Back pain is a common complaint. Anna, Kyle and I have learned a lot about effectively treating back pain. More importantly, we understand what can cause it. We want to do more than treat back pain, we want to explain why it happens so you can prevent back pain from ever happening and really, that’s the whole point.
It all starts with the basic design of the spinal column. Spines have curves at the neck, chest and low back that are designed to align your upper body. When your head, shoulders and hips are correctly balanced, your bodies use the least amount of energy possible to keep you standing tall. If the balance is off, that’s when you stand, sit and move in ways your body wasn’t designed for and the result is usually pain. Spinal curves are set up to stack the body so your head, shoulders, hips, knees and ankles are in line. At least in a perfect world. For those of us who don’t live in a perfect world, there are a lot of things that can throw off this ideal alignment:
- Wearing shoes with incorrect support can change what part of your foot takes the most of your weight. Standing with your weight on your heels makes the muscles on the back of your body have to work harder to balance which can lead to pain in your hips and low back. Standing with your weight on the balls of your feet make the muscles on the front part of your body work harder which can cause knee and hip pain.
- Sitting in a chair or car that doesn’t have proper low back support flattens out the curve in your low back and neck. Your whole upper body tends to pitch forward and makes your neck, shoulder and upper back muscles have to work hard to do the job of the low back and neck curve. This often leads to neck tension and headaches and pain in your shoulder blades.
- Working at a computer that isn’t at the right height can cause you to slouch which increases the spinal curve in your chest area. Your neck and low back curves flatten and cause the same neck tension, headaches and shoulder blade pain as a low back that doesn’t have the correct support.
The spine isn’t the only consideration when it comes to back pain. Your body was designed to be an integrated and adaptive system. Muscles attach to bones and the way you use your muscles can change the way your bones line up. Here are some examples:
- Lifting with your legs and not your back isn’t something OSHA developed just so they could make a poster. Your leg muscles are designed to control how your knees and hips bend. They are much bigger and can handle much more weight than the muscles in your low back.
- Core strength isn’t a marketing ploy designed by yogis and physical therapists. Our stomach muscles work with the muscles around our spines to maintain those important spinal curves. If your stomach muscles are weak, your back muscles have to work harder to keep your upper body balanced and vice versa.
Understanding what causes back pain is a big part of effectively treating it. There’s a bigger, more important part: understanding your back pain. There are a few questions that seem simple but contain some key details that your health care provider can use to efficiently treat your back pain:
- When does it start? – The time of day or movement that triggers the pain can tell us a lot about the cause of the pain and the better we understand that, the better we can treat it. If it starts in the morning but gets better after you move around a bit, it’s most likely caused by a muscle. If the pain remains constant throughout the day or gets worse as the day goes on it may be a degenerative issue.
- How does the pain feel? – A dull ache indicates muscle is the cause of pain. Sharp, burning or tingling sensations indicate nerve pain. General pain that’s hard to pinpoint can indicate pain associated with your organs or that the pain is a response to stress or an emotional upset.
- What makes it feel better or worse? – If heat decreases the pain muscle tension or overuse may be the culprit. If cold does the trick you might be suffering from inflammation.
- Do the shoes you wear or chair you sit in make a difference? – Where you place your weight on your feet and how you support your low back can change the way your muscles work. Sometimes a change to your footwear or office ergonomics is the best way to get long term relief.
- Do your hips, knees and/or ankles hurt too? If you have pain in multiple locations your pain might be the result of a compensation pattern. You may have an old ankle injury that seemed to heal just fine, but it took years of walking on it before the tissues started changing which caused you to move differently and affected how your knee, hip and low back line up and how your whole body works together.
People build careers out of learning the intricacies and applications of body dynamics. The purpose of this article isn’t to make you an expert on back pain. The goal is to give you information that can help you advocate for your body. Understanding how to explain your pain and provide insight into how your body works is often the hidden weapon healthcare providers need to treat your pain and prevent further injury.