Why Some Back Pain Won’t Go Away: The Role of Inflammation in Chronic Pain
Back pain is common, but for some people, it becomes persistent and difficult to manage. Many assume long-lasting pain must be caused by a “disc problem,” but this is not always the case. In many patients, chronic back pain inflammation is the true underlying cause of ongoing discomfort and stiffness.
Inflammation affects the spine differently from other areas because the spinal structures—discs, joints, ligaments and nerves—are tightly packed and highly sensitive. Even minor swelling can trigger significant pain.
Orthospine Works supports patients with persistent spine conditions by identifying the root cause of their symptoms and providing targeted treatment.
What Is Inflammation
Acute inflammation is a short-term response that helps the body heal after an injury, while chronic inflammation persists for weeks or months and becomes harmful rather than protective. When inflammation does not resolve, it can sensitise nerves, weaken surrounding spinal structures and slow recovery.
Ongoing inflammatory activity may lead to persistent swelling, tissue irritation, breakdown of cartilage or spinal discs, and reduced blood flow to affected areas. The spine is especially vulnerable because of its limited space— even mild swelling around a nerve or joint can cause noticeable pain, numbness or stiffness. This is why chronic back pain inflammation can be particularly persistent and difficult to manage without targeted treatment.
How Inflammation Leads to Chronic Back Pain
Inflammation affects the spine in several interconnected ways, often turning short-term discomfort into ongoing pain.
- Irritation of nerves - Inflammatory chemicals (like cytokines) can irritate spinal nerves, causing burning pain, tingling or sciatica-like symptoms.
- Swelling in joints, ligaments or discs - Even mild swelling puts pressure on tight spinal spaces, worsening discomfort when standing, sitting or bending.
- Degenerative changes - Inflammation speeds up the wear-and-tear process in discs and joints, contributing to long-term structural changes.
- Impact on mobility - Stiffness, reduced range of motion and muscle guarding are common when inflammation persists.
Common Causes of Chronic Back Inflammation
- Facet joint arthritis: Inflammation in the small joints of the spine can lead to localised pain and stiffness.
- Degenerative disc disease: Worn discs trigger inflammation around surrounding ligaments and joints.
- Slipped disc or disc bulge: Leaked disc material triggers inflammatory responses that irritate nerves.
- Autoimmune conditions: Conditions such as ankylosing spondylitis can trigger inflammation in the spine (mentioned at a high level).
- Posture and repetitive strain: Poor ergonomics and prolonged sitting overload spinal structures and contribute to inflammatory flare-ups.
- Weight and lifestyle factors: Excess weight increases joint load, while inactivity weakens stabilising muscles.
Myth Busting: Painkillers Alone Don’t Fix Chronic Inflammation
Many patients rely heavily on NSAIDs or painkillers, believing they are enough to resolve chronic back pain inflammation.
Extended use increases the risk of:
- Stomach irritation
- Kidney problems
- Cardiovascular concerns
Painkillers reduce symptoms—not the root cause. When inflammation persists, pain often comes back once the medication leaves the system. Long-term relief requires addressing inflammation through targeted movement, rehabilitation, posture correction and minimally invasive interventions when necessary.
Symptoms Suggesting Inflammation Is Driving Your Pain
Patients with inflammation-driven pain often report:
- Morning stiffness that gradually improves
- Pain that gets better with gentle movement
- Localised tenderness over joints or muscles
- Flare-ups after overactivity or long periods of rest
These patterns differ from purely mechanical pain, which typically worsens with movement and improves significantly with rest.
How Our Specialist Diagnoses Inflammatory Back Pain
At Orthospine Works, Dr Gamaliel Tan evaluates inflammatory back pain through a structured and detailed assessment to identify the underlying cause. The process begins with a clinical examination that reviews posture, muscle tightness, joint movement and nerve function.
During this assessment, Dr Tan differentiates inflammatory pain from mechanical pain by analysing symptom patterns— inflammatory pain often improves with gentle movement, worsens with rest, and is associated with stiffness, while mechanical pain follows a different pattern.
When further clarity is needed, imaging studies are arranged, with MRI being particularly useful for detecting inflammation in facet joints, discs, ligaments and nerves, while X-rays may reveal chronic degenerative changes.
Effective Treatments for Chronic Back Pain Caused by Inflammation
Conservative Solutions
- Physiotherapy to improve mobility and reduce joint stress
- Anti-inflammatory medication for short-term relief
- Activity modification to avoid aggravating movements
- Ergonomic adjustments at work and home
Minimally Invasive Options
When pain persists, targeted procedures may help:
- Corticosteroid injections to reduce swelling
- Radiofrequency ablation to disrupt pain signals from inflamed joints
- Nerve blocks to calm irritated nerves and confirm diagnosis
Long-Term Strategies
- Core strengthening to stabilise spinal structures
- Postural correction to reduce strain
- Weight management for load reduction
- Lifestyle modifications such as improved ergonomics and regular low-impact exercise
These address both the symptoms and the causes of chronic back pain inflammation.
When Chronic Inflammation Becomes Dangerous
Although many cases are manageable, certain symptoms require urgent evaluation:
- Nerve compression: Severe inflammation can irritate or pinch nerves, causing burning pain or numbness.
- Muscle weakness: Reduced strength in the legs or arms suggests nerve involvement.
- Loss of bladder or bowel control: This is a red flag for serious spinal compression and requires immediate medical attention.
- Preventing long-term disability: Early treatment reduces the risk of permanent nerve changes and chronic mobility issues.
Common Causes of Chronic Back Inflammation
Orthospine Works supports patients through:
- Evidence-based treatment: Management strategies based on current research and best practices.
- Comprehensive rehabilitation: Physiotherapy, education and gradual conditioning programs.
- Minimally invasive spine procedures: Targeted injections, nerve treatments and other options are used when conservative care is not enough.
- Tailored long-term pain management programmes: Designed to reduce inflammation, improve mobility, and support lasting recovery.
Taking Control of Chronic Back Pain with Dr Gamaliel Tan
Inflammation is a major—but often overlooked—cause of ongoing back pain. With the right diagnosis and management plan, chronic back pain inflammation can be addressed effectively. If persistent back pain is affecting your routine, early evaluation is important.
Patients consulting Dr Gamaliel Tan at Orthospine Works receive a structured assessment and a clear explanation of their symptoms, along with treatment options tailored to their condition.
Schedule a consultation with Orthospine Works to understand your symptoms and explore evidence-based approaches for long-term relief.