Back Pain: Causes & Treatments
About three million years ago, human evolution made a fateful turn.
At some point, and for reasons that are not terribly clear, our ancestors left eons of history behind, and started walking around on two feet.
And we’ve experienced back pain ever since.
Three million years is a long time, but it hasn’t been enough time for nature to work out a great bipedal back.
The truth is, our back is jury-rigged. Originally designed for tree-swinging and scurrying on all fours, it’s been struggling to carry us upright ever since we discovered hands were better for carrying things.
For most of us, dealing with back pain at some point is nearly unavoidable.
But, most of the time, it can be easily treated through a few simple steps at home—steps that I’ll go over in just a moment.
If that isn’t enough, at the least we can avoid making it worse.
A lot of doctors are quick to prescribe drugs and surgeries for back pain.
But drugs—especially opioids—can create problems much larger than your original back pain. They are very addicting, and taken long-term, have worrying health implications.
That’s why the American Academy of Neurologists recently suggested that opioids never be used for chronic pain, except in very rare instances (like cancer-caused debilitating pain).
Meanwhile, surgery is even worse. It rarely gets rid of the pain, and often exacerbates it. In a recent survey, just 26% of surgical patients were back at work two years later—compared with 67% of back pain patients who avoided surgery.
Those who had surgery also saw a 41% uptick in drug consumption.
Today, I’m going to help you figure out why your back hurts. And pay attention—because it won’t always be what you think. Sometimes, back pain is an indication of something completely different.
But in nearly every case, once you have a better idea why your back hurts, a few easy exercises every day should do wonders for your pain.
Pain Cause #1: Muscle Strain
This is the most common cause of back pain.
Your back is full of muscles, ligaments, and tendons. Every time you lift something, reach for something, or even just turn around to look at something—you can potentially hurt your ligature.
The best treatment for a muscle strain is heat, rest, and stretching. Perform some of your favorite back stretches ten times each session, until the pain is gone.
- Stand parallel to a wall. Put one hand on the wall and one hand on your trunk. Slowly stretch hips toward the wall, so your legs and chest form a V pointing at the wall. Hold 3 seconds and relax.
- Sit in a chair with knees spread more than shoulder width apart. Bend forward and reach your hands back underneath the seat. Hold 3 seconds.
- Lie on your back with your knees bent up and your feet together. Rotate your legs to the side, trying to get your knees to touch the ground. Hold 3 seconds, then rotate your legs to the other side and hold.
- Lie face down with your feet and lower back relaxed and your arms bunched underneath you. Peel gently upwards, just lifting your tummy off the floor, and relax.
After the pain fades, perform back exercises to strengthen your core, and reduce the odds of the injury reoccurring. Planks—essentially holding your body in the “up” position of a push-up, strengthens your transverse abdominal muscles, responsible for most of your core stability—are the best choice here.
Pain Cause #2: Disc Pathology
If it hurts when you bend forward, there’s a good chance your back problem is a spinal disc problem.
The discs between your vertebrae can grow brittle, thin, or simply shift over the years. And when that happens, it causes plenty of pain.
That pain can also radiate down your lower body, if a disc is pressing against your spinal cord.
If you’ve got a problem with a disc, your best path forward is strengthening your core. That means plenty of exercises that focus on your abdominal and back muscles.
Again, planks will be your best friend.
If you can strengthen the muscles around the disc, they’ll be able to relieve a lot of the burden.
Pain Cause #3: Stenosis
Stenosis is when the canal in your spinal column narrows. That pinches your nerves—and usually shows up as a greater pain in your legs than your back.
However, when you feel the pain in your back, it’s more likely to show up when you lean backwards.
For stenosis, you want to stretch out your back as much as you can. In addition to exercise 3 described above, you can also:
Back strength is always a good thing, but less important in this case.
Pain Cause #4: Old, Worn Shoes
If you walk or run for long distances, or if you keep your shoes for many years, you’ll eventually wear out the insoles and the soles of your shoes. Depending on the wear pattern and the surfaces on which you walk, the pain from walking on worn out shoes can hit your feet, your knees, or your back. If your back is fine except when you talk “too far”, try new shoes.
Pain Cause #5: Need to Ask a Doctor!
If your pain doesn’t fit any of the above—or if you’ve been stretching and exercising for a month, without results—it’s time to see a doctor.
It’s possible you have a more severe musculo-skeletal problem, which needs more precise treatment or therapy.
However, it’s also possible you have something entirely different. Many of our organs are gathered around our back, and a problem in one of them might present as back pain.
That can mean a problem with your kidneys, an autoimmune disease, or possibly even cancer.
But don’t freak out. There are lots of causes of back pain, and the vast majority are only painful, not dangerous.
Indeed, the worse the pain, the more likely you are dealing with something musculo-skeletal.
Still, if the pain persists despite stretching and exercise, always be safe and see a professional.
Luckily, if you perform a few stretches and exercises yourself every morning, you can avoid back problems altogether…but they can also cure any current back pain you may have. Without ever needing to risk drugs or surgery.
- ABC News, “Human Evolution: Why Did Our Ancestors First Walk Upright?”, Lee Dye, Mar 28, 2012 http://abcnews.go.com/Technology/human-evolution-human-ancestors-started-walking-upright-theory/story?id=16016294
- Los Angeles Times, “For most chronic pain, neurologists declare opioids a bad choice”, Melissa Healy, Oct. 1, 2014 http://www.latimes.com/science/sciencenow/la-sci-sn-for-chronic-pain-opioids-20141001-story.html
- NBC News, “Back surgery may backfire on patients in pain”, Linda Carroll, Oct. 14, 2010 http://www.nbcnews.com/id/39658423/ns/health-pain_center/t/back-surgery-may-backfire-patients-pain/#.Vp0kHjY5njI
- Live In The Now, “Lower Back Pain? Here’s How To Reduce Pain Without Drugs Or Surgical Intervention”, Rebecca Simonds, 2015 http://www.liveinthenow.com/article/lower-back-pain-heres-how-to-reduce-pain-without-drugs-and-surgical-interventions
- Pain Science, “When to worry about low back pain,” Paul Ingraham, Jan 13, 2016 https://www.painscience.com/articles/when-to-worry-about-low-back-pain-and-when-not-to.php
Last Updated: August 16, 2018
Originally Published: February 2, 2016