Different types of back pain

Back Pain: Understanding the Different Types

Understanding the different types of back pain is important for an accurate medical diagnosis to be made and an effective treatment to be offered. There are three classifications, axial, referred and radicular. The good news is that, in most cases, back pain can usually be resolved with an extended period of rest.

Purpose of the Spine

The spine is a vital part of the human anatomy and looking after it is important for good overall health.

This spine has three main jobs:

  • It protects the spinal cord and the nerve roots.
  • It gives us the ability to stand up and maintain an upright posture.
  • It enables us to bend, twist and turn

Around 80% of us will experience back pain at some time or another. It’s one of the common reasons that people go to see the doctor in modern society.

Here we take a look at the different types of back pain and what someone should do if they think they have a problem in this area of their body.

Identifying Back Pain

Back pain, a little like the spine itself, is incredibly complicated. Symptoms can vary from individual to individual and may be caused for a whole variety of reasons. Pain can be acute, suddenly flaring up and then disappearing or it may be chronic causing problems over many years.

Back pain in older adults often occurs because of wear and tear. It also occurs following an accident or injury to the spine or because of some underlying illness.

The main areas that can be damaged overtime and cause back pain to occur include:

  • The muscles that support the spine. If these muscles spasm for one reason or another they can cause intense pain.
  • Spinal nerves may also become trapped or damaged causing pain.
  • Joints, as well as the disks that provide cushioning for the vertebrae, may be worn or damaged.
  • Other areas that may cause pain include ligaments, tendons and bones.

Understanding pain and what is causing it can be difficult when it comes to the back and spine. The brain will sometimes be unable to pin down the exact area where the pain is being experienced and it may take a full examination to find out what is actually going on. Being a little more knowledgeable about the types of back pain can make a difference, particularly when someone is trying to get a proper diagnosis and the right treatment.

There are generally three different classifications for back pain: Axial pain, referred pain, and radicular pain.

Axial Pain

This common type of pain can vary quite a lot. It may be a dull pain or a sharp one, it might be constant or come and go. The pain can be relatively mild or quite severe.

Axial back pain is often referred to as mechanical and is the most common type of back pain that is experienced, especially when it comes to lower back pain. It is also called ‘non-specific’ which means that the doctor doesn’t have to identify the anatomical structure that is causing the pain as the condition will normally resolve itself in time.

Treatment includes resting the back, undertaking physical therapy, taking painkillers or applying heat or ice packs to the affected area.

Referred Pain

This is similar to axial pain except that it can radiate to other areas of the body, including the buttocks and the groin. It affects the lower back and the pain can often seem to move around.

All over the body, nerves radiate out to a large number of areas and that sense of pain can be referred or passed to different structures. Referred pain can sometimes be confused with radicular pain as the symptoms are perceived to be similar, another reason why a proper diagnosis is important.

As with axial pain, referred pain usually resolves itself after a period of rest and the use of appropriate pain relief.

Radicular Pain

This is often perceived as a searing or ‘electrical shock’ type of pain and is caused by a variety of health issues including spinal stenosis, spondylolisthesis, or a herniated disc. It is sometimes called sciatica, where the pain radiates down the sciatic nerve along the leg and even down to the foot.

The pain can be excruciating and may also include numbness. It usually affects just one side of the body and worsens if a person sits or stands.

Man sitting at desk with back pain
Poor seated posture can result in radicular back pain developing over time

There are thought to be some risk factors associated with developing radicular pain, including smoking, being overweight and poor work ergonomics (for example, sitting for long periods of time with a bad posture).

The first treatment for radicular pain is usually non-surgical but it’s important to have a complete and accurate diagnosis. That treatment will include pain management and physical therapy. In most cases, the sciatica will improve over a period of weeks.

In more severe cases, surgery may be recommended, especially if leg pain or weakness is persistent and seems to be progressing. For example, if the cause is a lumbar herniation, a microdiscectomy can be conducted to remove a small part of the disc material to provide room for the nerve.