Hi Thank you for your question to HCM. First , you don t need to worry at all due to the spina bifida. Spina bifida occulta is a type of an anomaly that is asymptomatic and many people live with this through their life without symptoms (that s why occulta). This spina bifida never causes back pain. This variation of spine development has been there in your back since birth and won t cause any symptoms. It is an incidental finding. A form of spina bifida which is symptomatic type presents in childhood with nerve problems and leg weakness related to those. Your back pain is very likely musculoskeletal and would respond to pain killers (ibuprofen,naproxen), local heat and pain killer ointments and physiotherapy. Avoid bending and twisting of back and lifting heavy weights for a month. Hope this is helpful. I would be happy to answer any questions you may have.