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The Science of Back Pain, Explained

Nothing can stop you in your tracks like back pain. It’s more than painful -- it’s debilitating. That’s because when your back hurts, it prevents you from doing the things you need to do, and pursuing the passions you love.

It’s a fate nobody wants. And that’s why if you want to avoid it, you must first understand it.

This article hopes to serve as a general guide to learning more about your back, what causes it to hurt, the risk factors of back pain, and how you can treat and prevent it.

First, here are some fast facts about back pain so that you understand how serious -- and pervasive -- the problem is:

  • Back pain accounts for more than 264 million lost work days in one year -- two work days for every full-time worker in America.
  • Worldwide, back pain is the single leading cause of disability, preventing many people from engaging in work as well as other everyday activities.
  • Experts estimate that up to 80% of the population will experience back pain at some time in their lives.
  • Worldwide, years lived with disability caused by low back pain have increased by 54% between 1990 and 2015.
  • Low-back pain costs Americans at least $50 billion in health care costs each year.

Now, let’s get to know this pesky part of our body that we call the back…

Structures Of The Lower Back

The vast majority of people who suffer from back pain experience it in the lower area. The lower back area usually refers to the first five vertebrae, referred to as L1-L5 in the lumbar region. This region supports much of your upper body weight.

What Causes Lower Back Pain

Most lower back pain is mechanical and involves soft-tissue injuries. These injuries can include damage to the intervertebral discs, compression of nerve roots, and improper movement of the spinal joints.

How does this happen?

Well, as we age, normal wear and tear of our bodies is expected, and the lower back is no exception. Spondylosis is a term that refers to the degenerative changes in the spine, such as bone spurs, degenerating intervertebral discs between the vertebrae, and weakening of the joints, discs and bones of the spine, over time.

The single most common cause of lower back pain is a torn or pulled muscle and/or ligament.

Other examples of mechanical causes of lower back pain include:

  • Sprains & strains
  • Intervertebral disc degeneration
  • Herniated or ruptured discs
  • Sciatica
  • Spondylolisthesis
  • Traumatic injury
  • Spinal stenosis
  • Skeletal irregularities
  • Infections
  • Osteoporosis
  • Endometriosis
  • Fibromyalgia

For a complete list and explanation of mechanical causes of back pain, the National Institute of Neurological Disorders and Stroke has a page on their website you can view here.

What Are The Risk Factors For Developing Back Pain?

Nearly 65 million Americans report a recent incident of back pain, and approximately 16 million adults experience persistent or chronic back pain.

Are you at risk?

Here are the largest risk factors for developing back pain:


As we mentioned, spondylosis refers to the gradual breakdown of the structures of the back over time. This results in things like disc degeneration and spinal stenosis that produce back pain. So if you’re 40, your more likely to experience lower back pain than someone in their 30s. People aged 30 to 60 are more likely to have disc-related disorders, while people over 60 tend to have pain related to osteoporosis.


In 2012, for the first time, researchers identified a gene linked to age-related degeneration of the intervertebral discs in the spine -- a common cause of lower back pain.

From ScienceDaily:

“Scientists compared MRI images of the spine in 4,600 individuals with genome-wide association data, which mapped the genes of all the volunteers. They identified that the gene PARK2 was implicated in people with degenerate discs and could affect the speed at which they deteriorate.”


Remember, your lumbar area is the foundational support for much of your upper body’s weight. Being overweight, obese, or gaining a lot of weight in a short amount of time put stress on that region, which can cause lower back pain. 25% of adults with back pain report fair to poor physical health, compared to just 11% of those without back pain.

Unfortunately, back pain is so prevalent that it can strike even if you have none of these risk factors, which is why it’s imperative you take necessary steps to protect yourself.

Occupational Risk Factors

Those who make their living doing physical labor report much higher incidents of back pain than those with sedentary occupations. If your job requires long hours where you bend and lift (such as a construction worker or custodian), or stand for extended periods of time (such as a barber or cashier), you’re at an especially high risk.

And if you do sit in a chair, if it does not provide adequate back, hip and pelvis support, you can be just as susceptible to lower back pain.

How To Treat & Prevent Back Pain

Treatment for lower back pain varies greatly -- both in methodology and price. One factor of your treatment is whether your pain is acute or chronic. If there is evidence of worsening nerve damage, surgery may be recommended.

For conventional treatments, different methods can help different people based on the root cause of pain. These include:

Hot & cold packs

Heat can help loosen up the back muscles and relieve tension, which can ease pain in the back. Heat is recommended for back stiffness and muscle spasms.

Light-to-moderate activity

If your pain isn’t due to a serious injury (i.e. a fracture), a chronic disease or a spinal tumor, low-intensity cardio and weight training can help manage your back pain. When you engage in this light-to-moderate activity, you increase blood flow to the area and the muscles around your spine are able to build strength. Stretching can also improve mobility in a tight back and surrounding muscles.

Strengthening exercises

If you can get the muscles and joints around your back stronger, you reduce your risk for acuta or chronic pain.

Strengthening exercises can be key in this area. There are many, many methods from which to choose. Some of the most popular ones include:

  • Pilates
  • Yoga
  • Walking
  • Mobilization and manipulation therapies
  • Movement control exercises

While there isn’t much evidence to suggest which of these methods is the most effective, all of them have been shown to help alleviate and prevent back pain.

Physical therapy

If you’ve been diagnosed with a condition associated with back pain, you may have been referred for physical therapy. The goal of physical therapy is to decrease back pain, increase function, and teach the patient a maintenance program to prevent future back problems.

The most common types of physical therapy are passive physical therapy and active physical therapy. Passive physical therapy includes things done to the patient, such as heat application, ice packs or electrical stimulation. Active physical therapy focuses on specific exercises and stretches in order to treat lower back pain. For most lower back pain treatments, active exercise is the main focus of the physical therapy program.


One of the most common forms of medication for lower back pain are over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). They help reduce pain, swelling and inflammation in the lower back. Unfortunately, since they are so easy to obtain (no prescription required), you risk overusing them.

Other options for severe back pain include opioids (such as oxycodone) which interact with the receptors on nerve cells in the body; and muscle relaxants, which act on the central nervous system to reduce acute pain for the short term and are often recommended when muscle spasms are present.

Hopefully this article has been helpful in providing a general understanding of back pain, where it comes from, and what you can do to reduce your risk.

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