Why Does My Back REALLY Hurt?

Mary Williams

23 Sep, 2022

We’ve all heard people talk about how “their back went out”. Something like, “I bent down to pick up a sock and my back went out.”

Or maybe there was an event, such as an automobile accident or athletic event.

We can think of these examples as the triggering event rather than an injury, meaning this event isn’t causing the current pain; but rather when the pain began.

In most cases of chronic back pain, it was not the event that let to prolonged pain, but factors that were in play before the initial onset.

The three main factors that set the stage for the triggering event and subsequent chronic pain are discussed below.

1 – Imbalanced Posture and Mechanics

When your musculoskeletal system (bones, joints, muscles, and connective tissues) is properly balanced and aligned, the bones and joints are oriented for optimal function.

Postural muscles can then be used for support while skeletal muscles (the ones that move the body) are relaxed, healthy, and available for movement.

The human body is naturally relaxed when aligned properly.

When your posture is out of balance, paired muscles can become inelastic and either elongated or shortened, resulting in tight muscles and pain.

When your bones are not properly aligned, it puts undue stress and shear on your joints, and skeletal muscles must then be used to perform the function of postural muscles.

An imbalanced posture is inefficient and may lead to musculoskeletal pain, discomfort or injury.

2 – Insufficient Physical Activity

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

When we exercise regularly, we also enjoy many 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

3 – Stress

When presented with a stressor, the human body is remarkable in its response. Many, many physiological processes either are slowed down or heightened.

The body prepares to do something physical (i.e., fight or flee) and responds with a heightened muscular response.

However, since most of today’s stressors do not require physical action and are often 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, plus are imbalanced and inelastic due to an imbalanced posture, so when they bent over their back muscles respond much as a twisted rubber band does under slack.

This causes pain that can lead 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.

In Conclusion…

While there are other factors that can contribute to back pain, above are the main ones.

To both prevent and recover from chronic back pain you can:

move often,
with good mechanics, and
address the chronic stressors in our life, and your response to stress.

Four Back Pain Myths

Mary Williams

10 Sep, 2022

Myth #1: I have a “bad back,” and it will never get better.

Most of us have heard people talk about their back “going out” or having “a bad back”. Having heard these stories, we can come to believe that there are two groups of people: the general population and those with “a bad back.” Further, we may believe that once our back “goes out” we necessarily become permanent members of the latter group.

It’s important to understand that the entire concept of a “bad back” is a belief, a myth. Instead, there are predictable factors that lead to the pain, and when we understand what is causing the pain, we can then work towards relieving the pain.

Myth #2: My back is damaged.

In 99.5% of cases of chronic back pain, there is no damage to a physical structure causing the pain, but several factors that led to muscle tightness.

Consider the following study results that affirm this.

64% of people without back pain show disc findings on MRI
Half of people with back pain show no findings
50% of people with back pain were “cured” after exploratory surgery showed no findings

There are real, physiological reasons that your back hurts, but it’s usually not because of damage.

Myth #3: My back needs to be protected.

It is very common and very natural to want to protect your back when it hurts. When we break a bone, for example, we protect it by casting and resting it until it heals. When we have the flu, we rest and slow or stop activities until the virus runs its course.

However, for most people with chronic back pain, the natural reaction of restricting activities, resting, or bracing in an effort to protect and heal your back can actually contribute to the pain.

Since most back pain is due to muscle tightness, when we attempt to “protect” it, we contract our muscles over a prolonged period of time which increases the pain we feel. When we rest, our muscles don’t get to be used in a healthy manner, and they become weakened and lose elasticity.

Muscles need to regularly contract and relax; prolonged contractions and inactivity work against optimal mucle health and function. Continuing to move – with good mechanics – is one of the best things we can do for our backs – even, in most cases, when your back hurts.

Myth #4: There is more back pain today because we walk upright, or because the back is fragile and poorly designed.

I hear this one a lot. It’s important to know that the human spine is a brilliantly designed, strong and stable structure. It is not often fragile, and is more than suitably able to perform the tasks we do each day.

That said, the way most of us typically sit, stand and move with our backs has changed quite a bit over the past 50 years, and it is how we move our backs that can contribute to the pain. Look at a photo of a person from the 1920’s or before, then compare their posture to a teenager sitting at a computer or an adult worker sitting in a chair while operating a tablet.

The increase in back pain is not because of poor design, but poor mechanics. When we learn to properly balance our postures, we can sit, stand and move with ease and without pain.

Follow this 3-step Plan to Regain Activities Lost to Back Pain

Mary Williams

1 Sep, 2022

If you experience persistent or periodic back pain, it may seem like the best thing to do is to stop engaging in activities you previously enjoyed.

However, your back and your body need to move regularly to function at their best, and participating in regular physical activity is an important step in recovery.

“Protecting” your back by restricting your activities may actually be contributing the pain.

If you’ve been restricting activities for a while, it’s likely that you’ll need to gradually resume activity, both to get your body used to it again and to, over time, learn how beneficial being active again can be.

In addition, if you’ve been inactive for a while, your muscles and joints may be tight and your cardiovascular system may not be at its best. Try this gradual, progressive, 3-step method for regaining all of your lost activities (adapted from Dr. Ronald Siegel’s Back Sense).

Step 1. List all of the activities that you’ve stopped doing entirely, or have modified or restricted because of the pain.

Be thorough and complete, and include activities from all areas of your life, including home, work, sports and recreation, travel, social, and other.

Step 2. For each activity, rate how much you enjoy the activity (enjoy/ok/dislike), and how difficult you perceive the activity to be (easy/moderate/difficult).

You could also use a number scale such as 1-5.

Step 3. Next, select an item to start with. Begin with an activity that you perceive to be both enjoyable and easy to do, and make a plan to do this activity in the next 24 hours.

Take slow, deep diaphragmatic breaths during the activity, noticing any areas where you feel tightness or pain. Allow any tight muscles to relax as you exhale.

Gentle walking is a great activity to start with for most people.

Make your way through your list one at a time until you can do everything that you wish to do and have fully regained all desired activities.

It may take a while, both from a physical standpoint and to adjust to the idea that it’s ok to move again. Each time you regain an activity you will be building your self-efficacy and have more confidence that you can go on to the next activity.

Enjoy all of the benefits of physical activity, including stress relief, a healthy spine and body, and the personal enjoyment of moving again.

Begin the process of doing everything that you wish to do – today!

PS: Message me if you’d like me to send you the chart/worksheet I use with clients for this exercise. -Mary