What Causes Back Pain?
"Back pain is the inevitable end result of repeated, abnormal spinal movements
that strain the muscles, discs, and joints, causing tissue damage."
You could write a book about what causes back pain. In fact, lots of very clever people have! Usually they are filled with lots of detailed information on spinal anatomy and medical stuff like orthopaedic testing etc. Whilst all those big words are important, they can be overwhelming and just plain confusing. So we are going to keep it as simple as possible, while still giving you everything you need to know about what causes back pain, and nothing more.
This post is quite a long read, but stick with it! Because once you know what actually causes your back pain, you will be in a much better place to fix it. It has been shown time and time again that people who actively learn about their condition get better results, and they get them faster!
Because of the scope of this topic, we will just sticking to mechanical causes of back pain, which covers the vast majority of back pain that people get.
Please be aware that back pain can occasionally be a symptom of serious disease, we cover this in more detail here.
Spinal Anatomy 101
Because nearly all back pain comes from the spine and its' supporting structures, it is helpful to have some understanding of what the spine is and how it works. So we are going to give you a quick crash course in basic spinal anatomy.
Your spine consists of a column of bones called vertebra that stack one on top of the other like blocks. This spinal column sits on top of your sacrum and pelvis, and your head balances nicely on top. There are 2 spinal, or facet, joints at the back that join each vertebra to the next, and a disc sits between each vertebra to act as a cushion or shock absorber.
In between each vertebra is an opening called a foramen where the spinal nerves branch off from the spinal cord and leave the spine. These spinal nerves carry messages all around your body, controlling and coordinating al the functions of your body. Clever stuff!
All of this is held together by many different ligaments and muscles that provide support, stability, and movement. Our spine has 3 basic functions. Firstly it defies gravity by being able to support us standing upright. Secondly it is flexible so we can bend, twist and move around. Be aware that your spine is not meant to be extremely flexible. Your hips, knees, ankles and shoulders are built to be flexible through a wide range of movements, not your back.
Lastly, and very importantly, your spine houses and protects your spinal cord. Your spinal cord is an extension of the brain, it is a very important part of the nervous system. This is why back problems can be so debilitating. Your body will automatically tighten muscles to brace and protect your spine and nervous system if there are any problems.
All right, that's basic Spinal Anatomy done.
Next, some medical stuff.
When most people ask the question, ‘What causes back pain?’ they are usually asking for a diagnosis. Indeed, if you see a doctor, they will often give you a diagnosis such as a Bulging Disc, Sciatica, Degenerative Disc Disease, Facet Syndrome or Sacroiliitis. In fact if you saw 3 different doctors, you would probably receive 3 different diagnoses. Don’t blame them, it’s not their fault. It’s because it is extremely difficult to pinpoint exactly where low back pain is coming from. Often pain from a facet joint has almost identical symptoms to sciatica and sacro-iliitis, and usually there is more than one underlying problem at play simultaneously, particularly with long lasting, chronic back pain.
Even the latest scientific research is showing that standard orthopaedic testing (that is the part where your doctor pokes and prods you, and gets you to move in different ways) is incredibly unreliable. Luckily, MRI and CT scans are allowing us to ‘see’ the body better than we ever have, allowing for a more accurate diagnosis. However, even if we were able to reliably identify exactly which part of our body failed to cause pain, and obtain a correct diagnosis, it still doesn't tell us why that particular tissue became damaged, regardless of whether it is a disc, ligament or whatever.
The sensation of pain from your back is the result of the spinal tissues being stressed, strained and over stretched. This can lead to microscopic tears of ligaments, discs, muscles etc. This, in turn, causes inflammation and muscle spasm as the body tries to stabilise and repair the injury.
So what places abnormal amounts of stress and strain on the spine? At the end of the day, it is incorrect movement patterns that are putting abnormal stress on to the spine, causing it to deteriorate. This is the true underlying cause of back pain!
What are movement patterns?
