How does inflammation contribute to back pain?

Inflammation contributes to back pain through a range of biological processes involving injured tissues, immune signaling and the nervous system.

Following an injury, inflammatory mediators help initiate tissue repair. In some patients, these same pathways can sensitize pain-sensitive nerve endings, amplify nociceptive signaling and contribute to persistent symptoms. In chronic low back pain, inflammatory mechanisms may also interact with central sensitization, psychological distress, sleep disruption and reduced physical activity.

The clinical challenge lies in identifying the role inflammation plays in an individual patient. Acute tissue injury, inflammatory spinal disease, disc degeneration and persistent nonspecific low back pain can involve different mechanisms.