Chronic back pain is one of the most common reasons people seek medical care, and it can affect your ability to work, sleep, exercise, and enjoy daily life. Back pain is considered “chronic” when it lasts longer than three months or keeps returning despite rest, physical therapy, or basic treatments.

Chronic Back Pain Causes & Treatment

What Is Chronic Back Pain?

Chronic back pain is pain in the upper, middle, or lower back that persists over time or repeatedly flares up. Unlike acute back pain, which often improves within days or weeks, chronic pain may continue for months or even years if the underlying cause is not addressed. Chronic back pain can develop from several conditions, including herniated or bulging discs, degenerative disc disease, facet joint arthritis, spinal stenosis, muscle strain, and sacroiliac (SI) joint dysfunction. In many cases, more than one issue contributes to ongoing pain, which is why a thorough medical evaluation is so important.

Symptoms You May Notice

Some people experience a constant dull ache, while others feel sharp or burning pain that may radiate into the legs. Stiffness, reduced flexibility, and pain that worsens with sitting, standing, or certain movements are also common signs of chronic back problems.

Degenerative Disc Disease

As we age, spinal discs naturally lose hydration and flexibility. This wear and tear can lead to disc degeneration, which may cause chronic pain, stiffness, and reduced movement.

Herniated or Bulging Discs

Spinal discs act as cushions between the bones of your spine. When a disc bulges or herniates, it can press on nearby nerves, causing back pain and sometimes radiating pain, numbness, or weakness in the arms or legs.

Common Causes of Chronic Back Pain

Facet Joint Arthritis

Facet joints are small joints in the spine that help guide movement. Arthritis or inflammation in these joints can cause localized back pain, especially with twisting, bending, or standing for long periods.

Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal that can put pressure on nerves. It often causes back pain, leg pain, numbness, or weakness, especially when walking or standing.

The SI joints connect the spine to the pelvis. Inflammation or dysfunction in these joints can cause lower back, buttock, or hip pain that is often mistaken for disc or muscle problems.

Sacroiliac (SI) Joint Dysfunction

Muscle and Ligament Strain

Poor posture, repetitive movements, heavy lifting, or previous injuries can lead to chronic muscle tension or ligament strain, contributing to ongoing back pain.

Most of the cases we handle at Pain Instacare come from incidents such as motor vehicle accidents, slips & falls, and worker's compensation cases. If you're experiencing pain related to any of these types of incidents, please reach out to us directly or have your attorney or chiropractor get in touch with us for additional pain management services.

How Chronic Pain Is Diagnosed

Proper diagnosis is key to effective treatment. Your evaluation may include:

• A detailed medical history and physical exam

• Imaging studies such as X-rays or MRI scans

• EMG or nerve conduction studies if nerve involvement is suspected

• Diagnostic injections to help identify the exact source of pain

The goal is to pinpoint the structure causing your pain, whether it’s a disc, joint, nerve, or muscle.

Non-Surgical Treatment Options for Chronic Back Pain

Focused exercises can improve strength, flexibility, posture, and spinal stability, helping reduce pain and prevent future flare-ups.

Medications may be used to help manage pain and inflammation, especially during flare-ups or while starting other treatments.

Targeted injections can help reduce inflammation and relieve pain at the source:

• Epidural steroid injections for nerve-related pain

• Facet joint injections for joint-related pain

• Sacroiliac joint injections for SI joint dysfunction

For some patients with chronic facet joint or SI joint pain, RFA can provide longer-lasting relief by interrupting pain signals from irritated nerves.

Physical Therapy and Rehabilitation

Medications

Injections

Improving posture, adjusting work habits, maintaining a healthy weight, and staying active can all play a role in long-term pain control.

Radiofrequency Ablation (RFA)

Lifestyle and Activity Modifications