Back pain inflammation is one of the main targets of treatment and is the exclusive reason why some drugs and injection therapies are utilized. However, inflammation rarely exists in any obvious form in chronic back pain conditions, causing any enlightened mind to doubt the logic of the entire treatment process.
Inflammation remains a much debated topic in back pain treatment circles. Some care providers have made their entire careers propagating the idea that "hidden" inflammation is the true source of most back pain. However, with the availability of incredibly detailed medical imaging, one would think that this inflammation would be visible, unless it was at a purely cellular level. Other doctors have said that this inflammation theory is literally the stupidest thing they ever heard and have gone far out of their way to debunk it. The famous Dr. John E. Sarno often criticized the idea of inflammation being used to justify many ridiculous back pain treatments.
This discussion takes an objective look at the theory of inflammation as a primary source of chronic back pain.
All manner of care providers have become frustrated with their results treating back pain and chronic pain, in general. This frustration has caused many doctors and therapists to think outside the box, since the traditional structural view of pain based on anatomical abnormality has long been proven to be largely incorrect. Most of these doctors are simply looking to make sense of crippling pain that does not seem to come from a structural origin. They know that the Cartesian diagnoses are wrong, since the pain persists even after the condition has been "successfully" resolved structurally.
The result of this chronic frustration is the diagnostic diversity that we now see every day in the back pain treatment sector. Some care providers have embraced alternative theories of pain and one of those theories says that inflammation is the actual source of chronic suffering in most patients. Some doctors cite traditional regional views of inflammation, while others hold the idea of cellular inflammation to be the culprit. There is little evidence that either theory is right, since regional inflammation is seldom seen, except in cases of transient pain due to obvious injury or muscular strain. Cellular inflammation can only be witnessed in the laboratory and is difficult to pin down as being widely experienced in the tissues of back pain sufferers. This makes it an ideal scapegoat for pain, regardless of whether any evidence of its existence is even present in a particular patient.
Many critics of back pain inflammation theory are almost insulted by the idiocy (as they put it) of these causative ideas of pain. They report that no evidence exists linking inflammation to back pain in the vast majority of people who suffer from it (over 99%). They also speak out against "fabricated" ideas of cellular inflammation, citing that these ideas of “pure fantasy” created to dupe naive patients out of money with unneeded and contraindicated treatment. We have read some very inflammatory (pun intended) research essays poking all sorts of holes in the theory of inflammation as a primary cause of back pain and can not help but to agree with virtually everything stated in these medical reports.
Many of the most noted figures in back pain research have come out against the notion of inflammation being used to explain chronic back pain. These doctors say that symptoms do not correlate in any way, the chronic nature of the condition flies in the face of accepted science regarding inflammation and that the entire idea is simply used to justify profitable care for the physician.
As long as some doctors place themselves in positions to make money at all costs and others stand their ethical ground, debates about the inflammation explanation for pain will rage on. Although doctors who doubt the validity of the theory of inflammation causation tend to accuse those who do believe in it of being charlatans, we tend to disagree in at least half the cases of care providers whom we have spoken to about the topic. Some of these doctors may be misguided, but they have noble intentions and are merely acting out against a diagnostic system that has failed patients across the board. They have found an idea that makes sense to them, at least more than the traditional view that spinal abnormalities are the universal cause of back pain (they rarely are).
The reason we are not on board with the theory of back pain inflammation is twofold. First we do not see evidence of inflammation occurring in chronic pain sufferers. Second, anti-inflammatory treatments are often used, but are rarely effective. If inflammation was the true symptomatic source, efficacy would be far better than it truly is. This is not to say that some people are not suffering from inflammatory issues, such as arthritis and autoimmune disease. However, these are not the sources of back pain in most people and therefore qualify as exceptions to the rule, rather than the rule itself.
We have similarly witnessed much resistance against the idea of ischemia as a source of chronic pain in years past. Many critics doubted the theory, since it undermined their economic bottom line in providing traditional treatment. However, with time and additional research, the idea of ischemia is now almost universally embraced as a primary source of chronic pain, since is can be proven to exist and has been treated successfully in the vast majority of people labeled as suffering from it. Remember, treatment efficacy is a great indication of diagnostic accuracy.