Spine-Related Pain Syndromes: Causes, Patterns, and Treatments

Back pain is one of the most frequent reasons for medical consultation worldwide, surpassed only by upper respiratory infections. Epidemiological data indicate that nearly 80 percent of individuals experience at least one clinically significant episode of back pain during their lifetime. Although often benign and self-limited, back pain can become chronic, disabling, and associated with substantial personal and socioeconomic burden when underlying mechanisms are not addressed.

Causes of Back Pain

Back pain may present as acute muscle spasm, persistent burning discomfort, or pain radiating to the limbs. Acute episodes typically resolve within days to weeks, while chronic back pain persists for more than three months and is frequently associated with structural or degenerative spinal pathology.

Muscle tension represents the most common initiating mechanism. Sustained contraction of paravertebral muscles reduces local blood flow, impairing oxygen and nutrient delivery. This process is strongly associated with prolonged static postures, particularly during sedentary professional activities.

Contributing factors include prolonged sitting without lumbar support, improperly adjusted office furniture, continuous use of digital devices with cervical flexion, prolonged standing occupations, and inadequate recovery time. Improper sleeping surfaces and pillows that fail to support spinal physiology further aggravate mechanical stress.

Pharmacological management commonly includes nonsteroidal anti-inflammatory drugs, short-term analgesics, or targeted injections in selected cases. However, long-term symptom control relies primarily on movement-based therapies and postural correction.

Low Back Pain

Low back pain is the most prevalent form due to the biomechanical load borne by the lumbar spine. It may be accompanied by stiffness, reduced mobility, or gait disturbances.

Common causes include muscle strain, disc herniation, sciatic nerve compression, spinal canal stenosis, compression fractures related to osteoporosis, and abnormal spinal curvatures such as exaggerated lumbar lordosis. Less frequent but clinically significant causes include spinal tumors, infections, inflammatory arthropathies, abdominal aortic aneurysm rupture, renal pathology, and gynecological disorders such as endometriosis or ovarian disease.

Careful evaluation is essential to distinguish mechanical low back pain from systemic or visceral causes.

Thoracic Back Pain

Pain in the thoracic spine requires particular diagnostic attention due to overlap with cardiac and pulmonary conditions. Musculoskeletal causes include rib fractures, costochondritis, intercostal nerve compression, vertebral tumors, and localized myalgia.

Because thoracic pain may mimic myocardial infarction or pulmonary pathology, persistent or atypical symptoms warrant prompt medical evaluation.

Coccygeal Pain (Coccydynia)

Coccydynia refers to pain localized to the coccyx and occurs more frequently in women, partly due to pelvic anatomy. Pain is exacerbated when transitioning from sitting to standing, during prolonged sitting on hard surfaces, defecation, or sexual activity.

Predisposing factors include pregnancy, childbirth, obesity, repetitive microtrauma, and menstrual-related pelvic pain. Mechanical instability of the sacrococcygeal joint often underlies symptom persistence.

Therapeutic Exercise for Back Pain

Movement-based therapy plays a central role in both treatment and prevention. Regular exercise improves muscle strength, spinal stability, and circulation, counteracting the effects of sedentary behavior.

Targeted strengthening exercises, such as controlled spinal extension movements, activate paravertebral and gluteal muscles, enhancing lumbar support. Stretching routines performed in supine positions promote spinal mobility and reduce muscular tension without requiring specialized equipment.

Consistency and correct technique are essential to avoid exacerbation of symptoms.

Therapeutic Massage and Physiotherapy

Physiotherapy integrates individualized exercise programs with manual therapy to restore function and reduce pain. After a detailed musculoskeletal assessment, the therapist designs a plan focused on improving endurance, spinal mobility, balance, and postural alignment.

Therapeutic massage complements exercise by reducing muscle tone, improving circulation, and facilitating neuromuscular relaxation. Preventive strategies, including ergonomic education and periodic reassessment, are key to long-term symptom control and recurrence prevention.

Scientific references

1. Ehrlich GE. Low back pain. The Journal of Rheumatology. 2003;30(6):1137–1139.

2. Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Practice & Research Clinical Rheumatology. 2010;24(6):769–781.

3. Chou R, et al. Diagnosis and treatment of low back pain: A clinical practice guideline. Annals of Internal Medicine. 2007;147(7):478–491.

4. Hartvigsen J, et al. What low back pain is and why we need to pay attention. The Lancet. 2018;391(10137):2356–2367.

5. Mayo Clinic. Back pain: Symptoms, causes, diagnosis and treatment. Mayo Clinic Proceedings.