The Complete Guide to Back Pain: Causes, Myths & Treatment
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Are you currently suffering from back pain that limits you from living your life the way you want? Do you struggle to understand why you are in pain and to find treatments that provide you with lasting relief? If so, you are not alone. Worldwide, back pain is the sole leading cause of disability, with most people experiencing it at least once in their lifetime.
The importance of managing back pain cannot be overstated -- if left unaddressed, this debilitating experience may spiral out of control. To make matters worse, a huge chunk of information discussing back pain is incorrect and leads people to believe things about their experiences that are simply not true.
These false beliefs can result in confusion, loss of hope, fear avoidance behavior, and depression. When these are combined with piercing pain, it is no wonder that many people have a very difficult time finding much, if any, relief.
This article will discuss in detail what back pain is, what causes back pain, and what you can do to find relief if you suffer from this condition.
Acute and Chronic: An Overview of Back Pain
It’s about as self-explanatory as it gets -- back pain is, before all, pain in the back. This unpleasant sensory and emotional experience associated with actual or potential body tissue damage can vary in degree of intensity. And while back pain can cover a large area of the body depending on how the person describes their experience, the most common area of pain is usually reported in the lower back.
Depending on how long the pain persists, we classify back pain as:
That is not to say, however, that chronic back pain cannot be overcome. With some self-reflection, a lot of persistence and the right treatment strategy, chronic back pain can be managed, improved or even remedied.
A Growing, Worldwide Epidemic
Whether it’s dull, constant ache or a sharp, unexpected sensation, back pain can emerge as a result of various causes. It could be triggered abruptly by an accident or worsen over time due to the vulnerable nature of our spine, which increases as we age. The causes are numerous and so are the people affected by this condition.
In fact, researchers estimate about 12% of people globally experience back pain at a single point in time. These numbers jump to 23%, 38%, and 40% for one month, one year, and lifetime timespans, respectively. (1) When you’re struggling with back pain, it may seem you’re fighting this battle on your own, but this notion couldn’t be further from the truth.
Other studies looking at the prevalence of back pain found that 19.6% of people between ages 20 to 59 reported chronic back pain, and 24% of those between ages 69 to 81 reported back pain in the last 12 months that interfered with their daily activities. (2, 3)
These numbers reflect a year-on-year epidemic. As back pain continues to rise and spread globally, so do the medical costs, decreased workplace productivity and inability of individuals to lead their lives at full capacity.
Living with Back Pain: What are the Symptoms?
Our backs are delicately structured. As we move around, a range of muscles, ligaments, tendons, disks and bones work together in harmony to support the body and help us move around. When incorrectly aligned or damaged, these structures result in back pain, symptoms of which can vary greatly depending on the severity of injury they sustain.
Here are some of the most common back pain symptoms:
Most Common Causes of Back Pain
Back pain may or may not be associated with tissue damage depending on the type of injury that occurs, as well as how long it has been since the initial injury. Below are some of the most common causes leading to back pain:
All of the mechanical causes listed above can potentially cause structural damage to the tissues in and around the lumbar spine. Below are some of the most frequent structural problems, what symptoms they may present and their typical impacts.
Chronic Back Pain: A Deeper Look
As mentioned earlier, chronic back pain is a debilitating problem for many, and people often remain clueless as to the root cause of their pain. Understandably, this can be frustrating, scary, and demoralizing for someone who has not been properly educated on how pain works.
In most cases, pain is a good thing. It protects us from repeatedly sustaining bodily harm. Think of someone touching a hot plate and instinctively pulling their hand away. This built-in reflex has protected humans and ensured their survival for as long as we’ve existed.
Think of pain as an alarm system. When there is a threat to the body, the alarm system turns on, and the person acts accordingly to reduce the threat. When the threat has been eliminated, the alarm system shuts off.
However, in the case of chronic pain, the alarm system may remain on even after the threat has been eliminated. Furthermore, the alarm might be overly sensitive to inputs that normally would not be perceived as threatening. This constant stimulation of the alarm system can cause normal activities to become painful, or may even cause pain without activity.
Additionally, many people have been driven to believe all pain occurs as a result of tissue injury and that pain is an input to the brain. However, modern pain science research has actually shown that pain is an output from the brain as a result of the cumulative effect of all perceived threats in someone’s life.
Pain is a perception. As just like other perceptions such as happiness or fear, our brains decide when to trigger it. Some of the external and internal signals that spark pain may include but are not limited to:
These non-physical factors may influence the brain to produce pain even though the output is not necessary.
Fortunately, most, if not all people living with chronic back pain are not lost causes. If the inputs causing symptoms can be identified and switched for more positive inputs promoting safety to the brain, the pain output can be decreased.
