Back pain classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2] Fahimeh Shojaei, M.D.


On the basis of origin, back pain can be broadly classified into three categories: axial, referred, and radicular. Back pain can also be classified on the basis of its underlying etiology into mechanical and non-mechanical.


  • Back pain can be classified into three broad categories on the basis of its origin including axial, referred and radicular:[1]
Origin Distinguishing Feature
Axial Pain Mechanical pain limited to one region. Could be sharp, dull, intermittent, throbbing, constant.
Referred Pain Dull/achy pain that moves around and varies in intensity.
Radicular pain Follows a spinal nerve pathway, mostly described as sensation of numbness, tingling, weakness.
Etiology Diseases
Mechanical Cauda equina syndrome, vertebral compression fracture, radiculopathy, spinal stenosis, ankylosing spondylitis, osteoarthritis, scoliosis, piriformis syndrome, sacroiliac joint dysfunction, lumbar strain, herniated disc
Non-mechanical Multiple myeloma , retroperitoneal tumors, psoriatic spondylitis, reactive arthritis, inflammatory bowel disease, endometriosis, chronic pelvic inflammatory disease, pancreatitis, cholecystitis, nephrolithiasis, pyelonephritis, abdominal aortic aneurysm, herpes zoster, metastatic cancer, spinal epidural abscess, vertebral osteomyelitis


  1. Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V; et al. (2019). "Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment". Curr Pain Headache Rep. 23 (3): 23. doi:10.1007/s11916-019-0757-1. PMID 30854609.
  2. Sun JC, Xu T, Chen KF, Qian W, Liu K, Shi JG, Yuan W, Jia LS (April 2014). "Assessment of cauda equina syndrome progression pattern to improve diagnosis". Spine (Phila Pa 1976). 39 (7): 596–602. doi:10.1097/BRS.0000000000000079. PMID 24150427.
  3. Deyo RA, Diehl AK (1988). "Cancer as a cause of back pain: frequency, clinical presentation, and diagnostic strategies". J Gen Intern Med. 3 (3): 230–8. doi:10.1007/BF02596337. PMID 2967893.
  4. "Acute low back problems in adults: assessment and treatment. Agency for Health Care Policy and Research". Clin Pract Guidel Quick Ref Guide Clin (14): iii–iv, 1–25. December 1994. PMID 7987418.
  5. Underwood MR, Dawes P (November 1995). "Inflammatory back pain in primary care". Br J Rheumatol. 34 (11): 1074–7. doi:10.1093/rheumatology/34.11.1074. PMID 8542211.
  6. Szadek KM, van der Wurff P, van Tulder MW, Zuurmond WW, Perez RS (April 2009). "Diagnostic validity of criteria for sacroiliac joint pain: a systematic review". J Pain. 10 (4): 354–68. doi:10.1016/j.jpain.2008.09.014. PMID 19101212.

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