Back pain – mechanical or inflammatory??

Your back hurts but you are not sure what the trigger is…

We group back pain into two main areas = mechanical and inflammatory.  Here is a little bit of information about the differences.

Somewhere between 12-33% population will have some back pain through their life.

Mechanical back pain =

This tends to be more frequent and refers to pain that arises from an injury to/issue with a specific structure within the spine.

The two structures often implicated as the cause of the back pain are the intervertebral discs and facet (zygopophyseal) joints.

Although not definitive, pain that is aggravated by flexion of the spine is more likely to reflect similarities with a discal pathology whereas pain worsened by extension movements is more in keeping with pain from the facets.

This is often called non-specific lower back pain and recovery usually takes between 2-12 weeks depending on the duration of symptoms when you receive treatment and other activities you may continue with that can aggravate it slightly.

Sometimes the close lying neural structures can be involved and this will lead to a nerve presentation of referred pain but isn’t a true disc bulge.  Again, this should settle with time.

Treatment will look to improve the function around these joints and exercises to keep the support muscles of the trunk in good order are important too.

Inflammatory back pain =

Inflammatory back pain is characterized by pain which is exacerbated by rest, relieved by activity, and is often associated with early morning stiffness. The morning stiffness generally lasts for more than 30 minutes.

This most commonly related to an inflammatory spondyloarthropathy. The classical condition termed Ankylosing Spondylitis.

The treatment approach most often utilised is based upon anti-inflammatory medication (often overseen by a Rheumatologist) and exercises, the latter of which aiming to maintain flexibility and therefore range of motion.

If you find that you experience these symptoms and need advice on the best course of management, an appointment with one of our physiotherapists will help get you back on track.