Movement patterns are basically the way we move, without having to consciously think about it. The best example of this is walking. We can generally walk down the street without consciously having to think ‘OK, right foot goes first, then my left foot, then right’, and so on.
In fact, most of our movements are subconscious; that is, we don’t have to think about the mechanics of it, we just do it. A part of our brain called the cerebellum stores the ‘program’ for each of our movements. So for example, when you want to raise a glass of water to your lips to take a drink, your brain basically runs the 'program' for that movement, and next thing you know you are enjoying a refreshing drink! It’s very clever when you think about it! Other great examples of movement patterns are hand writing, swimming, riding a bike, or learning to drive a car. All involve quite complex movements, which are fully orchestrated and co-ordinated by the brain and nervous system.
Unfortunately, sometimes these ‘programmed’ movement patterns can become incorrect or out of balance. Think of it as being like people having different walking styles, or different hand writing. This change in the normal mechanics will lead to placing abnormal stress and strain on the involved tissues. Change in 'movement programs' is happening right in the control centre, the brain, and it is the underlying cause of all ongoing, chronic back pain. You can think of it as being like a 'glitch' in the movement software or program.
Abnormal movement programs can result from an injury or trauma (sports injury, car accident), or an accumulation of spinal stress and strain over time from things like poor posture.
Our backs are particularly susceptible to this change in movement patterns. An accumulation of injuries, even minor ones, lifting the wrong way, and in particular, postural stress from sitting incorrectly and slouching, eventually change the mechanics of the spine, weakening it and making your back unstable. It changes the 'software programs' for correct spinal movement. After years of repetition, these bad movement habits become hard wired in.
The end result of this is the tissues are constantly under strain, and spinal muscles have to work much harder than what they are designed for because the spine is not moving correctly. Eventually something is going to give, and that is exactly what happens with back pain. The constant stress and load will cause muscles to strain, ligaments to over stretch and disc fibres to tear, resulting in pain. However, and this is crucial, the pain is not the problem. It is just the end result of incorrect movement patterns putting extra load onto the spine and its' surrounding tissues. Knowing that, we can move beyond just treating pain, and actually fix the underlying cause of your back pain.
Please read those last few paragraphs again if you have to, because this is the foundations of really getting to grips with back pain (more than many health professionals, unfortunately).
If you have been suffering with back pain, you know the frustration of trying therapies and techniques that simply do not get to the core of what causes back pain.
There is a solution!
In order to effectively treat back pain over the long term, you need to retrain your spine to move correctly again. This is exactly what the HealthySpines.org Total Back Pain Solution spinal rehabilitation program does. By following the step by step action plan that guides you through specific movements and easy to do exercises, you will actually be retraining your movement 'programs' so your spine will move the way it is supposed to. Over the days and weeks of the program you will actually be changing, or retraining/reprogramming these bad, habitual movement patterns at the neurological level. This results in a stronger, more stable back, every single time!
The program has been designed not just to increase spinal strength and flexibility (although it certainly does), but to actually reprogram your neurological spinal movement patterns for the long term.
The great thing is that as your movement patterns change, they will become automatic (like walking), which further reinforces the stability of your spine!
It is amazing how much easier your life is when your back is strong, stable and moving correctly.
So In a Nutshell.
Back pain comes from tissues that are being damaged as a result of having to endure abnormal stress loads. This is the result of the spine not moving correctly. Unfortunately, most back pain treatments stop at pain management. By only treating the pain, the problem is bound to return.
Once we understand that those abnormal stress loads are the result of incorrect movement patterns, we can start to actually fix the true cause of back pain. This is easily achieved by retraining the spine to move in a stronger more stable way. The way it is supposed to!
This is the only way you can truly fix back pain for good. By retraining your brain to properly control your spinal movements, you will be building a strong, stable, and well coordinated spine for the rest of your life.
If you have any questions, or would like to share your own experience, please leave us a comment below.
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