It’s easy to take our back for granted, until it demands our attention. When everything is fine, we don’t think about our hardworking spine. But when our back hurts — it can really hurt. Like when you bend down to put on your shoes one morning and you suddenly feel a sharp twinge and can’t stand back up. (Owwww!) Or maybe you’re dealing with a mild, nagging backache that comes and goes but is still a real nuisance.

What causes back pain? There are the obvious things, from poor posture, stress and excess weight to muscle and ligament strain and bulging or herniated spinal discs. But you might be surprised to learn that eating a high-fat, high-sugar diet and smoking (yes, smoking) can trigger back trouble too, says Daniel Mazanec, MD, the associate director of the Center for Spine Health at the Cleveland Clinic.

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When you look at all types and causes of pain, back pain is the most common type reported (followed by headaches and neck pain) and the number one reason for disability and/or missed days of work for people under the age of 40.

A sudden flare-up of back pain that lasts a few days to a few weeks is considered an acute episode, while pain that continues for three months or more is labeled chronic. In both cases, the level of pain can range from mild to severe.

Either way, back pain isn’t something that you have to grin and bear, says Dr. Mazanec. In fact, even if you have structural problems with your back (such as spinal stenosis or scoliosis), you can take steps to reduce your pain, and even prevent it from coming back.

Your best bet for a healthy back: living an active lifestyle that allows you to develop a strong core, reducing the amount of inflammatory foods you eat (see The Healthy Back Diet) and taking steps to manage stressors in your life.