What's the difference between mechanical and inflammatory back pain?

What's the difference between mechanical and inflammatory back pain?

Back pain is one of the most common complaints bringing patients to doctors' offices. Knowing what’s causing the pain is a key to getting relief.

Most of the time back pain is a result of “mechanical” causes; that is, something is wrong with the mechanics of the back—the way the spine, muscles, discs, and nerves work together. This may be caused by injuries, poor posture, pinched nerves, or simple wear and tear that comes with aging.

For some people, however, their back pain is considered “inflammatory.” In this case, it’s caused by an immune system gone awry that’s launching an attack on the spinal joints. This condition is also known as ankylosing spondylitis.

What your symptoms can tell you

A number of clues can help you determine whether your back pain is mechanical or inflammatory. 

  • When did the pain begin?If the back pain started at a younger age, say before age 35 or 40, it is more likely to be inflammatory.
  • What effect does exercise have?Moving around is likely to help lessen the pain of inflammatory back pain, while too much exercise may leave you in more pain if the issue is mechanical.
  • Is it worse early in the day or later?People with inflammatory pain tend to feel worse in the morning, while those with mechanical pain are apt to find their symptoms getting worse as the day goes on.
  • What other symptoms do you have?Those with inflammatory pain may have symptoms of inflammation elsewhere that seem unrelated, such as psoriasis, inflammatory bowel disease, or pain in ankle or knee joints.
  • Do anti-inflammatory medications help?If your pain is inflammatory, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are more likely to relieve the pain.

Why it matters what’s causing the pain

Treatment that is appropriate for mechanical back pain may not be right for inflammatory pain, and vice versa. With mechanical back pain, rest, physical therapy, and similar treatments may take care of the problem. If pain persists, a cortisone shot may be helpful, and as a last resort, surgery.

Those treatments, however, won’t stop the inflammation associated with ankylosing spondylitis. You may need medication to address the underlying problem with your immune system before it causes more damage. Ankylosing spondylitis can cause bone spurs to form, fusing the vertebra in your spine together, causing lasting damage. For that reason, it’s important to diagnose, monitor, and treat the condition as soon as possible. 

Tests your doctor may order

If you have continuing back pain, don’t try to tough it out and don’t try to diagnose yourself. Let your doctor know what’s going on and order the tests needed to make a firm diagnosis. You may need:

  • A through physical exam
  • Blood tests, to check for a genetic marker associated with ankylosing spondylitis
  • Imaging tests, such as X-rays and MRIs

If you’re suffering with back pain, please contact us at Tulsa Pain. We can help diagnose the problem and determine the right course of treatment to help free you from pain.

Tulsa Pain is a pain management practice in Oklahoma that specializes in the diagnosis and treatment of chronic pain. We are dedicated to helping those who are suffering find the relief they deserve. Our team uses a balanced approach by incorporating minimally invasive, outpatient procedures, complementary and alternative medicine, and medication to help patients take control of their pain. Call 918-742-7030 or Request An Appointment to meet with one of our talented pain management specialists today!

The advice and information contained in this article is for educational purposes only and is not intended to replace or counter a physician’s advice or judgment. Please always consult your physician before taking any advice learned here or in any other educational medical material.

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