Although back pain can sometimes be caused by internal organs referring their pain to the skin, or caused by direct trauma or injury, back pain usually indicates a very different type of pain altogether. This is because pain nerves can alert you to an active problem, but they can also send pain signals to the brain if the body believes that it is unstable.
Most back pain is not due to acute injury, but rather instability. If the low back does not think that it is capable of bearing the load of the body itself, it will send pain signals to the brain in order to tell the body about the problem. When the brain interprets the pain, your body will react accordingly. You might stop your motion or you might lay down, and in both cases you have relieved the back of its sudden load. The pain signals have done their job: they’ve alerted you to a problem.
This is why so much low back pain results from the simple act of bending over. Bending over does not cause acute injury or a ligament tear, but it does increase the load on your spinal discs and muscles by a very large amount. If the back believes itself to be unstable, then it will tell you, and you will feel back pain. This is why so many patients will say, “I was just bending over to pick up something from the floor, and it wasn’t even heavy. Why do I hurt?” You hurt because your back doesn’t think it’s strong enough to continue.
This is why, when a patient has back pain, often nothing definitive can be seen on an X-ray or MRI. If there is no structural problem, nothing will be positively identified on imaging. Sometimes doctors will even say, “Nothing seems to be wrong.” The bones are fine, the muscles are fine, the nerves are fine… but something is still wrong. Or, even worse, “You might just be imagining the pain.” No, the pain is very real, and the question is: What is wrong? Answer: The perceived stability of your low back.
In this case, the best thing you can do for your back is to continue to strengthen it, and continue to use it. This advice sounds counterintuitive, because normally when we feel pain we think it’s best to rest. However, we need to strengthen and stabilize unstable backs, and this requires work, effort, and normal motion.
This understanding of back pain and its origins has been around for the last twenty years or so, but it is starting to make an impression on the medical community. Fox News reports that a new book is out with much of this information, as well. I have not read the book and cannot review it, but this news article contains solid information:
Many Americans try to alleviate back pain with prescription pain medications, which can lead to dependence and other health problems. [Neurosurgeon Dr. Patrick] Roth believes taking pain medication may cause more harm than good.
“You have pain medication that is made by your body, it circulates, and you are in homeostatic condition most of the time,” he said. “If you take pain medication from the outside and you add it, the body thinks there is too much of its own medication and the receptors go down. So what happens is when that pain medication wears off, you’re actually more susceptible to pain.”
Roth said the majority of back pain goes away, and is a part of life that can be hard to avoid.
“One of the things people do wrong is they assume something is broken that needs to be fixed. And that mindset makes back pain persist,” he said.
When back pain strikes, Roth said the best thing you can do is get moving and don’t be afraid to exercise.
“Get back to activities and daily living,” he said. “You can begin to exercise even when in pain. A lot of people think the pain has got to be done before I start my exercises. They actually work well while you’re in pain.”
Your Peoria chiropractor can also advise you on the best exercises for your back, given your age and physical abilities. You don’t have to go through low back pain on your own, and it certainly isn’t all in your head.