Back and spine pain is one of the most common medical conditions that people seek guidance from medical providers for. Approximately 8% of adults experience chronic back pain, and many times without specific injury. The good news is that most spine pain is mechanical, meaning it isn’t caused by serious conditions like tumors, infections, fractures, instability, cancer, or inflammation, and therefore usually doesn’t require imaging or surgery. Chronic pain, on the other hand, is defined as pain lasting for three months or more, which may not have a clearly identifiable mechanical cause.
The most important (and frustrating) aspect of treating different types of back pain, whether acute or chronic, is understanding each case may require a specific and unique treatment plan. spine pain is that there is no single, one approach to all back pain. The key is finding the exact source of the pain, as each type of back problem involves different conditions and demands specific treatment approaches.
Understanding Pain
The science of pain continues to improve as we better understand the many causes of pain. Pain is not always directly related to a specific tissue being damaged. The cause of pain is different for everyone, as well as personal experience, so understanding the many causes of pain such as biological, psychological, social, and cultural are important to treating spine pain. Many times, people suffer from pain without any imaging test results showing anything as “positive” or present, and some images by X-ray or MRI will show marked damage or problems without ANY pain. How can that be? Pain is much more than finding soft tissue damage.
There are 2 main types of pain:
- Spine pain: This type of pain can be localized only in the spinal area. It can be constant or related to the position of the spinal column and strain or imbalance on structures. Spine pain can also be caused by a specific group of muscles, ligaments, tendons, or soft tissue. This usually feels like an ache, pull, throb, and will come and go when we use and relax the affected muscles.
- Radicular pain: This refers to pain leaving the area or radiating into the arms or legs. This type of pain can be described as sharp, stabbing, numbing, tingling, or like the limb is falling asleep. Radicular pain is often described as “nerve pain,” or a pinched nerve at the spine level.
Causes and Symptoms of Back Pain
The main sources of back pain are muscle strain, lower vertebrate issues, spinal stenosis, disc degeneration or bulge, osteoarthritis, and mechanical instability. Spinal stenosis is a narrowing of the space where the nerves exit the spinal cord and is closely related to arthritic changes. People usually suffer from increased pain with extension or backward bending activities when they have stenosis, arthritic type pain, or vertebrae disorders. This pain can be eliminated or decreased with improving mobility, strengthening the area around the spine, and flexion, or forward bending, activates and exercises. This approach helps in managing severe cases and reducing the strain on affected muscles and vertebrae.
Additionally, stress is a common but often overlooked cause of back pain. Chronic tension can lead to muscle tightness and discomfort, exacerbating existing spinal issues. Addressing stress-induced back pain through relaxation techniques, posture awareness, and movement-based therapies can play a crucial role in alleviating pain and promoting overall spinal health.
Common Types of Back Pain
Back pain can manifest in different ways, ranging from sudden, short-term discomfort to persistent, chronic pain that affects daily life. Understanding the type of back pain you’re experiencing is essential for finding the right treatment and preventing long-term complications. Below are some of the most common types of back pain, their causes, symptoms, and treatment approaches.
1. Acute Back Pain (0–6 Weeks)
Acute back pain comes on suddenly and is often the result of muscle strain, injury, or inflammation. It typically resolves with rest, movement, and treatment. Common types of acute back pain include:
Mechanical Back Pain (Non-Specific Low Back Pain)
The most frequent cause of acute back pain, often linked to poor posture, muscle strain, or repetitive movements.
- Symptoms: Localized stiffness, aching, or sharp pain in the lower back.
- Treatment: Rest, gentle movement, and targeted strengthening exercises to prevent recurrence.
Herniated or Bulging Discs
Herniated discs occur when the soft center of a spinal disc pushes out, potentially compressing nearby nerves.
- Symptoms: Radicular pain (shooting pain down the leg or arm), numbness, and tingling.
- Treatment: Physical therapy, postural training, and core stabilization exercises to relieve pressure on the disc.
Facet Joint Pain (Arthritic Back Pain)
This is when small joints in the spine can become inflamed, leading to pain, especially during bending or twisting movements.
- Symptoms: Localized stiffness and sharp pain, often aggravated by movement.
- Treatment: Manual therapy, mobility exercises, and postural corrections to restore proper function.
