It is common for Lone Star patients to complain of lingering back pain that just will not seem to go away. For some, it has been several months since they last felt pain free. For others, the pain has lingered for years. But why? What is it about back pain – particularly when it occurs in the lower back – that makes it so persistent?
There isn’t just one reason. The back is a complicated structure comprising multiple types of tissue that all need to work together in just the right way. If one little thing gets out of whack, pain could be the result. Getting things put back together again is no easy task, even for a body that is naturally designed to do just that.
Here are four reasons lower back pain can linger for so long:
1. Ongoing Structural Problems
Many cases of persistent back pain involve structural issues with the spine and the core muscles that support it. As long as those structural issues persist, even daily tasks can be enough to re-irritate already sensitive tissue. In addition:
- Age-Related Changes – Age-related changes, like osteoarthritis and disc degeneration, make the lower back more vulnerable to repeated irritation.
- Past Trauma – Past trauma, old injuries, etc., can open the door to a repeated cycle of flare-ups.
Even years of poor posture and body mechanics can put undue stress on the back, leading to a cycle in which the body’s natural repair mechanisms can never fully catch up to repair the original cause of a person’s pain. The longer the poor posture or body mechanics persist, the more likely the person’s pain will also persist.
2. Nervous System Sensitization
Many people do not know that the central nervous system can become more sensitized as a result of persistent back pain. As sensitivity increases, signals to pain pathways are amplified. Minor pain now feels more severe.
Central nervous system sensitization has been linked with higher pain intensity and more widespread body pain in some patients. Higher pain intensity tends to diminish quality of life commensurate with severity. This is true even when structural damage to the back is modest.
3. Strategies for Avoiding Pain
We human beings are pain averse. We go out of our way to avoid pain. So a person experiencing persistent back pain is likely to adopt strategies to avoid further discomfort. In a practical sense, lower back patients avoid bending, twisting, lifting, etc. Unfortunately, this creates yet another problem.
Typical strategies for avoiding pain tend to lead to weakened muscles and stiff joints. Over time, the person’s pain only increases because the back is not getting the support it needs. The less a person moves, the stiffer they become. This only causes more pain.
4. Nervous System Mismatch
Finally, we have a condition known in the medical community as mismatch. It is a scenario in which the nervous system’s responses to stimuli do not match the actual condition of the body itself. You might have a patient who demonstrates normal wear and tear common with age. It is nothing that would cause pain to most people. But the nervous system interprets this wear and tear as major damage, thereby sending inappropriate pain signals to the brain.
Here is the good news in all of this: just as there are multiple reasons lower back pain can linger for so long, there are multiple treatment approaches as well. Here at Lonestar Pain Medicine, we do not automatically default to the prescription pad. We help patients manage their pain, improve function, and take their lives back.
