Low back pain is one of the most common irritants in daily life, affecting millions of people worldwide. In fact, studies show that nearly 80% of people will experience back pain at some point in their lives. Whether it’s a sharp stabbing sensation or a constant dull ache, back pain can range from annoying to downright debilitating, limiting your ability to perform everyday tasks, work, or enjoy your favorite activities.
The spine is an amazing device - it is responsible for structural stability, force transmission from the lower to the upper body (and back) and through the core across all three planes. It forms the fascial anchor for many of the body’s largest muscles, along with housing and protecting nearly half of the nervous system (spinal cord). Its unique, intra-joint articulations allow for an unbelievable combination of mobility and stability, a flexible pillar so-to-speak, that is so effective it has been a staple in the mammalian kingdom for millions of years. And yet, because of its complex functional variability and humans’ tendency to walk upright (and spend a lot of time sitting), it is prone to injury and dysfunctions that can creep in over time.
While back pain can sometimes seem like an inevitable part of aging, many of its causes are rooted in simple functional or mechanical issues and are preventable or treatable, some of which have very little to do with the spine itself. At AlloVitae, we believe that understanding your back pain is the first step in managing it and effectively self-treating. In this post, we’ll explore the most common causes of back pain, from lifestyle factors to orthopedic issues, and provide our expert guidance on simple interventions that will help you take control of your pain and give you and your spine the support you both deserve to change your life!
1. Muscle Spasms, Strains and Ligament Sprains
Injuries to the muscles of the back are highly common, and can be both chronic and acute. Muscle strains will occur when a muscle is overstretched rapidly, overloaded beyond it’s capability, or repetitively overused (or a combination of all). A strain will generally present as a sharp pain in a very specific area. Spasms, on the other hand, will present as sharp, broad pain across a larger surface area. Unlike muscular strains, spasms generally occur as a protective or reflexive response to trauma or misalignment. The body subconsciously senses a problem in one of the many joints of the spine, and will signal the surrounding musculature to contract, maximally and painfully (spasm) to prevent further irritation, damage, or movement to the area. Common activities that can cause strain or spasm include heavy lifting, twisting awkwardly, or even a simple cough or sneeze if the muscles are already weakened or have a habitual response to back pain.
When ligaments in the back are overstretched or torn, it causes a sprain. This will occur when a trauma is great enough to the area that the connective tissue itself is disrupted. Sprains, like strains, are primarily due to forces through the connective tissue that it isn’t capable of tolerating or prepared for - whether due to a fall or rapid unexpected movement, lifting a heavy weight, or anything that compromises the position of the joint. Pain from a sprain will be very similar to a strain, but take longer to heal, and can also cause protective muscle spasms in order to protect the area.
AlloVitae Knowledge Key:
While traumatic and painful, muscle strains are often temporary and it is about managing symptoms while maintaining function (do what you can without irritating it). Ligament sprains are less common, but should be managed similar to a strain - manage the symptoms while maintaining as much function as you can without making it worse (listen to your body).
Muscle spasms in the back themselves can be debilitating, and could point to signs of deeper dysfunction (sprain, instability, joint irritation, etc.). Managing them can be tricky, as the muscles are spasming for a reason - so the trick here is not to force too much on a spasming muscle and give it time to loosen up, nudging it along while understanding that even as it relaxes, the underlying mechanism might still be present.
Symptoms of muscle strain or ligament sprain:
Sudden pain after lifting or twisting
Muscle spasms
Stiffness and limited mobility
Pain that worsens with certain movements
AlloVitae recommendations:
For immediate relief, lie in the recovery position on your back, with your feet flat on the floor and knees in the air
Increase movement variability and improve mobility to better utilize the and trunk legs for lifting and work related tasks (squatting, lunging, hinging, rotating)
Maintain good posture when lifting/doing manual work or when sitting or standing for long periods
Incorporate regular strength training of the lower body and core to decrease the load on the spine and improve the supporting musculature
Prepare for sudden, jerky movements that put strain on the back by incorporating rhythmic activities, balance, and excursions to maintain stability
Be diligent with continued activity and try moving in ways that don’t irritate the back directly such as walking, riding, or gentle ground based core exercise
2. Herniated or Bulging Disc
Intervertebral discs are soft, cushion-like structures located between the vertebrae of the spine. They act as shock absorbers, helping to reduce the impact of movement on the bones and joints of the spine. A herniated disc, also known as a slipped or ruptured disc, occurs when the inner gel-like substance of the disc pushes through the outer layer, potentially pressing on nearby nerves. A similar, less severe version of a disc herniation is a ‘bulging’ disc, which is a distortion of the shape of the disc without the full rupture or protuberance of the inner material (nucleus pulposus).
