Mechanical vs Inflammatory Back Pain |
What’s the Difference?

Dr. Jeffrey Jones, DC

Hey everybody, it’s Dr. Jones here from SpineCare Chiropractic in Madison, Alabama.

I want to talk to you a little bit about deciphering what to do when you’ve got back pain.

There’s lots of different assumptions of, you know, when you wake up and your back hurts, what’s going on, or sometimes it’s after activity. So I want to provide a little clarity in figuring out what those first steps are and what are the things you should be doing, and sometimes more importantly, what are the things you should not be doing.

If we get rid of the really rare forms of low back pain, the far less common, what we really come down to is you’ve got mechanical low back pain and you’ve got inflammatory low back pain.

Now, the way I describe the difference between these two is using my finger here. If I take my finger and bend it back as far as it goes and put a little extra pressure through, now that’s mechanical pain. I’ve mechanically deformed the joint and the soft tissues around it, and if I want to feel anything different, I have to mechanically change its position. That’s mechanical pain.

Chemical pain, on the other hand, or inflammatory pain it’s like when you get a cut on your finger and you forget about it and you get that hand sanitizer, and it stings like crazy no matter what position I put it in. I can put it up, put it down, put it in my pocket. As long as that chemical reaction is happening, I’m going to feel pain. That’s chemical or inflammatory pain.

So if you have mechanical pain, the only treatment for it is to change the mechanics. And if you’ve got inflammatory pain or chemical pain, the only fix for that is to pour some type of chemical solution on that to stop that reaction from happening, or a non-steroidal anti-inflammatory, a steroid, something of that nature.

The majority of pain that we see in the low back is mechanical in nature. It’s, we assume a lot of times that it’s, you know, I’ve strained a muscle or I’ve pulled a muscle in my low back. That’s really not as common as you’d think. So, the mechanical issues are the ones that we see most common and it’s good because those are the ones that are typically easiest to fix because you’re in the driver’s seat when it comes to what to do about your mechanical pain.

The key hallmarks of mechanical pain are that you’ll have pain with certain movements, but you can find positions of relief typically. You might even find some movements that drastically decrease your pain and other movements typically in the opposite direction that drastically worsen your pain or even maybe send that low back pain down the leg.

So, that’s the first step in figuring out what type of pain you’re dealing with because if you have mechanical pain and you’re treating it as chemical or inflammatory pain, you’re never going to get it to resolve, and vice versa. If we see an inflammatory dominant condition in our office and we’re trying to mechanically change the position and move those joints, those are the patients that we need to get out and either take a non-steroidal anti-inflammatory or maybe even send them out for, for an injection or a five-day steroid pack.

So, that’s the first step is figuring out what type of pain you’ve got and making sure that the treatment that we’re rendering is for that type of pain.  If you’ve got questions on this please come see us, we’d be happy to help you navigate that.