It is estimated that every adult will experience some form of back pain at least once in their lives. There’s a difference between mechanical and inflammatory back pain. With inflammatory back pain, movement tends to help it, while resting worsens the pain. For some individuals, relief from inflammatory back pain is something they could have to manage for some time. Fortunately, there are effective management and relief options available.
Inflammatory vs. Mechanical Pain
Chronic back pain has two major causes. These are Mechanical and Inflammatory. They have slightly different characteristics when presenting. Chiropractors know what to look for to tell the difference between the two. Then a decision can be made on how to proceed with treatment or management.
Pain caused by inflammation can be described as:
- Not having a known definite cause.
- Characterized by stiffness, especially after waking up.
- Pain reduces with movement, activity, stretching, exercise.
- Is worst during the early hours of the morning.
- Is often accompanied by pain in the buttocks/sciatica symptoms.
Mechanical pain can be described as:
- Pain that becomes worse with activity, stretching, or exercise.
- Pain reduces with rest.
- There is no stiffness after sleeping.
- This pain is not constant but can become intense/severe for short periods.
- Pain in the buttocks/sciatica symptoms do not present.
Inflammatory and Non-Inflammatory
Non-inflammatory is the same as mechanical pain. Mechanical/non-inflammatory back pain has causation related to the mechanics of the back and can result from injury or trauma. The cause of non-inflammatory pain does not necessarily present right away. For example, poor posture that leads to back pain is a mechanical/non-inflammatory cause. However, non-inflammatory back pain can be accompanied by inflammation as a natural reaction to injury. But this inflammation is not the cause of the pain. Non-inflammatory back pain can be treated effectively with conservative treatments. This includes:
- Chiropractic adjusting
- Physical therapy
- Spinal decompression
Contributing Autoimmune Diseases
When inflammation is the cause of pain, it is considered inflammatory pain. Autoimmune disease/s can cause the body to attack different areas of the body mistakenly. Chronic pain can be caused by autoimmune diseases that include:
- Rheumatoid Arthritis
Arthritis causes the immune system to attack the joints throughout the body.
- Ankylosing Spondylitis
This is a rare type of arthritis that affects the spine. It is found more in men and usually begins in early adulthood.
- Multiple Sclerosis
This is a disease where the immune system attacks nerve fibers and can lead to back pain.
- Psoriatic Arthritis
This type of arthritis is characterized by patches of psoriasis along with joint pain and inflammation.
Inflammatory Pain Treatment
Individuals that think they might have inflammatory back pain should consult a doctor, spine specialist, and/or chiropractor. A general practitioner can misdiagnose inflammatory back pain as mechanical back pain. Many find relief from taking non-steroidal anti-inflammatory drugs or NSAIDs and following an exercise/physical activity regimen. However, sometimes this is not enough. This is where chiropractic treatment and physical therapy comes in.
Chiropractic and Physical Therapy
These medical professions complement each other well and can be beneficial as a part of an overall treatment plan. A chiropractor, with the help of a physical therapist, can bring significant relief. Management techniques involve:
- Chiropractic adjustments
- Posture correction
- Personalized exercises
Inflammation Night Pain
Inflammatory back pain tends to worsen at night. What happens is the inflammatory markers settle down when the body is not moving. A few simple practices can help you get better sleep.
Stretch Before Bed and When Waking
Performing stretches before going to bed and after waking up helps keep the body limber.
Inspect Pillows and Mattress
Sleeping with the spine out of alignment could exacerbate the problem. Using a too-soft mattress or a too-large pillow could be contributing to the pain. Sleeping on the side is recommended to use a pillow between the legs to keep the low back straight.
Some exercises should be discussed with your doctor. Individuals have found that exercise and stretching are essential for relief.
These exercises increase heart rate, boost mood, and release natural pain killers. Low-impact cardio exercises:
Strengthening the core muscles will help maintain posture and spine support. Some of these include yoga poses:
- Cat and cow
- Upward and downward dog
- Glute Press
Sustainable and easy to follow three basic elements: following the diet, physical activity, and high levels of socializing. For individuals that want to change their diet and lifestyle to the Mediterranean, try the following:
- Add more vegetables to meals. This can be salads, stews, and pizzas. Kidney beans, lentils, and peas are common Mediterranean staples.
- Switch to whole grains as well as products made from whole grain flour. The high fiber content can improve heart health and can help lower blood pressure. Minimize refined carbohydrates like white bread and breakfast cereals.
- Balance rich desserts with fresh fruits like oranges and bananas that can include antioxidant fruits like blueberries and pomegranates.
- Treat meat as a side dish instead of the main course. Adding strips of chicken or beef into a vegetable saute/soup.
- Balance meat dishes with fish and seafood. This includes sardines, salmon, clams, and oysters.
- Go vegetarian for one day a week.
- Cut out processed meats with high levels of preservatives.
- Add healthy fats like avocados, sunflower seeds, nuts, and peanuts to meals.
- Add dairy like cheese and Greek or plain yogurt.
- Increase physical activity into a routine.
- Talk to friends and family.
Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002
Dahlhamer, James et al. “Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults – the United States, 2016.” MMWR. Morbidity and mortality weekly report vol. 67,36 1001-1006. 14 Sep. 2018, doi:10.15585/mmwr.mm6736a2
Riksman, Janine S et al. “Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting.” Chiropractic & manual therapies vol. 19,1 5. 7 Feb. 2011, doi:10.1186/2045-709X-19-5
Santilli, Valter et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized, double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001
Teodorczyk-Injeyan, Julita A et al. “Nonspecific Low Back Pain: Inflammatory Profiles of Patients With Acute and Chronic Pain.” The Clinical journal of pain vol. 35,10 (2019): 818-825. doi:10.1097/AJP.0000000000000745
rofessional Scope of Practice *
The information herein on "Back Pain: Inflammatory or Mechanical and Chiropractic Care" is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional.
Blog Information & Scope Discussions
Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez DC or contact us at 915-850-0900.
We are here to help you and your family.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*
Licensed in: Texas & New Mexico*
Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
My Digital Business Card