Causes of Back Pain

Back pain can be caused by injury, a wrong movement, or a variety of diseases. It can occur at any age, but the likelihood increases with aging (though usually not because of aging itself).

Back pain can be related to the bones of the spine, the intervertebral discs between them, the ligaments and spinal-supporting muscles that provide stability, as well as the nerves that exit between the vertebrae, internal organs, and the skin.

Main causes of back pain

Your back is a complex structure of vertebrae, ligaments, tendons, discs and muscles. The spine provides upright posture and support for the chest and abdominal wall that protect your internal organs.

Between the vertebrae are intervertebral discs; they partly fill the gaps and absorb shocks. The structure’s stability depends on the strength of your spinal-supporting muscles. As long as they are strong and trained, they hold your weight. Only so much force acts on the vertebrae and the discs as they can tolerate, so you have no complaints.

With sitting or standing work and little physical activity, the supporting muscles weaken and the discs take on an increasing load. This creates the basis for the development of back pain.

Movement and posture

It is common that the pain is triggered by something that seems harmless. For example, if you slouch in front of the monitor all day, sit in the driver’s seat as a driver, hold your arms up as a hairdresser, or perform repetitive movements along a conveyor. By the end of the shift the ligaments and muscles stiffen and you feel tight, aching pain.

A sudden movement, a slip, pushing, lifting or dragging a heavy object — even a sneeze — can trigger back pain.

If your mattress is too hard or too soft for you, it will overstrain or flatten the normal curves of your spine. If your neck, back, or lower back feel tight or painful when you wake up, it indicates that the mattress firmness is not appropriate.

You and your partner may not need the same mattress! Different body sizes, weights and builds may require different mattresses.

Muscle-related pain

A common cause of back pain is strain, sprain or injury of the back muscles, which can be caused by lifting with poor posture, lifting something too heavy, or a sudden movement.

The pain is caused by the injured, tight muscles and ligaments.

Back pain originating from spinal joints

Like any other joint in the body, the spinal joints can be affected by inflammatory diseases (arthritis). A consequence can be narrowing of the spinal canal (stenosis), where the spinal cord and nerves become "trapped" in progressively narrower bony channels.

Abnormal spinal curvatures have similar consequences. In scoliosis, the lateral curvature of the spine, a nerve on one side may become compressed while the muscles and ligaments on the other side are overstretched and painful.

Intervertebral disc-related back pain

The intervertebral discs can also cause complaints. The fibrous ring surrounding the disc weakens and the gelatinous core bulges out — similar to how the inner part of a damaged car tire bulges out.

In more severe cases the ring ruptures and the core "spills out." Much like squeezing jam out of a doughnut.

Whether it’s a bulge or a full rupture, pressure is exerted on the spinal cord or the nerve fibers exiting the spinal cord. The symptoms depend on whether the disc damage occurs in front, behind, or to the side.

Radicular (nerve-root) symptoms

Sudden, lightning-like, extremely severe back pains usually indicate that a nerve root exiting between the vertebrae is being compressed.

This can be a momentary "pinch" caused by a bad movement, sudden twist, slip, or lifting a heavier object. Although these complaints can torment you for days or even several weeks (e.g., lumbago, sciatica), if the nerve root is relieved of pressure, they slowly disappear.

A severe disc herniation is suggested if the pains do not subside and cause sensory or motor loss. This means a condition has developed that will not resolve "on its own" and continuously compresses the nerve root. In most such cases surgical intervention is performed.

A spinal tumor can also lead to radicular symptoms if the growing tumor tissue compresses the nerves.

In osteoporosis the bone mass of the vertebrae weakens and they may collapse, damaging the nerve fibers.

Organ causes and other factors

Some chest and abdominal diseases can also manifest as back pain. For example, a heart attack often first appears as pain radiating to the back. A renal colic presents as lower back pain.

Shingles causes band-like pain along the course of a spinal nerve. It always affects only one side and strictly respects the midline.

Inflammation or infection of the spinal cord and brain can also lead to neck and back pain, but this is usually revealed quickly by other symptoms such as fever and general weakness.

Risk factors

Any activity that weakens the back and spinal-supporting muscles increases the likelihood of developing back pain, because it increases the load on the vertebrae.

• lack of exercise, little physical activity, neglect of the back and spinal-supporting muscles
• sitting or standing work
• obesity and excess weight place extra load on the spine (even with strong back muscles they can cause problems)
• monotonous physical work, especially performed with poor posture
• genetic factors, for example general connective tissue weakness increase the risk
• during pregnancy the growing baby’s weight and altered posture can cause back pain, which usually resolves after childbirth
• Important! Constant stress, tension and anxiety can first show up as tension, stiffness and pain in the neck and back muscles!

Back pain can be prevented

As you can see, back pain most often arises for reasons that you can avoid or prevent.

Avoid becoming obese, because the excess weight is carried by your spine — it was designed for a normal body, not for one that is overweight!

If you wake up with back pain, your mattress firmness is probably not right! Replace it. You may need a firmer or a softer one.

If your shoulders, neck or back feel tense by the end of the workday, consider that stress may be the cause. Look for a different job or resolve the tensions you can (for example, a malicious, bossy employer is usually only remedied by changing jobs, but a toxic relationship with a colleague may be solvable).

If your work is monotonous, you spend the day standing, sitting or holding a fixed position, then physical exercise is especially important for you! I know you are tired in the evening and it is hard to start. But believe me, exercise will feel good over time and will save you from many complaints for the rest of your life!

You are mistaken if you think you can get rid of back pain with pills, injections or hocus-pocus! These have no effect on your spinal-supporting muscles.

But here is the good news: you can strengthen your back muscles with regular exercise, gymnastics or yoga even at the age of 100 and maintain them. In most cases you can prevent back pain!

If you are too lazy to exercise, then use a muscle stimulation device. Although I primarily recommend exercise, if you cannot manage it, a stimulator is an effective "substitute solution" that can eliminate your complaints.