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Back pain is a common issue, with around 16 million Americans suffering from persistent or chronic back pain. Inflammation in the back is often the underlying cause of this chronic discomfort. Inflammation can be caused by a pulled muscle or chronic conditions like arthritis. This inflammation can lead to conditions such as sciatica, where the nerve running from the lower back down the leg becomes irritated. Chronic inflammation is also associated with autoimmune diseases, where the body's immune system attacks healthy tissue. This can lead to conditions such as spondyloarthritis, which affects the spine. Living with inflammatory back pain can be challenging, and it is important to get a proper diagnosis to determine the best treatment options.
| Characteristics | Values |
|---|---|
| Inflammation | Can be acute or chronic |
| Inflammation causes | Injury, irritation, strain, overuse, underlying health conditions, external factors, chronic stress |
| Inflammation symptoms | Pain, swelling, stiffness, fatigue, abdominal pain |
| Treatment | Nonsteroidal anti-inflammatory drugs (NSAIDs), prescription medications, muscle relaxers, physical therapy, hands-on manipulation, massage therapy, epidural steroid injections (ESIs), platelet-rich plasma (PRP) therapy, chiropractic care, surgery |
| Prevention | Exercise, movement, yoga, swimming, walking, core strengthening, anti-inflammatory foods, turmeric supplements, vitamin D & magnesium supplements |
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Chronic back pain
Inflammation is the body's natural defence mechanism, responding to injury or irritation by increasing blood flow and immune activity. While acute inflammation helps in healing, chronic inflammation can lead to prolonged pain and tissue damage, especially in the spine. Chronic back pain can be classified as mechanical pain or inflammatory pain. Mechanical back pain occurs when there is injury to the joints, bones, or tissues of the back. Inflammatory back pain occurs when there is inflammation in the spine, often due to the body's immune system attacking the joints of the spine.
Inflammatory back pain primarily occurs when inflammation affects the vertebrae in your spine or the sacroiliac joints. Ankylosing spondylitis, a chronic autoimmune disease, occurs from inflammation in the vertebrae, creating inflammatory spine pain. As a form of spinal arthritis, this condition can be painful and debilitating. Other types of arthritis can also cause inflammatory back pain, such as psoriatic arthritis and reactive arthritis.
To relieve chronic back pain, it is important to understand the underlying cause and seek proper diagnosis and treatment. Treatment options may include medications such as non-steroidal anti-inflammatory drugs (NSAIDs), prescription medications, and muscle relaxers. Physical therapy can strengthen muscles and improve flexibility, posture, and alignment. Hands-on treatments like massage therapy, osteopathic manipulation, and chiropractic adjustments can also help relax tight muscles and reduce pain. Additionally, stress management techniques and lifestyle changes, such as incorporating anti-inflammatory foods and low-impact exercises, can help reduce inflammation and manage chronic back pain.
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Sciatica
The symptoms of sciatica include pain, often described as burning or like an electric shock, which may shoot or radiate down the leg on the affected side. This pain commonly occurs with coughing, sneezing, bending or lifting the legs upward when lying on the back. Other symptoms include tingling or "pins and needles", numbness, muscle weakness, and in severe cases, urinary or faecal incontinence.
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Ankylosing spondylitis
The exact cause of AS is unknown, but genetic factors play a significant role. Individuals with the HLA-B27 gene are at an increased risk of developing the condition. However, not everyone with this gene will develop ankylosing spondylitis, and other genes are believed to be involved. Environmental factors, such as bacterial infections, may also contribute to the onset of the disease.
The most common symptom of AS is lower back and/or hip pain and stiffness, which typically worsens during periods of rest or inactivity. The pain may improve with movement and exercise. Over time, the symptoms may progress to other areas of the spine or body, including the ribs, shoulders, knees, ankles, heels, and small joints of the hands and feet. Some people with AS also experience eye disease (uveitis), skin disease (psoriasis), or gut disease (inflammatory bowel disease).
While there is currently no cure for ankylosing spondylitis, treatments are available to lessen symptoms and slow the progression of the disease. These treatments include exercise, physical therapy, occupational therapy, and medications to manage pain, control inflammation, and improve posture. With proper management, most people with AS can lead productive lives.
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Spondyloarthritis
The symptoms of Spondyloarthritis typically develop gradually over several months or years and may come and go. They usually appear earlier than other types of arthritis, before the age of 45, and often begin during a patient's teens or 20s. Spondyloarthritis is not caused by injuries or mechanical problems, such as a slipped disc or muscle spasm. While there is no cure for Spondyloarthritis, treatments can help manage symptoms and slow the progression of the disease. These include disease-modifying anti-rheumatic drugs (DMARDs) and biologics, which target the immune system to control inflammation. Physical therapy and exercise are also recommended to help manage symptoms and slow disease progression.
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Stress
Back pain can also be caused by strains and sprains, which are injuries to the muscles or tendons in the back. This can happen suddenly or over time, and it can be caused by lifting something too heavy or not lifting safely. Back pain can also be caused by spinal fractures, disk problems, arthritis, structural problems, or other conditions.
If you are experiencing back pain, it is important to seek medical advice. Your healthcare provider can recommend at-home treatments, refer you to physical therapy, and prescribe muscle relaxants or pain-relieving medications if necessary. Staying active and avoiding bed rest is generally recommended when experiencing back pain, as bed rest can lead to a loss of muscle strength and increased muscle stiffness, adding to pain and discomfort.
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Frequently asked questions
Symptoms of inflammatory back pain include chronic pain lasting longer than three months, abdominal pain, and fatigue. Lower back pain is more common than upper and middle back pain. It may also cause stiffness, making it difficult to move or straighten your back.
Inflammatory back pain is often caused by an injury or strain, such as lifting something heavy. It can also be caused by overuse, like a full day of yard work, or by underlying health conditions. Chronic inflammation is associated with autoimmune diseases, where the body's immune system attacks healthy tissue.
Treatment options include medication, physical therapy, and hands-on manipulation. Medications may include nonsteroidal anti-inflammatory drugs (NSAIDs), prescription pain relievers, and muscle relaxers. Physical therapy can strengthen muscles and improve spinal flexibility, while hands-on treatments like massage therapy can relax tight muscles.
Yes, chronic stress increases cortisol levels, which can heighten inflammatory responses in the body. Engaging in stress management techniques and low-impact exercises like yoga or swimming can help reduce inflammation-related back pain.
