Classifying Back Pain

Classifying back pain is an important first step towards resolving it with an appropriate treatment. Doctors use classifications to guide their diagnostic and treatment protocols. The classifications can help doctors to categorize a person's back pain based on the area of the spine involved, the type of symptoms experienced, and whether referred pain is involved. The doctor may use several resources in order to arrive at a particular diagnosis, including a careful physical examination, medical imaging, blood tests, and recording of the patient's symptoms. Sometimes, a doctor may be able to arrive on classification based on a profile of symptoms that are unique to the person's back problems. At other times, a patient may match more than more than one criterion for back pain.

Some classifications are based on the specific types of soft tissues involved, such as whether the source of the pain is from cartilage destruction in the joints, loss of height in the spinal discs, or laxity of the ligaments and tendons involved with support and movement of the spine and other joints. Some classifications will be made on the precise location of where the pain is, or disease condition involved. Let's take a look at chart physicians often use for classifying back pain.

Inflammatory
  • Arachnoiditis: Arachnoiditis is inflammation of the spinal canal, which may be caused by infection, physical trauma, or from a side effect of surgery or injection to treat or repair a back problem. Arachnoiditis symptoms may range from mild to severe. Some symptoms of this condition include weakness or paralysis in the arms or legs, depending on the location of the spine where the spinal canal has been infected or traumatized.
  • Infections that affect the soft tissues, bones, and joints.
Rheumatoid Arthritis is the most common inflammatory condition to affect the spine and joints throughout the body. Note that there are many forms of inflammatory arthritis.

Mechanical Pain
  • Arthritis (Osteoarthritis or Rheumatoid)
  • Degenerated Discs
  • Fractures
  • Leg length difference (One leg is longer than the other)
  • Ligament or muscle strains
  • Misaligned Pelvis
  • Nonspecific muscular of ligamentous sprains or strains
  • Restricted hip motion
  • Spinal deformities such as scoliosis
  • Spinal disc herniation (slipped disc)
  • Spinal Stenosis (Spinal stenosis is a narrowing of the spinal canal which houses the spinal cord and meninges - which support and protect it.)
  • Spondylolisthesis (an abnormal displacement of one vertebra over the other, which cause instability to that level of the spine, as well as pain and dysfunction to the affected nerves.)


Metabolic
  • Osteoporotic fractures. The vertebral bones are particularly vulnerable in conditions of osteoporosis, due to the weight-bearing nature of these spinal bones. Osteoporotic vertebral fractures may cause lordosis or kyphosis of the spine, reduced mobility, and upper back pain or lower back pain.
Neoplastic
  • Bone tumors (Primary or metastatic)
  • Spinal Tumors
Paget's Disease (Paget's disease is caused by abnormal growth and formation of bone, causing the affected bones to become misshapen)

Psychosomatic (Mood abnormalities such as depression and anxiety may cause back pain or elevate a person's severity of symptoms)

Referred Pain: Structural abnormalities or degenerative conditions in the spine may affect structures elsewhere in the body, especially the hips and lower legs.
  • Pelvic/abdominal disease
  • Prostate cancer