Why does my back really hurt?

We’ve all heard people talk about how “their back went out”. Something like, I slipped on a toy and my back went out, or I bent down to pick up a sock and my back went out. Or maybe there was an event, such as an automobile accident, athletic event or maybe it started at work. I think of this not as the “injury”, but as the “triggering event”, meaning that this event did not cause the pain, but designates the time that the pain began.

What many may not understand is that, in most cases, it was not the event that caused the pain, rather the contributing factors that were in play before the initial onset.

Primary Factor #1: Stress

When presented with a stressor, the human body is remarkable in its response. Many, many physiological processes either are slowed down or heightened. Since the body is preparing to do something physical (i.e., fight or flee), it responds with a heightened muscular response. However, since most of today’s stressors do not require physical action and are typically chronic stressors, we end up with back muscles that are regularly tightened in preparation for an action that doesn’t happen.

So, when we hear that someone bent over to pick up a sock and their “back went out”, what actually happened is that their back muscles have been chronically tightened and when they bent over their back muscles knotted up, much as a twisted rubber band does under slack. This causes a lot of pain that leads us to think that some damage has occurred.

The important thing to know about stress is that if we don’t deal with both the underlying stressors and our physiological response to stress, it will be very difficult to achieve complete, long-lasting relief from back pain.

Primary Factor #2: Imbalanced Posture

When your musculoskeletal system (bones, joints, muscles and connective tissues) is properly balanced and aligned, the bones and joints are oriented for optimal function, with postural muscles used for support and skeletal muscles (the ones that move the body) relaxed, healthy and available for movement. The human body is naturally relaxed when aligned properly.

When your posture is not balanced, muscle pairs become overstretched/shortened, inelastic, and not available to you for optimum use and movement. The joints are not properly aligned, putting undue stress and shear on the joint, and skeletal muscles are then called upon to perform the function of skeletal muscle.

A balanced posture is relaxed, at ease and supported by its natural structural attributes. An imbalanced posture is inefficient, and may lead to musculoskeletal pain, discomfort or injury.

Primary Factor #3: Inadequate Exercise

Our bodies are designed to move, so sedentary lives come at a cost. Our muscles are healthiest when they are used regularly, especially when we move with a balanced posture.

When we exercise regularly, we enjoy the following benefits.

  • Our muscles are available for both movement and postural support
  • Exercise uses up the byproducts of the stress response, relieving the stress, bringing our bodies back to baseline and reducing muscular tension
  • Exercise affects our brain chemistry, increasing (among other things) beta endorphin and serotonin, which helps us improve our outlook, feel better about ourselves, and acts as a natural pain-killer
  • When we exercise, we have increased energy to become and remain healthy and active and perform our daily activities
  • Regular exercise has been shown to be as effective as Prozac in reducing depression. (Note: this does not mean that, if you are on antidepressant that you should discontinue their use. Rather, building a foundation of regular exercise may help you to reduce or eliminate taking antidepressants under the care of your physician.)
  • When exercising, we have a break from thinking about life’s problems as we focus on the exercise
  • Exercise often provides social support, a very effective stress management tool
  • … there are many, many more positive effects of exercise and no known negative side-effects!

Summary

While there are other factors that influence back pain, I consider these three to be the primary, foundational factors. It is important that each of these be addressed and implemented in your daily life. When you experience recovery from chronic back pain, you may at times feel that you are slipping back or experiencing pain. In these times it is a good idea to go back to the basics and address the above three primary contributing factors.