Disc issues are very common, and they often can be asymptomatic. It isn’t uncommon to have a minor disc bulge and never know it or for it to not cause any issues. On the other hand, disc issues can cause significant back pain, weakness, or prolonged inhibition, especially if it compresses a nerve. So even if you are diagnosed with a disc injury - the symptoms you have could vary greatly.
This condition is common in the lower back (lumbar spine) but can occur in any part of the spine.
AlloVitae Knowledge Key:
Discs tend to rupture/bulge posteriorly (towards the back), due to stress during forward flexion (bending over). Posture, strength, and mobility of the hips are keys for disc health, along with passive movements into spinal extension through activities like a floor press up with the hips on the ground.
Symptoms of a herniated disc:
Sharp, shooting pain that radiates down the legs (sciatica)
Muscle spasms in the surrounding area
Numbness, tingling, or weakness in the legs
Pain that worsens with certain movements, such as bending or lifting
Lower back pain that persists or worsens over time
AlloVitae recommendations:
Practice good posture and do frequent postural resets throughout the day to offload and pump new fluid into the disc
Continue low-intensity activity such as walking or swimming to maintain blood flow and tissue quality
Utilize soft tissue therapy to decrease stiffness of the surrounding musculature,
Strengthen the back, hip, and core muscles using isometrics if symptomatic
Be mindful of posture when lifting heavy objects
3. Degenerative Disc Disease (DDD)
Degenerative disc disease (DDD) is a condition where the intervertebral discs gradually lose their ability to cushion the spine due to aging and wear-and-tear. As the discs lose water content and become thinner, they are less able to absorb shock and protect the spine, leading to back pain. DDD is most commonly seen in people over the age of 40 but can occur earlier in life if there has been prior injury or excessive strain on the spine.
AlloVitae Knowledge Key:
DDD is all about smart management. By maintaining the functional trinity of strength, mobility, and coordination, you can do a lot to offset the effects of DDD. A good method is treating your DDD as you would a disc injury, and managing it with the same protocols (as you’ll see below). Improving your function with an otherwise limiting condition is about gradually exposing your system to increasing demands. Do the things that help it to feel better first, and add new things slowly over time. By improving your strength and mobility, you will take excess strain off the disc themselves by increasing the load distribution across the muscle tissues that are designed for it. By improving coordination, you can better avoid and respond to positions that would otherwise irritate your back, and also recover faster from episodes.
Symptoms of degenerative disc disease:
Chronic, dull lower back pain that may worsen with movement
Pain that improves when lying down
Increased pain after prolonged sitting, standing, or lifting
Pain that comes and goes over time, with flare-ups of intense discomfort
AlloVitae recommendations:
Practice good posture and do frequent postural resets throughout the day to offload and pump new fluid into the disc
Continue low-intensity activity such as walking or swimming to maintain blood flow and tissue quality
Utilize soft tissue therapy to decrease stiffness of the surrounding musculature,
Strengthen the back, hip, and core muscles using isometrics if symptomatic
Be mindful of posture when lifting heavy objects
4. Osteoarthritis of the Spine and Spondylosis
Osteoarthritis (OA) is a form of arthritis that causes the cartilage in joints to break down over time, leading to pain, stiffness, and reduced mobility. Often OA and spondylosis are used interchangeably to describe the general wearing down of the tissues in the spine. These conditions often affect the facet joints (the small joints that connect the vertebrae) as well as weaken/degrade the discs (see above). When the cartilage wears away, the bones may rub against each other, causing inflammation and pain. OA can also affect the vertebral bone itself, and cause increased bone growth such as in stenosis (see below).