Debunking Common Myths Surrounding Back Pain
With so many misconceptions surrounding back pain, it is no wonder many people find it hard to fully recover and their condition worsens. Here are some common myths that need to be tackled.
Common Treatments for Back Pain
There are several viable treatments for back pain, and these may include home remedies or seeing a healthcare provider. If you experience back pain, you should begin treating it immediately and take care not to ignore your symptoms. The longer you wait, the more difficult treating back pain will be.
Treating Back Pain Inside Your Four Walls
When dealing with back pain, starting from the comfort of your home is usually the best way forward. Several treatment options are at your hand when looking for temporary and prolonged relief from the pain, including:
Inversion tables have been shown to help ease back pain. (5, 6, 7) The practice involves the use of a table that tilts the user at an angle of their choosing to provide decompression to the spine. This decompression can allow for improved intervertebral space, improved disc height, decreased pressure on nerves and muscles, and decreased pain.
Furthermore, inversion is a safe and cost-effective way of treating back pain without ever leaving your home.
Research has also shown that traction is useful in treating back pain. (8, 9, 10) Similar to inversion, traction induces a decompression force that widens the intervertebral space, freeing the discs, nerves, joints, and muscles of the spine.
The main difference between traction and inversion is that traction uses a mechanical unit to provide the decompression, whereas inversion uses gravity to do so. Mechanical traction units may be more expensive than inversion tables, but they can be an effective option to manage back pain.
Heat and Cold
The main premise behind the use of heat and cold is to relax the body and inhibit the nervous system from producing as strong of a pain output.
Heat and cold can come in a variety of forms such as heating pads, ice packs, hot showers, ice baths, topical sprays or patches, and many more. Your preference is what is most important when choosing a temperature modality. The more relaxed you feel, the more benefit you will gain.
Clinical studies have shown some essential oils can alleviate back pain. Ginger oil, for example, has anti-inflammatory properties while lavender oil can help with muscle pain and headaches.
You can either apply these topically or inhale them throughout the day; either way, make sure you don’t take them orally and avoid contact with your eyes -- essential oils can be quite potent.
Although you may have difficulty identifying and reaching all of the problem areas that a massage therapist can, it may be beneficial to use tools at home to work these painful muscles out yourself.
There are many products out there like acupressure mats, massage sticks, vibration devices and similar tools to help you massage painful areas. Sometimes, it can be as easy as using a tennis ball or lacrosse ball. Simply find the muscular areas that feel tight or painful, press the ball on them, and roll against a wall or on the floor.
This may be quite painful, so make sure you don’t surpass your tolerance levels. A little discomfort is normal, but don’t use too much force to the point where it hurts. If you are tensing up against the ball, then you are likely not doing anything beneficial.
Below is a list of general exercises that may be beneficial for back pain. It is important to note that this is not an exhaustive list, and that some exercises may not be as helpful for you depending on the nature of your injury. This is when it becomes important for you to seek advice from your local healthcare professional to properly assess and diagnose your specific condition.
That being said, these exercises aim to restore normal and pain-free motion of the lumbar spine. Pick the exercises that seem to work best for you. You should perform them to your tolerance level, and modify your range of motion as needed to reduce excessive symptoms.
If self-treatment doesn’t leave you with positive results, seek help from back pain specialists in your area. Let’s have a look at who does what.
Seeking Professional Help
Medical practitioners who specialize in back pain treatment and diagnosis are:
A physical therapist can conduct a comprehensive evaluation of you and your back pain. A good evaluation will typically consist of a thorough subjective history intake, a complete objective examination assessing your movement, imbalances, areas of weakness, and diagnostic testing.
Following this, the therapist will lay out a plan to help decrease your pain, improve your function, and get you back to living your life to the fullest as soon as possible.
Depending on where you live and what that area’s physical therapy practice guidelines are, they may be able to perform several treatments in clinic, including but not limited to: massage, joint mobilization or manipulation, dry needling, soft tissue mobilization, cupping, ultrasound, electrical stimulation, ice or heat, and traction.
While all of these treatments can be beneficial when used correctly, the physical therapist should always encourage an active recovery process. As such, expect that they will prescribe selective exercises based on your specific limitations so that you can return to your life with the tools to prevent future episodes of pain.
Chiropractors, like physical therapists, conduct a thorough evaluation of you and your back pain. Their approach may be different but the end goal is always the same: to address any skeletal dysfunctions and imbalances to relieve pain and restore your full mobility.
Chiropractors typically employ a treatment approach relying heavily on joint manipulations and body realignment techniques to reduce pain and improve movement. They may also use other mechanical tools to help achieve this as well.
