As painful as it can be, the exact source of back pain is often difficult to identify or pinpoint. In fact, there are numerous possible pain producers including muscles, soft connective tissue, ligaments, joint capsules, cartilage, discs, and nerves. These areas may be pulled, strained, stretched, or sprained through everyday activities—exercise, lifting, playing a sport, etc. Sometimes, small tears that occur in the outer layer of a spinal disc can result in severe pain. Many people experience pain from an abnormal disc that may be degenerating, bulging, or even herniated. Even if the actual tissue damage is considered minor, which means it is likely to repair on its own, the pain's intensity might be quite severe.

There is frequently a chain reaction that contributes to a person’s pain experience. In the body, numerous chemical substances are released in response to tissue irritation or injury. These substances “stimulate” the surrounding pain-sensitive nerve fibers, resulting in the sensation of pain. Some of these chemicals trigger the process of inflammation, or swelling, which also contributes to pain. The chemicals associated with this inflammatory process feed back more signals, which perpetuate the process of swelling. The inflammation from this cycle of events may persist for days to weeks.