Our back is really an amazing feat of engineering. For one thing, our spine is a structure made up of 33 bones called vertebrae that support our entire body.
It’s not surprising, then, that figuring out where pain is coming from in this highly intricate piece of anatomy often amounts to a good deal of guesswork. Even with X-rays and MRIs (magnetic resonance imaging, which uses radio waves and magnets to create cross-sectional images), “85 percent of the time, it’s difficult to pinpoint a precise cause for back pain,” says Daniel Mazanec, MD, the associate director of the Center for Spine Health at the Cleveland Clinic and a medical acupuncturist.
Stimulate Your Core: Lie flat on your back with your knees bent. Place your thumbs on the bottom of your floating rib and your index fingers on the tops of your hipbones. Inhale and feel the space expand; exhale and forcefully push all the air out of your lungs, concentrating on using your abdominal muscles to push your belly button back to your spine. As you do this, you’ll feel the space between your thumbs and forefingers contract. Keep the tension (belly button to spine) for a count of 10 seconds. Inhale, exhale and repeat five to 10 times, twice a day.
Some of the biggest causes of back pain, such as soft tissue injuries (muscular injuries or ligament sprains/strains), can’t be seen in an MRI or X-ray. And the things that can be imaged, such as joints, discs, bones and nerves, don’t always tell the whole story.
For instance, even if the MRI shows an abnormality, it may not be what’s causing the pain. Less common causes of back pain are due to spinal nerve issues, primarily related to disc problems, bony spurs from arthritis or a combination of both; these affect around 5 to 10 percent of people.
While the cause of your back pain may remain a mystery, a qualified physician or physical therapist, for instance, can still devise a successful treatment and prevention plan. Taking into account your symptoms, current health, diet, activity level and medical history, your doctor will tailor a plan just for you.
The even better news: No matter what’s causing your spine to ache, 99 percent of people do not need surgery to eliminate their back pain, says Dr. Mazanec.
Common Causes of Back Pain
Lifestyle plays a huge role in back injuries. Major factors include:
- Weight. Being overweight is a big trigger. Your discs — the jelly-like tissues that cushion the bones of your spine — take a real beating, thanks to the excess weight creating constant pressure on them. In general, people with a body mass index of 30 or greater are at the most risk of developing back pain due to extra weight. Pregnancy weight gain, which is unevenly distributed, can also do a real number on your back. (If you’re pregnant, do your baby and your back a favor and stay within the recommended weight gain guidelines.) For overweight folks, incorporating regular exercise (see below) and healthy eating habits can reduce the number on the scale and, consequently, your back pain.
- Inactivity. If you don’t move your body, you’re going to gain weight and weaken your lower back and abdominal muscles, known as your core. A weak core can put incredible strain on your back. By strengthening it, you put less pressure on your spine.
- Occupational hazards. We’re not talking about high-rise window washers! Sitting at a desk for eight hours a day (especially with poor posture) is one of the worst things for your back because it puts extra pressure on your discs, says Dr. Mazanec.
- Overuse. Active people have plenty of back issues too. If you’re a runner, for instance, the front of your legs might become stronger than the back, or your legs may be strong, but your core could be relatively weak. Over time, these muscle imbalances affect the way your pelvis rocks back and forth when you run. Eventually, it can lead to misalignment and pain. The bottom line: All sports and workouts come with overuse risks. No matter what you do, core-strengthening exercises (such as Pilates) can help you balance your flexibility and muscle strength and, consequently, protect your back.
- Smoking. “It’s not a well-known risk factor, but it’s a big one,” Dr. Mazanec says. Your jelly-like discs are largely made of fluid and naturally start to lose fluid as you age. The nicotine in cigarettes speeds up this process because it causes blood vessels to constrict, which ultimately starves your discs of nutrients.
- Age. We’re talking about the simple wear and tear on your discs and joints that occurs over time. Frail bones from age-related conditions like osteoporosis are also a factor.
- Stress. A lot of people hold tension in their neck and upper back, which can cause back pain. “Clearly, there is a mind-body connection with some back pain,” Dr. Mazanec says. When he and his colleagues suspect that stress is playing a major role in the pain, they recommend treatments such as acupuncture and biofeedback to help a patient learn to relax those tense muscles.