After people with back pain finish their course of care with us and are feeling a lot better, their next, logical question is, “How do I keep this from coming back?”
If you’ve never had back pain, you may wonder, “Is back pain avoidable?”
Ah, those are tough questions, indeed.
You may know the statistics that approximately 80% of people worldwide suffer a back pain episode at least once in their lives. So odds are good that you will, too.
I always like to think of back pain in a way similar to headaches or colds. Nearly everyone gets them, often several times in their lives. They’re part of the human condition. Like back pain, we don’t always know why headaches or colds started, but they usually go away with time and leave no lasting damage. Just as there are ways to prevent or reduce the risk of headaches or colds, and reduce their severity when they happen, there appear to be ways to reduce the risk of back pain.
It’s important to remember—or perhaps learn if this is you’re first time hearing it—that around 90% of back pain doesn’t have a clear cause. Traumatic injuries like fractures, ligament sprains, and muscles strains are rare. These injuries usually require extremely high forces, or unexpected forces, that are applied quickly. That doesn’t explain how you get back pain from sleeping or bending over to pick up a sock off the floor, two mechanisms that I commonly hear. Even herniated discs only account for 5-10% of back pain.
According to research, the most likely mechanism of back pain is your body’s nervous system getting overly protective and saying “enough” and basically putting your back in timeout. It does this through pain, our body’s protective sensation. Why it does this is even more speculative, but possibly in response to a perceived threat like your back is feeling overworked or a sudden, unexpected movement. Tough to accept, but the other more commonly accepted causes mentioned above—discs, sprains, strains, fractures—just aren’t seen in most back pain, so they’re not the answer for the majority of back pain sufferers.
Going back to the earlier statistic, if 80% of people get back pain that also means 20% of people don’t get back pain. Sadly, I haven’t seen any research into why those lucky 20% might be spared. With so many variables involved in back pain, navigating the minefield might just be pure luck, but I have some suggestions that could help. As a matter of fact, these tips are applicable to avoiding or reducing the risk of all kinds of pain and injuries.
Stress is a risk factor for so many diseases, aches, and pains. Don’t you feel more sore after a stressful day? It’s not all in your head. The hormones released with a stress response can make your muscles sore and your tissues more sensitive to mechanical stresses. Your nervous system is also on amped up and ready to react more quickly to threats, which can make your healthy back more vulnerable to minor insults that lead to a painful episode.
How you manage stress is up to you, but there are plenty of resources out there.
Get Adequate Sleep
Sleep is restorative for our mental and physical well-being. It’s when the damage done during the day is repaired. Without it, you won’t recover as well, making you vulnerable to next day’s stresses. If the next day includes lots of activity, your taking chances. Lack of adequate sleep also directly contributes to stress, so it’s a double whammy.
If you think your 5-6 hours is enough, think again. You may feel like you’re functioning okay, but the best sleep research tells us that less than 7 hours is really not doing it for you.
Get Adequate Exercise
Following the America College of Sports Medicine’s guidelines, doing moderate-intensity cardio most days of the week, and some resistance training twice a week is really important for maintaining a healthy body that can handle your daily activities. In numerous large studies, exercise is the only thing that has been consistently shown to reduce the likelihood of getting back pain and to help alleviate it once it happens. It also helps you manage stress and can improve the quality of sleep. Just do it.
Do you already have a few exercises you like to do to prevent back pain? If you feel that they’re helpful then there is no reason to stop those, but a well-rounded program would include plenty of cardio and some resistance exercises aimed at the back and hip muscles.
Avoid Spikes in Activity
Pain and injury happens when you exceed your body’s capabilities. That’s why you should be careful about activity spikes. If your body is used to a particular activity level and has adapted to that, a sudden increase will put you at risk of pain or injury. This probably the most common mistake that people make. If you usually run 3 miles then decide to run 6 miles, that’s risky. If you haven’t lifted weights before and suddenly decide to give heavy back squats a try, that’s risky. Or, how about being mostly sedentary during the week, then playing 2 hours of flag football on the weekend?
Ease into things. With exercise, increase your weight, repetitions, volume, mileage, etc. by less than 10% at a time and wait a few days to see how you react before increasing again. Your body needs time to adapt. If you’re going to play a sport you haven’t played in a while, ideally play for less time or at a lower intensity until you get used to it. A good warm-up is always a prudent idea.
So there are broad suggestions for reducing your risk for back pain. Unfortunately, there is no silver bullet, just boring, common sense advice to be the healthiest version of you that you can be.
If you still end up with back pain, don’t despair. It’s usually not serious, and often resolves within 6 weeks.
If you’re having trouble, feel free to contact us for a free 15-minute phone consult to see how we may be able to help.