Chronic Low Back Pain (CLBP)

The pain in the lower back can come from different places:

• Discogenic Pain: This one’s pretty common. It usually stays in the lower back area. Our discs have an outer annulus fibrosis and a nucleus pulposus inside. When the disc dries out or gets messed up, this nucleus moves out through cracks. This hike in local blood flow and nerve activity causes classic discogenic pain.
• Radicular Pain: If the pain shoots from your back to buttocks and legs (known as sciatica), it’s radicular pain. Most of the time it’s because of ectopic signals from the spine’s dorsal root or its ganglion, often due to a herniated disc. It’s more tied to nerve inflammation than just nerve squeezing. Doctors match symptoms with MRI findings to figure this out.
• Spinal Stenosis: Over time, narrowing of central canals & side spaces can squeeze the spinal cord and nearby nerves & vessels. Causes? Could be discs pushing out, thick ligaments, overgrown bones, or even old surgery scars. Patients get clumsy legs, odd feelings, or weakness especially when standing for long periods but feel better bending forward.
• Facet Joint: These joints help our vertebrae move together and get achy too like any load-bearing joint. The pain is mostly centered near the spine but doesn’t go past the buttocks much. Around 30% of CLBP may come from these joints with pain starting in its synovial membrane or nearby tissues.
• Sacroiliac Joint Disease: These joints linking our spine to pelvis help us stay upright with little movement allowed. Pain shows up around the upper parts of the hips but doesn’t reach all way down like sciatica does. Sitting long or bad postures make it worse – possibly coming from arthritic bones or irritated tendons/ligaments around these joints.
• Piriformis Syndrome: This issue feels like sciatica with pain mainly in buttocks area because the piriformis muscle irritates the sciatic nerve.