It is estimated that up to 84 percent of adults have low back pain at some time in their lives [1,2]. For many individuals, episodes of back pain are self-limited. Patients who continue to have back pain beyond the acute period (four weeks) have subacute back pain (lasting between 4 and 12 weeks) and may go on to develop chronic back pain (persists for ≥12 weeks) [3]. Rarely, back pain is a harbinger of serious medical illness.

The intensity and manageability of pain are very different for every person. For example, one person may have a large herniated disc and experience no pain at all, and another individual may have a simple muscle strain that can cause excruciating back pain and difficulty moving but will heal on its own in a few days.

Also, with some conditions, the pain can flare up from time to time and then subside, only to flare up again after a few weeks or months and gradually intensify over time. Because only you know your level of pain, your treatment will most likely be more successful if you proactively participate in making decisions about your medical care.

There are many interconnected and overlapping structures that make up the spine are capable of producing back pain. Moreover, the spine is prone to injury because it is subject to many different forces: twisting, sudden jolts, and daily stresses (such as sitting too much, moving in the same direction repetitively, poor posture) [4]. Common anatomical causes of back pain include:

The large nerve roots that go to the legs and arms may be irritated
The smaller nerves in the discs may be irritated
The large paired back muscles that support the spine may be strained
Any of the bones, ligaments, or joints throughout the spine may be injured

There is a lot of overlap of nerve supply to most of the anatomical structures in the spine (discs, muscles, ligaments, etc.), which often makes it impossible for the brain to distinguish between injury to one structure versus another. For example, a torn or herniated disc can feel identical to a bruised muscle or ligament injury [4].

The type way you describe your pain, the area of distribution of the pain, and any related symptoms are important to determine a back pain diagnosis, and the treatments will usually be different depending on the diagnosis [4]. Three common classifications of back pain include:

Mechanical pain. Also called axial pain, may be described in a number of ways, such as sharp or dull, constant or comes and goes, etc. Specific motions bring about this pain. A muscle strainis a common cause of mechanical/axial pain.
Referred pain. Often characterized as dull and achy, referred pain tends to move around and vary in intensity. As an example, in the lower back degenerative disc disease may cause referred pain to the hips and posterior thighs. Stenosis will present in both legs and thighs versus degenerative disc disease may occur in only one leg.
Radicular pain. Often described as deep and searing pain, radicular pain follows the path of the nerve into the arm or leg and may be accompanied by numbness or weakness. This type of pain is caused by compression, inflammation and/or injury to a spinal nerve root. Other terms for radicular pain are sciaticaor radiculopathy, and can be caused by conditions such as a herniated disc or spinal stenosis, or spondylolisthesis.

Ultimately, participating in the decision-making process about your medical care should definitely help you have a better outcome, and understanding your pain is an important element of this process. Come in for a visit today so we can help you understand, evaluate, and treat your low back pain.

Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine (Phila Pa 1976) 1987; 12:264.
Cassidy JD, Carroll LJ, Côté P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976) 1998; 23:1860.
Chou R. In the clinic. Low back pain. Ann Intern Med 2014; 160:ITC6.
Burke S. Understanding different types of low back pain. 2016. Available at: https://www.spine-health.com/blog/understanding-different-types-back-pain