Diagnostic tests show few of these structures. In most cases, back pain is unaccompanied by any abnormality on studies. Many people with no back problems turn out to have abnormal discs if a CT scan is done for other reasons. So even if someone has pain and an abnormality, it is difficult to know that the abnormality is the cause of the pain. As complicated as this is in acute back pain, the situation is even more challenging in the chronic back pain.
Most back pain is muscular in nature.
Muscle pain perpetuates what is known as the Pain Cycle. The back is especially susceptible to this phenomenon. Muscle pain is associated with spasm, and in the Pain Cycle, spasm may distort disc, joints, and nerves. This will lead to further pain, with further reflex spasm, and compounding of the initial process. If nerve involvement is severe enough, pain may radiate down the leg, resembling pain associated with disc herniation.