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Back Pain

Why does my back hurt?

If you’re experiencing chronic back pain, you’re not alone. In fact, up to 80% of people in the United States will experience back pain at some point in their lives. And while different factors could be contributing to the underlying source of pain, the resulting symptoms often feel the same. That’s why people with chronic back pain can go undiagnosed, or remain unsure of the cause behind it.

Did you know that not all back pain is the same? There are 2 types of back pain—mechanical and inflammatory. They may cause similar symptoms, but they’re very different.

What to watch for

Mechanical Back Pain

  • Symptoms can appear at any age

  • Pain comes and goes; can be acute

  • Rest and relaxation can help ease symptoms

  • Pain may worsen with exercise

Inflammatory Back Pain

  • 25

    On average symptoms first appear at age 25

  • 3+

    Chronic back pain, stiffness, and changes in mobility lasting 3+ months

  • Symptoms that worsen at night and in the morning

  • Exercise tends to provide symptom relief

Mechanical Back Pain

Mechanical back pain is a common condition that causes pain that’s deep and agonizing in nature. The term “mechanical” means the source of the pain may be in the spinal joints, discs, vertebrae, or soft tissues. When treating mechanical back pain, rest and relaxation are often encouraged to help ease its symptoms, which typically improve in 4 to 6 weeks.

When treated symptoms typically improve in 4-6 weeks

Inflammatory Back Pain

Inflammatory back pain is chronic—which means it never really goes away, even if its symptoms come and go. That’s because inflammatory back pain is usually caused by an underlying autoimmune condition.

Autoimmune conditions occur when healthy cells in the body’s immune system attack each other and trigger an inflammatory response. Basically, affected cells produce proteins that cause inflammation that leads to painful symptoms—like lower back pain, stiffness, and reduced mobility—that can interfere with even the most basic activities.

What makes it different?

Symptoms of inflammatory back pain can be debilitating, and usually last more than 3 months. Inflammatory back pain also tends to affect younger people, with most experiencing symptoms before the age of 40 and, in some cases, as early as age 17.

People with inflammatory back pain may notice that their symptoms improve when they’re moving. That’s because symptoms are often made worse by inactivity. In fact, many people report a worsening of their symptoms when they’ve been sitting still—especially in the morning and at bedtime. This discomfort can affect sleep quality, and is one reason why many people with inflammatory back pain experience sleep disruptions.

Symptoms last more than 3 months


Axial spondyloarthritis (axSpA) is an inflammatory arthritis of the spine that causes stiffness and reduced mobility. It’s primarily diagnosed in early adulthood, and is very difficult to diagnose. In fact, only about 1 in 20 people who experience back pain have an axSpA diagnosis.

Could a form of axSpA be causing your unexplained back pain?

About 1 in 20 with back pain have an axSpA diagnosis

Find a rheumatologist

Could your unexplained back pain actually be caused by axial spondyloarthritis (axSpA), an inflammatory arthritis of the spine? A rheumatologist is the right doctor to help you find out. Your quiz results, and knowledge of your family history, could help your rheumatologist discover what’s causing your pain. Download this Family Conversation Starter, and find a local rheumatologist who may help.

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