As with physical therapists, a chiropractor should be facilitating an active approach to recovery and empower you to take control of your symptoms.
A massage therapist can address areas of muscular restriction that may be causing pain or dysfunction. Massage can help improve blood flow, reduce muscle hypertonicity and guarding, and promote an overall feeling of relaxation.
Massage can be a useful tool in conjunction with active recovery tools and movement assessment to return you to your previous level of function.
Physicians, Physician Assistants, and Orthopedic Specialists
This group of healthcare practitioners can diagnose injuries through a combination of subjective examination, objective tests and measures, and imaging such as X-rays or MRIs. They can educate you about your pain and your possible treatment options. Depending on your location, a physician referral is required to see another healthcare professional.
These healthcare professionals may prescribe medications to help improve pain and encourage movement. If this is unsuccessful, they may recommend injections such as steroidal injections or epidurals to alleviate pain. If these treatments in addition to all other forms of treatment (chiropractic, physical therapy, etc.) have been unsuccessful, they may recommend surgery if you are a candidate. This option, however, should be your last resort and only conducted when all other options have been exhausted.
5 Back Pain Prevention Tips
Now that your back pain is gone, how do you prevent it from coming back? The answer may vary between individuals, but there are many general lifestyle modifications and habit changes you can make to decrease your risk for back pain.
1. Move Often
“Motion is lotion” is a common saying in the rehabilitation sector of healthcare, and for good reason. Movement helps with overall blood flow, joint lubrication, flexibility, strength, endurance, and overall health and wellness. Walking, cycling, yoga, strength training, and sports are a few examples of movement.
Any type of movement is sufficient as long as you enjoy it. Enjoying the activity will ensure that it is sustainable for you and you’re able to make it a long term habit.
2. Improve Your Posture
Much attention has been paid to posture recently. And while there is no such thing as the “perfect posture,” there are certain things we can focus on to reduce our risk of problems in certain positions.
Our bodies typically do not like to be in one position for long periods of time. This is why we roll around in our sleep, fidget at our desks or in the car, and shift back and forth with prolonged standing. Unfortunately, these situations are unavoidable at times, and that makes our positioning much more important.
This is particularly important when sitting. Many of us have desk jobs that require us to sit for hours. When sitting for long, gravity eventually brings us into a rounded posture which makes certain muscles in our back and neck get tight and others weakened. Proper ergonomic setup of your chair and desk will decrease gravity’s toll on your body. Here are some tips for proper desk ergonomics:
In addition to proper workspace setup, it is recommended that you get up and move around for 3-5 minutes every 30-60 minutes you spend in front of the screen. This will ensure some vital time off your back needs to avoid the risk of developing stress and imbalance leading to pain.
3. Assess Your Sleeping Positions
During sleep, we often spend long periods of time in a single position which affects our muscles, joints, nerves, and other tissues. Our bodies tend to prefer a “neutral” position. In relation to the spine, this means maintaining the normal curvature without excessive flexion, extension, rotation, or side bending.
Typically, most people have their preferred position to sleep. Some are back sleepers, others side sleepers, and the rest are stomach sleepers. Depending on your position of preference, you will need to assess how you can use your mattress and pillows to maintain a neutral position of your spine. If you’re waking up with pain or stiffness in the morning, make sure you reassess your sleeping positions.
4. Plan Ahead of Long Journeys
Long-distance trips are especially uncomfortable for your back. Sitting down restricts your blood flow and can provoke back pain, making what was supposed to be a relaxing trip an aching journey. To ensure your back is well rested and you enjoy a pain-free journey, follow the following tips:
5. Improve Your Lifting Mechanics
All of us have to pick things up and carry them around at some point in our day. Many people injure their lower back because of poor lifting technique.
Especially with heavier objects, it is increasingly important to use good body mechanics to decrease the stress applied to the lower back.
Here are five correct lifting techniques you need to keep in mind:
Reuniting with Relief
Now that you’re better educated on the most common causes behind back pain, effective treatment methods and not-so-effective myths surrounding the condition, you will have a better chance of living your life free of pain and limitations the issue brings along.
Remember that back pain is an incredibly common musculoskeletal problem that most people experience at some point in their lives. Also, keep in mind that addressing the problem swiftly can prevent your condition from worsening down the road.
With so many potential causes of back pain, getting to the root cause of your ache can seem like a daunting task, but remember that numerous resources, tools, and professionals are there to guide you towards a more fulfilled, pain-free life.
Lastly, if there is one thing you’ll take away with you after reading this article, make it the fact that back pain can be managed, improved and prevented through treatment methods, correct attitude and lifestyle changes.