This burning is often less widespread and more localized than the radiating pain caused by a compressed spinal nerve.
Inflammation in the joints and supporting structures of the spine, such as arthritic flare-ups in the facet joints, can also generate burning pain. When these joints become inflamed, the surrounding tissues and associated nerves are irritated, producing a deep, localized burning discomfort. Degenerative changes in the spinal discs can also cause chronic inflammation that irritates nearby nerve structures, contributing to a persistent burning feeling.
Signs Requiring Immediate Medical Care
While many causes of burning back pain are manageable, certain accompanying symptoms, known as “red flags,” indicate a potentially serious condition requiring immediate medical evaluation. The sudden onset of severe weakness or numbness in the legs, especially if affecting both sides, warrants urgent care. This can signal significant nerve compression that could lead to lasting damage if not addressed quickly.
A sudden loss of control over bowel or bladder function is an especially serious sign, as it may indicate Cauda Equina Syndrome. This rare condition involves severe compression of the bundle of nerves at the end of the spinal cord, necessitating emergency intervention. Burning pain accompanied by a high fever, chills, or night sweats suggests a possible spinal infection, such as osteomyelitis or discitis, which requires immediate diagnosis and treatment.
Unexplained, unintentional weight loss alongside persistent back pain can be a sign of a systemic issue, such as an infection or tumor in the spine. Back pain that is unrelenting and fails to improve with rest, particularly pain that is worse at night, should also be evaluated by a healthcare provider without delay. These symptoms are warning signs that the underlying cause may be progressing rapidly.