We’ve all had muscle pain in our backs from time to time, but if that minor pain becomes severe or even permanent, we can begin to worry. While minor causes can bring about some major pain, there are many causes of back pain that are more severe and need to be treated by a doctor.

Most back pain is simply muscle pain from too much strenuous activity, or just overstressing yourself.

Chronic back pain is actually fairly common and doesn’t necessarily mean there’s a serious problem. Often it can be caused by improper posture, a poorly adjusted chair, or a bed that isn’t supportive enough. While this kind of pain isn’t serious in and of itself, it can cause serious psychological and physical problems, especially if it keeps you from sleeping.

Sometimes, however, back pain is a sign of a more serious condition and shouldn’t be ignored. Here are a few more serious problems that might be causing your back pain.

Osteoporosis. This is a fairly common problem in post-menopausal women. It is caused when loss of bone mass due to hormone changes causes the bones to weaken and tiny fractures occur. If left untreated, this can lead to severe pain and mobility problems. Osteoporosis is often treated with increased calcium and vitamin D levels, weight-bearing exercise (even walking is enough for most people), and additional medication. Even if you haven’t got these symptoms yet, it is worth considering adopting these lifestyle changes as soon as possible to prevent the problems from ever happening.

Herniated disc. There are soft cushions called discs between the separate bones in your spine. Occasionally, these discs can slip or rupture, pinching nerves in the back and causing pain or numbness. There is a common surgical option to fix this along with exercises to ease the pain.

Spinal stenosis. This problem can be caused by various underlying conditions and is simply a thinning of the spinal column. It usually occurs in older people and may or may not be correctable by surgery.

Fibromyalgia. There is not much known about the cause of this disease, but it is characterized by pain spread throughout the body, sleep problems, and tender points at specific places on the body. There are many treatments being studied for this condition.

While the disorders listed cause a lot of the back pain people experience, they are not the only reasons you might be hurting. There are a wide variety of skeletal, muscular, and more serious causes of back pain like cancer or an infection. You should see a doctor immediately if your back pain is constant, spreads down the legs or is accompanied by tingling or numbness in the legs, if you are having problems controlling your bowels or bladder, and if it is accompanied by fever, weight loss, or abdominal pain.

Most back pain causes are curable or manageable if treated appropriately by your doctor.