What to do about back pain?

Back pain is the third most common reason people visit their doctor. It’s estimated that 80% of people will experience back pain at some point in their lives. What is the cause for the majority of those who suffer from back pain? Is it damage to our spines ? Is it that we sit too much? These are important questions.

Pain is complicated and identifying the source can be challenging. Pain is rarely a sign that there is damage to the body. If you were to squat down and hold that position for five minutes, at some point you are likely to feel some pain. It could be in the knees, hips, or back. Does that mean there is damage? No. Likewise, if you were to look down at your phone for an hour straight there is likely going to be some pain in the neck. Does that mean there is damage? No, again.

The great majority of the time, when back pain is present, one should see it as a warning signal. It’s kind of like the ‘check engine’ light in your car. It is not necessarily that there is damage causing the pain; it could mean that the back is being overworked -- just like the neck in the phone example, and the knees, hips or back in the squatting example.

What are the most common ways we overwork our backs?
Sitting for long periods throughout the day can place added stress on your back. Poor posture can also add to the stress. However, most people don’t realize that the back can be overworked because something else in the body isn’t working as it should. For example, if the hips lack mobility, then the lower back has to be more mobile as you move throughout the day. If the upper back lacks mobility, then the lower back also has to be more mobile. Many people I see for lower back pain lack mobility in both areas. This creates a domino effect. If one area isn’t moving well, another area must make accommodations. It is likely that you are completely unaware of the true problem when it comes to your back pain. This is because the under-worked area of the body isn’t the one in pain while the overworked area is.

Have you been diagnosed with spine damage?
Lower back spine degeneration has been shown to be present in 40% of those under the age of 30 and in over 90% of those between the ages of 50-55. Likewise, 36% of people aged 50 were shown to have a low back disc herniation. What’s startling is none of the people in either of these studies complained of back pain. Osteoarthritis of the spine is very similar. It’s not a matter of if you will be diagnosed with arthritis, it’s a matter of when, and it’s rarely the cause of pain. Science has shown time and time again that “spine damage” is actually normal aging. Just like we have wrinkles on our skin, we age on the inside of our bodies as well.

So what is the solution to back pain?
If there was a traumatic event such as a car accident, or a fall, it would be best to seek out the expertise of your physician or orthopedist first. The use of an X-ray or MRI can be useful in ruling out anything which is of immediate importance such as a fracture or spinal cord injury.

Although contrary to popular belief, rest is not going to be a solution for those suffering from back pain. Performing some light yoga poses such as a cat cow, child's pose, or simply walking will speed up the recovery process. If these movements are too painful then you should seek the guidance of a physical therapist. Here in North Carolina, we have what's known as direct access. This means you can go directly to your physical therapist without requiring a referral from your physician. You should expect to notice a positive change in your symptoms within 3-4 sessions and feel close to 100 percent in about 6-10 sessions.

The solution is found in getting the entire body acting and moving in the way it was meant to, not just treating pain.

Dr. Derek Nielsen is a physical therapist and the owner of Kaizen Physical Therapy in Durham, NC.