What Is Chronic Low Back Pain?

Why Is Low Back Pain So Difficult?

Chronic low back pain is challenging for several reasons.

1. The cause is often unclear

In about 85% of chronic low back pain cases, no single, definitive cause can be identified.

That can be frustrating — "If they can't find what's wrong, why does it hurt?"

The reality is that the lower back has many structures capable of producing pain — discs, facet joints, sacroiliac joints, muscles, nerves, and more. In most cases, several of these are involved simultaneously, making it difficult to point to one specific "culprit."

For more detail, see Why Does My Back Hurt?

2. Imaging doesn't tell the whole story

Being told "your MRI shows something abnormal" can be alarming. But here is a fact that surprises many people:

Among people in their 80s, 96% have disc degeneration visible on MRI — even when they have no pain at all.

In other words, many MRI "findings" are simply normal age-related changes and may not be the source of your pain.

3. Mind and body are deeply connected

Pain is not "all in your head" — but stress, anxiety, depression, and poor sleep are scientifically shown to amplify pain. A vicious cycle can develop: pain leads to inactivity, which leads to deconditioning, which leads to more pain, which leads to more inactivity.