By Daniel G. Graetzer, Ph.D.
Faculty Member, School of Health Sciences
Chronic back problems that restrict your range of motion are among the most prevalent, debilitating and costly injuries in Western society. In fact, the history of back pain can be traced back to ancient Egypt and the forced labor of slaves who built the Pyramids and other temples. Twentieth-century archaeologists have found the mass graves of Egyptian slaves, and subsequent medical analysis on the cadavers revealed severe spinal deformities, particularly in their lumbar and sacral areas.
What Causes Back Pain?
An injured back is most often caused by twisting and lifting movements, such as exercising on gym equipment or performing household chores such as vacuuming. These twisting and lifting movements force the lower back muscles to control the rate at which the back tilts. The same muscles later return the back to its normal upright position.
The small muscles attached to the spine, particularly in the lower back, are at a tremendous mechanical disadvantage during tilting. The distance from the upper body to the point on the low back where pivoting occurs (about 20 inches on an average-size individual) is much greater than the distance from the lateral attachment of the back muscles to their medial attachment on the spine near this critical pivot point (about two inches).
As with any lever system, the shorter the lever arm, the more force it must exert at the pivot point to resist the longer lever arm. In the case of many movements, that force can be greatly magnified by rapid changes in torque.
Aging Causes Back Muscles to Weaken
As people age, their back muscles progressively weaken. As a result, the compressive force that the disks between their vertebrae can withstand decreases dramatically.
Compressive testing of cadaver spines has shown that people under age 40 can withstand more than twice the compressive force to their backs without damage. For people over age 60, this same force would cause back damage.
The Structure of the Spinal Column
The spinal column consists of 33 vertebrae, which are stacked like blocks on top of each other. From top to bottom, these vertebrae include:
- Seven cervical vertebrae
- 12 thoracic vertebrae
- Five lumbar vertebrae
- Five sacral vertebrae
- Five coccygeal vertebrae
The sacral and coccygeal vertebrae are generally viewed as individual units, because they are almost always fused and give you 26 active vertebral units. The disks between the vertebrae normally function as shock absorbers, but they can become excessively compressed due to bouncing during weight-bearing sports activities, such as running. The compression is further compounded by twisting and lifting motions and by dehydration.
Related link: Overtraining and Hans Selye’s General Adaptation Syndrome
The Back’s Disk Compression Also Causes Your Height to Shrink Slightly during the Day
The general influence of gravity and constant inactivity such as prolonged sitting also contribute to excessive disk compression during non-exercise hours. Compaction of these disks actually causes you to shrink up to one inch by the end of a day.
For instance, try measuring your height immediately when you wake up in the morning, measure it again in the evening and compare the difference. Because of my long spinal column in my 6’6″ frame, I must readjust the rearview mirror in my car before I drive home at the end of the day, due to my daily fluctuations in height.
Most Back Problems Resolve on Their Own
Often, doctors tell their patients who suffer from acute back pain that they will recover and be back to normal within four weeks. Some patients often disbelieve their doctors when they offer this information.
However, studies have consistently shown that a vast majority of back problems seem to mysteriously resolve on their own in about one month. In such situations, diagnostic tests such as x‑rays, computed tomography, and magnetic resonance imaging are not all that useful for acute back pain problems, and surgery often provides surprisingly few benefits for relieving back pain.
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Pay Attention to Pain Signals and ‘Red Flag’ Conditions
A physician should certainly be consulted, however, when you have persistent symptoms that are creating back pain. There are several serious “red flag” conditions involving your back that need immediate healthcare intervention, such as:
- Fractures (such as the fractures created by osteoporosis)
- Tumors
- Bacterial infections
- Cauda equina syndrome
If you experience some of these symptoms, they may indicate the presence of a serious condition such as a malignant tumor or an infection:
- Pain that gets considerably worse when you lie down at night
- Recurrent fever and chills
- Bladder and bowel dysfunction
- Nerve problems affecting your knee and ankle muscles, especially if the problems are progressively getting worse
Relieving Back Pain
Back pain sufferers have accidentally discovered interesting ways of relieving their chronic discomfort. For example, a pilot of a small stunt airplane found relief from excruciating back pain while flying upside down, later learning that inversion therapy has been used for years to relieve pressure between disks and vertebrae within the spine. Similarly, patients who were transported via a horse-drawn carriage to a hospital for therapy often found their back pain was relieved by repeated movement via a bumpy ride along cobblestone streets than by a rehabilitation session.
Dealing with back pain generally involves controlling the pain, not necessarily getting rid of the pain entirely. One important function for pain following the initial injury or damage is to keep a damaged region undisturbed and allow healing to proceed.
Pain is a critical, built-in mechanism to protect your body. It serves the same function as the fatiguing effects of lactic acid produced in your muscles during exercise, especially high-intensity exercise. This lactic acid creates muscle fatigue, warning you to slow down and avoid injury or debilitating exhaustion.
Pain is also useful for diabetic patients, who sometimes lose pain sensation in their legs and feet due to peripheral neuropathy. For instance, someone with advanced diabetes could step on a rusty nail, walk around for days with that nail embedded in the sole of a foot and develop tetanus.
Think of your spine as a traffic light with green, yellow and red signals. On green light days when your back feels good, you can do activities that are stressful to your back, such as high-intensity exercise.
On yellow light days when your back feels moderately tender, proceed with caution when you pursue activities with the potential to aggravate recurring back pain. Remember that an ounce of prevention today will easily be worth a pound of cure next week.
On days when you feel your back is in the red danger zone, take the day off from exercise completely and appropriately curtail other physically or psychologically stressful activities. This advice is not only important for amateur and professional athletes, but also for “industrial athletes” who regularly encounter physically and/or emotionally stressful situations in the workplace.
It is very difficult to continue your normal life activities without using your spine. Consequently, immediate medical treatment, an appropriate amount of rest and relaxation, and conducting a regular rehabilitation program are the most important keys to relieving chronic back pain.
Regular Exercise Is Beneficial
Some regular exercise is beneficial for your body, however. Too little activity can be just as detrimental to the back as too much or inappropriate activity. The technological advances of the 20th century have enabled most Americans to live a sedentary existence for most of the day for the first time in human history.
After sitting in a chair hunched over a computer at a professional or home office all day, inactive living often continues during your off hours. The deterioration of our bodies in the absence of physical stress during much of the workday has greatly contributed to our current back pain epidemic.
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