2. Subacute Back Pain (6–12 Weeks)
Subacute back pain lasts longer than acute pain but still has a high chance of recovery with proper treatment. Common types of subacute pain include:
Nerve Root Pain (Radiculopathy)
This type of pain, often referred to as “pinched nerve” pain, radiates from the spine into the arms or legs.
- Symptoms: Burning, sharp pain, tingling, or weakness.
- Treatment: Targeted exercises, nerve glides, and postural corrections to relieve nerve compression.
Sciatic Nerve Pain (Sciatica)
Sciatica involves pain along the sciatic nerve, which runs from the lower back to the foot. It’s usually caused by a herniated disc, spinal stenosis, or tight muscles pressing on the nerve. This condition can make activities like lifting and bending particularly painful.
- Symptoms: Sharp, burning pain, numbness, or weakness in one leg.
- Treatment: Stretching, nerve mobilization, and strengthening exercises to reduce nerve irritation.
Thoracic or Mid-Back Spine Pain
Although less common due to the stability of the thoracic spine, pain in this region can still occur due to osteoporosis, poor posture, or fractures.
- Symptoms: Dull aching or sharp pain in the mid-back region.
- Treatment: Postural correction, mobility exercises, and strengthening routines to restore function and alleviate discomfort.
3. Chronic Back Pain (12+ Weeks)
Chronic back pain persists beyond three months and often requires a comprehensive treatment approach. This type of radiating pain can be of any cause, and does not require the patient to have a specific pathology, injury, or disease. Better understanding the personal pain experience, treating the cause of pain, and improving functional limitations with the use of movement and exercise are important to improving quality of life, and regaining prior levels of function.
Common types of chronic back pain include:
Chronic Pain Syndrome
This is a complex condition where pain persists beyond normal healing time and may not be directly linked to an active injury.
- Symptoms: Persistent, widespread pain, stiffness, or fatigue that worsens with stress, anxiety, or poor sleep.
- Treatment: A multidisciplinary approach, including exercise, movement therapy, and lifestyle modifications to reduce back pain sensitivity and improve daily function.
Cauda Equina Syndrome (Medical Emergency)
Cauda Equina Syndrome is a serious neurological condition caused by compression of the nerve roots at the base of the spinal cord.
- Symptoms: Loss of bladder or bowel control, numbness or weakness in the legs, difficulty walking, or severe lower back pain.
- Treatment: Immediate medical intervention to relieve pressure on the nerves and prevent permanent damage.
How to Treat Back Pain
Effectively managing back pain starts with identifying its cause and duration. Imaging studies often reveal spinal degeneration, but many of these findings are a normal part of aging and may not always be the source of pain. Because most spine pain is mechanical, back pain treatment should focus on movement-based therapy rather than relying solely on imaging or surgery.
Physical Therapy for Back Pain
Physical therapy is a proven approach to treating and preventing back pain by improving mobility, strengthening muscles, and promoting proper movement patterns. A customized rehabilitation physical therapy plan may include:
- Targeted exercises: Strengthening core muscles and improving flexibility to support spinal health.
- Manual Therapy: Hands-on techniques to relieve tension and restore movement.
- Postural & Movement Training: Correcting habits that contribute to pain and strain.
- Collaborative Care: Physical therapists work alongside physicians to explore non-surgical treatment options such as the McKenzie Method.
Don’t Let Your Back Pain Define You
Back pain doesn’t have to control your life. With the right treatment and a proactive approach, you can reduce pain, restore mobility, and regain confidence in your daily activities. Whether you’re dealing with acute discomfort, chronic pain, or recovering from an injury, seeking expert guidance can make all the difference.
At Ivy Rehab Physical Therapy, our physical therapists provide personalized treatment plans tailored to your unique needs. We use evidence-based techniques, hands-on therapy, and targeted exercises to help you build strength, improve flexibility, and prevent future pain.
Take the first step toward lasting relief—find your closest Ivy Rehab Physical Therapy location and schedule an appointment today. Your path to a healthier, pain-free back starts now.
Article by Jeffrey Vaisberg PT, DPT
Jeffrey Vaisberg PT, DPT Cert. MDT, SFMA, CWC. Progress Physical Therapy, Feasterville, PA
