Back pain pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S [2]

Overview

The normal physiology of [name of process] can be understood as follows:

The exact pathogenesis of back pain depends on the underlying cause.
Back pain can be broadly classified into inflammatory, mechanical, degenerative, oncologic and infectious.^[1]^[2]^[3]^[4]

Type of back pain	Pathophysiology
Inflammatory	Inflammation of joints (sacroiliitis), inflammation of enthesis (spondyloarthritis)
Mechanical	Trauma, muscle sprain, extra weight on muscles (pregnancy, heavy lifting),
Oncologic	Lytic lesions in spine, nerve compression due to mass effect, pathologic fracture due to weakened bone
Degenerative	Cartilage degradation and bone remodeling decreases elasticity and causes pain , fractures can also occur due to osteoporosis,
Infectious	Infection involving spine, disc, joints, abscess formation.

Lumbar disc disease have been linked to genetic involvment. The risk of developing lumbar disc disease increases if found in other close relatives.
Genes involved in the pathogenesis of back pain include:^[5]
- SOX5
- CCDC26/GSDMC
- DCC

Conditions associated with [disease name] include:

On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

↑ Patrick N, Emanski E, Knaub MA (2014). "Acute and chronic low back pain". Med Clin North Am. 98 (4): 777–89, xii. doi:10.1016/j.mcna.2014.03.005. PMID 24994051.
↑ Goode AP, Carey TS, Jordan JM (2013). "Low back pain and lumbar spine osteoarthritis: how are they related?". Curr Rheumatol Rep. 15 (2): 305. doi:10.1007/s11926-012-0305-z. PMC 3606549. PMID 23307577.
↑ Ross MD, Bayer E (2005). "Cancer as a cause of low back pain in a patient seen in a direct access physical therapy setting". J Orthop Sports Phys Ther. 35 (10): 651–8. doi:10.2519/jospt.2005.35.10.651. PMID 16294986.
↑ Chien JJ, Bajwa ZH (2008). "What is mechanical back pain and how best to treat it?". Curr Pain Headache Rep. 12 (6): 406–11. doi:10.1007/s11916-008-0069-3. PMID 18973732.
↑ Suri P, Palmer MR, Tsepilov YA, Freidin MB, Boer CG, Yau MS; et al. (2018). "Genome-wide meta-analysis of 158,000 individuals of European ancestry identifies three loci associated with chronic back pain". PLoS Genet. 14 (9): e1007601. doi:10.1371/journal.pgen.1007601. PMC 6159857. PMID 30261039.