What are the different types of back pain?

Back pain treatment and management depend on what type of back pain you’re experiencing. Most back pain is mechanical, but if your back pain is inflammatory, it’s important for your doctor to know, as it can affect your treatment plan.

There are two types of back pain:

Inflammatory

Mechanical

  • They may feel the same, but they have different causes and may need different treatments. You can have both at the same time.

  • If you are told you have mechanical back pain, it’s very important to tell your doctor if symptoms persist for more than three months.

  • Here are some more differences between inflammatory and mechanical back pain:

WHAT AM I FEELING? (SYMPTOMS)

Inflammatory

Similar to mechanical except alternating symptoms from one side of the buttocks and/or lower back to the other

Enthesitis: Pain is felt in areas where tendons and ligaments join to the bones

Loss of movement/increased stiffness in hips or lower back

Pain or tenderness on sides of pelvis

Mechanical

Pain, muscle tension and stiffness, weakness in legs or feet, throbbing or aching

At what age does it happen?

Inflammatory

Usually starts in people under 40

Mechanical

At any age

How fast does it develop?

Inflammatory

Gradually and lasts longer than 3 months

Mechanical

Quickly

Better after rest?

Inflammatory

No

Mechanical

Yes

Stiffness in the morning?

Inflammatory

Yes – lasting more than 30 minutes

Gets worse at night

Can wake you up during the second half of the night

Mechanical

Yes – lasting 30 minutes or less

How did it happen? (Causes)

Inflammatory

Rooted in a group of conditions called spondyloarthritis where the immune system overreacts and inflames healthy tissues in the body

Mechanical

Injuries, slipped discs, worn out joints, muscle or ligament strain

Any related conditions?

Inflammatory

Family history of: ankylosing spondylitis (AS) and/or psoriasis; uveitis, iritis (eye inflammation); dactylitis (swollen fingers or toes); inflammatory bowel disease; arthritis pain in the hips, shoulders, knees or wrist; pain and tenderness along breast bone

Mechanical

None

What is inflammatory back pain?

What is inflammatory back pain?

Among the many types of inflammatory back pain, ankylosing spondylitis (AS) is one that affects younger Canadians.

AS is a common type of inflammatory back pain

Between 150,000 and 300,000 Canadians are affected by AS

People in their teens and early 20s are more susceptible

Family history plays a role (90% of people with AS have a gene called HLA-B27)

People of Western European descent, Inuit, Sami, and some North American tribes on the Pacific coast, may have a higher risk of developing AS 

Starts at the bottom of the spine and spreads upwards over time. Currently there is no cure, but early back pain treatment can make a difference and provide pain relief

  • AS is an autoimmune condition, meaning, the immune system attacks healthy cells in the body, and as a result, they become inflamed.
    • This inflammation can occur in various parts of the body, including the spine, joints and tissues.
    • People with AS will visit a rheumatologist, as they are experts in inflammatory conditions.

Early AS detection is vital. Speak to your doctor today if you think you may have AS! He or she may need to give you a referral to a rheumatologist.

What else should I know about AS?

  • AS is a chronic condition that can get worse over time. Without back pain treatment, there can be permanent damage.
  • There is a potential for severe chronic pain and even deformity. The bones of the spine can fuse or grow in abnormal ways and mobility can become very difficult.
  • Early detection and back pain treatment can make a big difference! If you think you could be at risk of having AS, talk to your doctor right away, who will be able to give you a referral to a rheumatologist.
  • Depression, anxiety, and fear are common in people who suffer from chronic pain.
    • If you have concerns, speak to your doctor so that they can help you find ways to manage your AS and associated stress effectively.
What else should I know about AS?

What other things should I consider?

Speak to your doctor for more information about your type of back pain.

We’ve put together a list of websites that can give you more information about types of back pain.

Deborah, Squamish, British Columbia

I’m not letting AS take away my passion for running.

“I spent time in a wheelchair because of my AS — and as a runner of 15 years, it was devastating. I felt as though my legs had been taken away. But now, with the help of my medications and other treatments, I am happy to say that I’m able to run ultra marathons and teach. I am feeling 400 times better than I did nine years ago!”

 

- Deborah, Squamish, British Columbia*

*

Actual patient. May not be representative of all patients.

Geri, Waterloo, Ontario

I wouldn’t necessarily have come up with AS right off the bat.

"I didn’t even know it could manifest in ways other than lower back pain, even after I was diagnosed. But because of my long journey, I’d say, get it looked at right away. If your doctor can’t help you then go and see a specialist. If you’re honest with yourself, it becomes obvious that it’s gone beyond a casual injury like you’d get running."

 

- Geri, Waterloo, Ontario*

*

Actual patient. May not be representative of all patients.