Chronic Back Pain Syndrome: What It Is, What Causes It, and
How It Can Be Treated

Chronic back pain is defined as a dull or aching pain in the back that persists for three to six months or longer.  Chronic back pain may be contrasted with acute back pain, which usually lasts for only a relatively short period of time ranging from a few days to a few weeks.  While nearly every person experiences back pain at some point in his or her life, the pain becomes chronic in less than 10% of these cases.

Although back pain develops into chronic back pain in only a small percentage of the affected population, statistics show that chronic back pain is a major medical concern among individuals in today.  According to the Canadian-based Chronic Back Pain Clinic, in North America alone, chronic back pain is among the top five reasons that individuals seek out medical care, and as many as 80% of people will visit a doctor at some point in their lives as a result of chronic back pain.

Moreover, chronic back pain is the second most common cause of missed work days, with only the common cold ranking higher.  Among money spent on medical care, chronic back pain comes in sixth in total dollars invested, and this painful condition is the third most common reason individuals undergo surgery. 

Not a respecter of persons, chronic back pain impacts women and men of all races, and rather than showing indication of improvement, chronic back pain disability rates are worsening at a rate 14 times greater than population growth.  It is estimated today that as many as 70 million people in the United States – or as much as 15-30 percent of the US population – suffers from chronic pain.  In fact, more people are affected by chronic pain than heart disease or cancer.  

These sobering statistics indicate that now more than ever it is vital that we understand this debilitating disease, its causes, and the best mechanisms for treating it.

Back pain can be caused by a variety of factors, including injury, trauma, bone disease, or spinal degeneration occurring over time.  When the pain recurs more than three times within a year, or when it lasts longer than three to six months and interferes with regular activities such as sleeping, walking, bending, driving a car, sitting, or standing, it may be classified as chronic. 

Chronic pain can be broken down into two categories: pain the source of which is specific (as in an injury) and pain the source of which is not identifiable (such as an injury that has healed).  While both conditions technically describe chronic pain, usually, the term is used to refer to the latter condition in which the injured tissue has healed, yet the pain persists. 

Contributing Factors to Chronic Back Pain

When real pain is present, pain signals are sent to the brain through the nervous system.  In some cases, however, even after the original source of pain is no longer causing pain, the signals continue to be sent.  In essence, the pain becomes the condition itself rather than merely a symptom of another condition.  Naturally, this prolongs the “chronic” nature of the pain. 

Additional physical and psychological factors can also contribute to chronic back pain.   For example, physical deconditioning due to lack of exercise plays a key role in causing and prolonging chronic back pain.  Exercise, and specifically exercises aimed at strengthening the lower back, can help prevent the onset of back pain and, where pain is present, exercise can help reduce its effects.  Conversely, however, lack of physical exercise can contribute to the continuance of chronic back pain. 

Psychologically, mental health can play a key role in causing chronic back pain.  In instances in which injury is not present, emotional or mental stress and anxiety can actually bring about chronic back pain.  And where pain is already present, an individual’s thoughts about the pain, as well as his or her falling into a state of depression and/or anxiety resulting from the pain or other factors, may contribute to prolonged suffering.  Researchers estimate that as many as 20-50% of individuals with chronic pain also show signs of depression and anxiety. 

Because the causes of chronic back pain may extend beyond apparent medical conditions to include emotional and psychological factors, treatment must also go beyond the physical.  In addition to prescribed medications to help alleviate pain, a doctor may recommend psychological evaluation and treatment and emotional therapy and support to address the root causes of the pain.  In reality, in many cases, this multidisciplinary approach is the best method for effectively treating chronic back pain. 
 
In summary, regardless of the initial cause, back pain can become chronic for any number of reasons, including physical, emotional, and psychological in nature.  With accurate diagnosis and treatment by an experienced healthcare professional, most cases of chronic back pain can be managed and the ability to live an active and full life restored.