Inflammatory vs. Mechanical Back Pain

Chronic back pain can be broadly categorized as inflammatory or mechanical. 

Mechanical back pain is typically caused by an issue with the spinal joints, discs, vertebrae, or soft tissues. Typically, mechanical pain results from bad habits, such as poor posture, poorly-designed seating, and incorrect bending and lifting motions. Mechanical back pain persisting for more than 4 to 6 weeks may warrant further diagnostic testing and imaging. Common causes of mechanical back pain include spinal stenosis, herniated discs, zygapophysial joint pain, discogenic pain, vertebral fractures, sacroiliac joint pain, trigger point & myofascial pain. A wide variety of treatments are available, with different treatments specifically targeted toward different causes.

Trigger points or muscle “knots” are sore spots in soft tissue that cause deep aching. Too many of them is often called myofascial pain syndrome (MPS), a chronic pain disorder. Trigger point massage is mostly rubbing and pressing on trigger points, which can feel amazingly relieving. It can be a safe self-treatment with the potential to help with many common pain problems that don’t respond well.  

Inflammatory back pain is a chronic condition characterized by insidious onset at an age less than 40 years, persisting for three months or more, associated with morning stiffness, and improving with exercise. The pain also tends to radiate to the buttocks. Ankylosing spondylitis is more common in men. 
If you think you have inflammatory back pain, it is important you see a rheumatology expert. They can work with you for treatment of the inflammation with medication, which often results in significant improvement in symptoms and is essential to reducing the risk for permanent joint damage.