Back Pain Causes & Solutions: What You Need to Know
Back pain is one of the most common complaints in the world with millions of people suffering from it daily. It can be triggered by various reasons, such as different types of arthritis, inflammatory diseases, injury, sprains, and strains, among others. However, there are instances when someone may be experiencing back pain without any apparent reason, and it can be difficult to come up with an explanation.
Definition of pain
“An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
Some important points that the IASP also make are that:
‘Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.’
‘Pain cannot be inferred solely from activity in sensory neurons.’
‘Through their life experiences, individuals learn the concept of pain.’
‘A person’s report of an experience as pain should be respected.’
‘Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.’
Essentially stating that there are lots of different factors that can impact pain, that it may not necessarily be related to actual physical damage, and that it can have a negative impact on a variety of different aspects of people’s lives (not just the physical).
Back pain across the world
According to the World Health Organization (WHO), over 1.5 billion people across the world suffer from musculoskeletal conditions. These are now considered to be the ‘leading contributor to disability worldwide, with low back pain being the single leading cause of disability in 160 countries’ (WHO, 2022).
Back pain can affect anyone at any age
Causes of back pain
Doctors and researchers have been trying to understand the causes and mechanisms behind back pain for many decades. Although there are numerous reasons for back pain, such as muscle tension, spinal disc herniation, and pinched nerves, there are still cases where the cause is unknown. It's important to remember that back pain is a complex condition, and sometimes it may not be attributable to a specific cause. It is estimated that over 90% of chronic low-back pain cases do not have a known origin (Oliveira et al, 2018).
For example, 60% of 50 year olds have a disc bulge without even knowing it (Brinjikji et al, 2015). They don’t feel any pain. This percentage increases each decade. Disc bulges normally heal within 12 - 18 months (although pain reduction and return to normal daily activities can often occur within just a few months) - so if you’re still in pain after that, there’s a good chance it’s no longer related to the injury.
Love a good podcast? The ‘Empowered Beyond Pain’ series created during the start of the pandemic gives great information for both practitioners and patients and explains this in more detail.
Factors that can impact back pain
Recent studies have shown that psychological factors such as anxiety, depression, and stress can cause or worsen chronic pain, including back pain. Psychological pain can create a vicious cycle where pain leads to anxiety and depression, which can then aggravate the pain. Therefore, managing psychological pain may help alleviate chronic pain. Techniques such as counselling, meditation, relaxation, a healthy diet, and exercise (yay Pilates!) can all assist in reducing your stress and strengthening your mental health.
A sedentary lifestyle can actually lead to muscle stiffness, weakness, and poor flexibility, all of which can cause back pain. This also links to the psychological factors listed above - one symptom of anxiety and depression can be a lack of interest in getting moving. Therefore, it is essential to engage in regular physical activity such as walking, cycling, swimming, going to the gym, or Pilates, to keep your muscles and joints healthy, reduce your risk of back pain, and improve your mental health.
It might seem counterintuitive, but exercise is great for back pain!
How to manage back pain
So, what can you do to manage or prevent back pain? The answer lies in adopting a holistic approach that addresses multiple factors, including your lifestyle habits, physical activity level, stress management, diet, and sleep quality. Further studies also provide ‘evidence of the health-promoting effects of optimism, including its protective role in acute and chronic pain’ (Basten-Günther et al, 2019). And guess what has been proven to be one of the best exercises for back pain? Pilates!!! (Hayden et al, 2021).
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References:
- American Psychological Association. (2016). Chronic Pain and Psychological Distress. Retrieved from https://www.apa.org/monitor/2016/02/chronic-pain
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2019). Back Pain. Retrieved from https://www.niams.nih.gov/health-topics/back-pain
- Harvard Health Publishing. (2019). Back Pain: What You Can Do. Retrieved from https://www.health.harvard.edu/pain/back-pain-what-you-can-do
- International Association for the Study of Pain. (2020). IASP Announces Revised Definition of Pain. Retrieved from https://www.iasp-pain.org/publications/iasp-news/iasp-announces-revised-definition-of-pain/
- World Health Organization. (2022). Musculoskeletal health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
- Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CC, Chenot JF, van Tulder M, Koes BW. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018 Nov;27(11):2791-2803. doi: 10.1007/s00586-018-5673-2. Epub 2018 Jul 3. PMID: 29971708.
- Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27. PMID: 25430861; PMCID: PMC4464797.
- Moseley, G.L., Zalucki, N., Birklein, F., Marinus, J., van Hilten, J.J. and Luomajoki, H. (2008), Thinking about movement hurts: The effect of motor imagery on pain and swelling in people with chronic arm pain. Arthritis & Rheumatism, 59: 623-631. https://doi.org/10.1002/art.23580
- Basten-Günther J, Peters M, Lautenbacher S. Optimism and the Experience of Pain: A Systematic Review. Behav Med. 2019 Oct-Dec;45(4):323-339. doi: 10.1080/08964289.2018.1517242. Epub 2018 Dec 20. PMID: 30570408.
- Hayden JA, Ellis J, Ogilvie R, Stewart SA, Bagg MK, Stanojevic S, Yamato TP, Saragiotto BT. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. J Physiother. 2021 Oct;67(4):252-262. doi: 10.1016/j.jphys.2021.09.004. Epub 2021 Sep 16. PMID: 34538747.