What you need to know about back pain

When you have back pain, it’s understandable to feel weak. An attack can leave you immobilized for days or even weeks, wondering if you’ll ever get better.

I have several herniated discs in my back and I understand the feeling. But as someone who recovered from back pain and now lives a pain-free, active lifestyle, I’ve made it a point to provide people with the information and resources they need to heal and live pain-free. That’s why I’m sharing this four-part series.

Working as a mobility coach in professional sports, creating treatment and prevention protocols for back pain is part of my job. So my advice in this series of articles is not only based on medical research and my own back pain journey, but also my work experience helping hundreds of professional athletes overcome and prevent back pain over the past two decades.

In this first article, I’ll help you better understand your own experience with back pain, why proactive approaches are more effective than passive ones, and how you can find relief now and prevent future pain. In part two, we’ll look at exercises for permanent relief and strength recovery, while the third article focuses on sciatica relief. In the last part, I’ll help you create your back pain prevention plan.

If you’re ready to get out of pain and stay out, join this series.

Understanding your pain as your own experience

Back pain is an individual problem with many causes and presentations that will affect your recovery and prevention strategies.

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The good news is that, according to the American Association of Neurological Surgeons, back pain is not caused by serious conditions such as surgical fractures or cancer, and 90% will not get better. Below I have included a list of common reasons. Consider which of these may be relevant to your lifestyle and may be contributing to your illness.

Poor breathing mechanics and posture

Because your ribs are attached to your spine and core respiratory muscles, and your diaphragm is attached to your lumbar spine, how you breathe affects your spine’s position, overall posture, and therefore back pain.

pelvic tension

Your lower back is designed to be more stable than mobile, so when our hips are tight and there’s no rotation, trying to compensate for your back in twisting movements can lead to muscle and disc injuries.

physical trauma

Spine fractures are rare, but they can be caused by serious injuries such as severe falls or car accidents. Generally, these events result in hernias and/or muscle injuries rather than fractures.

age-related degeneration

Back pain is not a normal part of aging. However, after the age of 30, when bone density and muscle mass begin to decline, the health of the spinal discs also begins to deteriorate, so back pain can occur, especially if you do not exercise regularly.

sedentary lifestyle

If you are living with chronic pain, this activity can bring relief

As mentioned above, regular exercise is key to healthy muscles and bones. Our bodies are designed for movement, so sitting creates tight, weak muscles and reduces joint fat, including dehydration of the spinal discs, which can lead to back pain.

overweight or pregnancy

Excess abdominal weight puts extra pressure on the spine and increases the risk of back pain, which can lead to muscle strain, pinched nerves and herniated discs.

stress

When you experience chronic stress, your body’s stress response causes muscle tension, increased sensitivity to pain, and lower back pain.

Low back pain is usually classified as acute, chronic, or subacute depending on its duration:

• Acute lasts less than four weeks.

• Chronic for more than 12 weeks, even if it is intermittent.

• Subacute lasts four to 12 weeks.

Understanding the possible cause or causes of your pain and its classification will allow you to communicate more effectively with your doctor and other health care professionals.

Safe and effective help-seeking

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Increasingly, research supports that exercise is the key to healing and prevention. A meta-analysis published in 2016 in JAMA, which included more than 30,000 patients, found that active use of exercise reduced back pain and reduced risk compared to conventional passive approaches such as medications, braces, orthotics, and bed rest. And combining education with exercise reduced the risk of back pain recurrence by an additional 10% compared to exercise alone.

When your back pain first starts or if your chronic pain has worsened, just thinking about exercise can hurt. Don’t worry. In the following articles, I will share some safe exercises to relieve back pain. For now, here are two science-based methods that you can easily use for relief, as neither is against any condition.

mindfulness meditation

According to research, meditative deep breathing can reduce the intensity of pain.
Many studies have shown that mindfulness meditation is effective in reducing back pain, especially chronic conditions. A recent meta-analysis published in the journal Pain Medicine found that meditation provides a safer and more effective way to manage low back pain by reducing pain intensity and improving quality of life than non-meditative therapies.

breathing exercises

Practicing diaphragmatic breathing is the cornerstone of my back pain treatment and prevention programs in pro sports. That’s because deep breathing not only helps reposition the ribs and pelvis to take pressure off the spine, but it also facilitates the stress response and recovery by activating the parasympathetic “relax and restore” aspect of your nervous system. Try these simple 5-7-3 breathing exercises to reduce stress.

Additional pain relief options include massage, acupuncture, and chiropractic care. Before trying these treatments, check with your doctor to make sure they are not contraindicated for your condition.

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When you see your doctor, be sure to share your personal experiences about your goals for life after recovery, as well as possible causes of your pain. Listen carefully, take notes and ask questions as an active participant in your care plan. For example, if your doctor orders imaging such as an MRI or CT scan, don’t be afraid to ask what they’re looking for. After your doctor makes a diagnosis, ask why your condition suggests that diagnosis and what the prognosis is. If your doctor recommends extreme measures such as bed rest or surgery, ask them to explain why they think this is the best option and get a second opinion.

Finally, if your doctor prescribes an opioid pain reliever, ask if non-narcotic alternatives are available and, if prescribed, ask for a refill authorization. As of 2017, the American College of Physicians has issued new guidelines urging physicians to recommend exercise-based treatments and all other treatments before prescribing opioid medications for non-radicular low back pain.

Creating a proactive pathway to recovery and prevention

As you work toward recovery, remember that words and thoughts have power. Often, when someone has severe back pain, they describe it as a “popping” in their back. This type of negative, passive phrasing conveys a lack of understanding and responsibility that can hinder healing. That’s why it’s important to arm yourself with the right information and resources to stay positive and proactive.

Our bodies are amazing vehicles that we are blessed with to manage our lives. We have a responsibility to take care of them, and the only way we can do that effectively is to educate ourselves, use the resources of health professionals, and take action. By reading this article, you have already started on the active path. Look for the next article to help you determine the best exercises for long-term relief.

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