Top 3 Causes of Chronic Back Pain

Chronic back pain affects millions of people worldwide. Understanding the source of your pain can help you adjust the way you move and take steps to manage your condition. Here are the top three causes of chronic back pain, backed by scientific research:

1. Discogenic Pain

The most common cause of chronic back pain is discogenic pain (40%), originating from damage to the intervertebral discs. Tears can develop in the disc, extending from the nucleus pulposus (the soft inner core) to the outer third of the disc (where nerve fibers are present). These tears allow inflammatory proteins to escape and irritate the nerve fibers, leading to pain.

Research has shown that internal disc disruption is a significant contributor to chronic low back pain. (Schwarzer et al., 1995; Bogduk, 1991)

2. Facet Joint Pain

Facet joints, which connect the vertebrae in the spine, are another common source of chronic back pain. Inflammation in these joints is often caused by degenerative changes such as wear and tear of the cartilage. This type of pain is particularly prevalent in individuals over the age of 60, with studies indicating that facet joint issues account for 30% of chronic back pain in this demographic.

Degenerative changes in the facet joints are a well-documented cause of back pain, highlighting the importance of maintaining joint health. (Eubanks et al., 2007)

3. Sacroiliac (SI) Joint Pain

The sacroiliac joints, located at the base of the spine, can also be a source of chronic pain. SI joint pain is typically caused by inflammation within the joint, which may result from degenerative changes, trauma, or altered biomechanics. While less common than discogenic or facet joint pain, SI joint pain accounts for 10-15% of chronic back pain cases.

Research has validated the role of SI joint dysfunction in chronic back pain. (Maigne et al., 1996; Schwarzer et al., 1995)

The list of possible causes of low back pain is extensive, but the three discussed here are among the most common. Take the time to understand what’s causing your pain and adjust your daily movements to reduce discomfort and enhance your quality of life.

References

1. Adams, M. A., Bogduk, N., Burton, K., & Dolan, P. (2012). The biomechanics of back pain (3rd ed.). Churchill Livingstone. https://doi.org/10.1016/C2009-0-61897-8
2. Bogduk N. The lumbar disc and low back pain. Neurosurg Clin N Am. 1991;2:791–806.
3. Cooper, G. (2015). Non-operative treatment of the lumbar spine. Springer International Publishing. https://doi.org/10.1007/978-3-319-21443-6
4. Eubanks JD, Lee MJ, Cassinelli E, Ahn NU. Prevalence of lumbar facet arthrosis and its relationship to age, sex, and race: an anatomic study of cadaveric specimens. Spine. 2007;32(19):2058–62.
5. Maigne JY, Aivaliklis A, Pfefer F. Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine. 1996;21:1889–92.
6. Schwarzer AC, Aprill CN, Bogduk N. The sacroiliac joint in chronic low back pain. Spine. 1995;20:31–7.
7. Schwarzer AC, Aprill CN, Derby R, Fortin KJ, Kine G, Bogduk N. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine. 1995;20:1878–83.
8. Schwarzer AC, Wang S, Bogduk N, McNaught PJ, Laurent R. Prevalence and clinical features of lumbar zygapophysial joint pain: a study in an Australian population with chronic low back pain. Ann Rheum Dis. 1995;54:100–6.