Back Pain Isn’t One-Size-Fits-All
Back pain has a way of taking over: sitting, standing, sleeping, even the simplest daily tasks. And when you’ve searched for answers but still don’t have relief, it can feel discouraging
It’s also one of the most common reasons people visit urgent care, the ER, or their primary doctor. Yet the answers patients often hear don’t explain why the pain feels this bad or why it keeps coming back.
The truth is, back pain isn’t a one-size-fits-all problem. For some, it’s a herniated disc. For others, it’s a muscle that won’t fire, a nerve that won’t calm down, or an inflammatory condition no one’s ever tested for. In fact, up to 90% of back pain is considered ‘mechanical’ or ‘nonspecific’—very real pain, but harder to pin down with just a scan.
At Vertrae®, serving patients across Dayton and throughout Ohio, we take a different approach. We don’t just look at your imaging. We look at how your spine moves, how your muscles respond, and how your nervous system is processing pain.
Most back pain falls into three key categories:
🟦 Structural causes (visible on imaging)
🟧 Functional causes (invisible but real)
🟩 Emerging neurological or inflammatory causes
Let’s explore what those actually mean and why the right diagnosis matters.
1. Structural Causes of Back Pain (The Common Culprits)
These are the conditions most doctors look for first, and some are visible on X-rays or MRI:
- Musculoligamentous Strain or Sprain
Tiny tears or overload of the muscles and ligaments, often from lifting, twisting, or prolonged sitting. Painful, but usually not visible on imaging. - Herniated Discs
When the cushion between spinal bones bulges or ruptures, pressing on nearby nerves — often causing sharp, shooting pain down a leg.
Learn more › - Degenerative Disc Disease
Over time, discs lose water, height, and flexibility, leading to stiffness, instability, and sometimes chronic pain.
Learn more › - Spinal Stenosis
A narrowing of the spinal canal that compresses nerves, often causing leg fatigue, numbness, or pain when walking.
Learn more › - Facet Joint Arthritis (Facet Arthropathy)
Inflammation of the small joints in the back of the spine, leading to pain with twisting, leaning, or standing. - Spondylolysis & Spondylolisthesis
Tiny fractures or a slipping vertebra, more common in teens and athletes. Often causes pain with back extension or impact sports. - Vertebral Compression Fractures
Sudden, localized pain, often from osteoporosis or minor trauma in older adults.
Learn more › - Axial Spondyloarthritis (Inflammatory Back Pain)
A chronic inflammatory condition that improves with activity but worsens with rest. Often mistaken for “just stiffness.” - Postural Back Pain
Poor ergonomics, pregnancy, or heavy repetitive lifting (including childcare or construction work) can overload spinal support muscles.
These are the “usual suspects,” but they don’t explain every case. That’s where functional causes come in.
2. Functional or Mechanical Causes (Often Overlooked)
Sometimes your MRI looks “normal,” but you still hurt. That’s often because functional problems, the way your muscles and joints work together, don’t show up on a scan. At Vertrae®, we use movement testing to uncover these hidden culprits:
- Multifidus Dysfunction: This deep stabilizing muscle can “shut down” after injury or surgery, leaving the spine unstable.
- Poor Core Engagement: Weak coordination between abs, hips, and pelvic floor shifts the workload to the back.
- Postural Overload & Fatigue: Long hours of sitting, poor ergonomics, pregnancy, or repetitive lifting (like childcare or construction work) can overload the spine’s support system.
These problems are often overlooked or dismissed. Yet for many patients, they’re the hidden root of ongoing pain
3. Emerging Cause With New Solution
Advances in neuroscience and imaging have shown us something important: not all back pain comes from discs, joints, or pinched nerves. Sometimes, the problem lies elsewhere, and that means new solutions are possible.
- Basivertebral Nerve Pain (Vertebrogenic Pain)
A deep, aching pain that comes from inside the vertebral body, where the basivertebral nerve becomes chronically irritated.
✔ Treatment: The Basivertebral Nerve Ablation Procedure, a minimally invasive outpatient treatment, uses radiofrequency ablation to quiet this nerve at its source, without affecting the rest of the spine.
When Should You Worry? Red Flags We Always Watch For
Most back pain isn’t dangerous, but some symptoms need urgent attention. Call us right away if you experience:
- Sudden bowel/bladder control issues
- Numbness in the groin or inner thighs (saddle anesthesia)
- Fever or chills with severe back pain
- Night sweats or unexplained weight loss
- History of cancer or recent infection
- Pain after a fall (especially with osteoporosis)
These symptoms may signal urgent conditions such as cauda equina syndrome, spinal infection, tumor, or fracture, all of which require immediate imaging and care.
Why the Right Diagnosis Matters More Than the Right Tool
Pain relief shouldn’t be a guessing game. But too often, patients get injections, medications, or even spine surgery without ever understanding the true cause of their pain.
At Vertrae®, we believe better outcomes start with better answers. That’s why we always begin with a comprehensive evaluation, looking beyond symptoms to uncover the true source of your pain.
“When we understand the root cause, everything else becomes clearer.”
— Dr. Kamal Woods
Your path to healing may include:
- Diagnostic nerve blocks
- Advanced MRI or motion testing
- Collaboration between rehab specialists and spine physicians
It’s all part of how we help patients across Dayton, Ohio get their lives back without unnecessary surgery or endless trial-and-error.
So… What’s Next?
In our next blog, we’ll take a closer look at one of the underdiagnosed causes of chronic back pain: Multifidus Dysfunction.
If your spine feels unstable…
If physical therapy helped — but didn’t “stick”…
If your pain always returns after rest…
🡪 This might be what’s missing. Read the next article on multifidus dysfunction ›
Still Searching for the Root Cause of Your Back Pain?
You don’t have to live with it.
And you don’t have to settle for a generic answer.
📞 Call 1-844-255-2225
💻 Request an Appointment Online ›
At Vertrae®, we see the full picture. Let’s find a plan that works for your spine, your goals, and your life.
