Why your back hurts
Most patients that I see with complaints of back pain have no idea what is causing their pain. The facts are that back pain is not something that comes one day and is gone forever with a few treatments. Most people with back pain can expect to have repeated episodes. To complicate the matter and frustrate patients even more is the vast majority of back pain is known as mechanical low back or non-specific low back pain (NSLBP). Up to 95% of people fall into this category while less than 5% of people exhibit true nerve root pain. True nerve root related pain such as a herniated or bulging disc (and no discs do not “slip” despite what a local yoga website may tell you) is actually much easier to clinically diagnose than the various entities that exist under NSLBP. It’s called non-specific for a reason.
The bottom line is your back hurts mainly because somewhere along the way you learned to move improperly. The pain did not become evident right away because of this movement and may in fact have take years to present. And despite one singular event such as mowing the lawn or picking up a piece of furniture causing an acute episode of back pain, that event is not to blame in the vast majority of situations. This can be frustrating for a patient, because it seems like a simple event occurred to cause the pain and a simple fix can cure it. Unfortunately it is often more complex than that and while pain relief can hopefully be achieved quickly, to truly improve your pain long term, some retraining and education is in order.
Like I said blaming back pain on one single wrong movement is inaccurate. It is the hundreds and possible thousands of times that you have done that movement (most commonly bending and twisting) that is to blame and finally your back said “enough is enough”. Until you manage to improve your quality of movement, you can be rest assured you will always be at risk of another episode of acute pain. Treating the acute pain through the use of adjustments, soft tissue techniques such as Active Release Techniques and modalities like electrical stimulation can be very helpful to increase your function and get you feeling normal again. That is not the whole solution though. A person with back pain has to remove those movements that cause the pain in the first place. They have to work within what is called their pain free functional range of motion. This is why as part of my first office visit with a patient I will get a patient to show me how they move in terms of getting out of bed, getting into and out of a chair and how they lift. This usually gives me a wealth of information to work on with a patient when I show them how these movements completed incorrectly all their lives are a direct contributor to their pain.
Education is key for the patient. As a practitioner if I can teach a patient alternative ways to move that will spare their back and still allow them to complete the activities they need or want to do, it is incredibly empowering for the patient. This takes time, patience and practice however, because often a patient is relearning new movement patterns to replace ones that they have used for most of their lives.
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