OA of the spine can occur as part of the natural aging process but can also develop due to previous injuries, obesity, or genetic factors.
AlloVitae Knowledge Key:
While there is no way to turn back the clock or heal arthritis, it's all about managing and maintaining activity levels and movement variability. Keeping the muscles strong, downregulating pain, and maintaining mobility are the critical aspects to managing arthritis.
Symptoms of osteoarthritis of the spine:
Pain and stiffness in the lower back
Pain that worsens with activity or after long periods of inactivity
Decreased range of motion in the back
Possible radiating pain or numbness if nerve compression occurs
AlloVitae recommendations:
Maintain a healthy body weight to reduce stress on the spine
Engage in low-impact exercises like swimming, cycling, or walking to keep the joint flexible
Use isometric strength progressions initially to develop strength in the lower body without irritating the back
Focus on improving the quality of your soft tissue through foam rolling, vibration, massage, and light mobility/stretching work to begin to untangle deficiencies and dysfunctions and reduce pain
Improve coordination and movement variability slowly, and focus on activities that promote balance and control
5. Spinal Curvature Disorders (Scoliosis, kyphosis, and lordosis)
Scoliosis is a condition in which the spine curves sideways, often in an "S" or "C" shape. Structural scoliosis is often diagnosed in childhood or adolescence, and describes a physical shift in the shape of the spine. It can also develop later in life due to aging or other underlying conditions. Functional scoliosis, by contrast, is a form of quasi-temporary misalignment due to postural dysfunction or other factors such as leg length discrepancies, that present symptomatically as a curved spine would, but have little to do with the actual spinal mechanics.
Kyphosis is the term for the convex shape of your upper back (thoracic spine). The curve of the spine is critical in the load bearing nature of your spinal column. But in the context of dysfunction, kyphosis is a postural maladaptation leading to an increased forward curvature of the thoracic spine. This can be due to genetic factors, growth over time/aging, or functionally created due to poor posture. As the spine becomes misaligned, it can lead to uneven pressure on the muscles and ligaments, resulting in back pain.
Lordosis, similarly, is the term for the concave shape of your lower back (lumbar spine). Similar to kyphosis, an increased lordotic curve can cause issues due to imbalance loads and pressure on the spinal column and surrounding structures (the hip, for example). Excessive lordosis is common in athletic populations and running sports, but can also be due to genetic factors and natural conformation arrangements (i.e. leg and trunk length, pelvic structure, hip socket depth and orientation, etc.).
AlloVitae Knowledge Key:
Structural spinal curve disorders are not correctable through activity, but they are manageable. Strength and mobility are critical to offset the load imbalances caused by the structural issues. For the most part, if the issues are only ‘functional’ - i.e. the symptoms present like the structural but there is still (mostly) normal alignment or an ability to reset the skeletal positions - then it’s all about the corrective strength work. Focusing on good posture and core strength is critical in alleviating the symptoms of any curve imbalance - but true structural limitations will potentially limit improvements in mobility and range of motion of certain tasks.
Symptoms of Spinal Curve Disorders:
Uneven shoulders or hips (scoliosis), excessive ‘swayback’ or protruding stomach (lordosis), slumped or humped shoulders (kyphosis)
Back pain that worsens with certain movements or prolonged activity
Stiffness or limited range of motion of the hamstrings (lordosis), upper back and chest (kyphosis)
Visible, exaggerated curvature in the spine
AlloVitae recommendations:
Regular check-ups to monitor spinal health
Implementing a regular strengthening routine for the back, trunk, and leg muscles to support spinal alignment and load resistance
Improving hip and thoracic spine mobility through stretching and excursions to offload the skeleton and distribute load through the spine more evenly
Practicing good posture and using ergonomic seating - especially if the issues are functional
In some cases, wearing a brace or seeking medical treatment may be necessary
6. Spinal Stenosis
Spinal stenosis occurs when the spaces within the spine narrow, putting pressure on the spinal cord and nerves. This narrowing can happen anywhere along the spine but is most common in the lower back (lumbar stenosis) or neck (cervical stenosis). Spinal stenosis is often caused by age-related changes, such as the thickening of ligaments, deterioration through wear and tear, or the formation of bone spurs, but can also result from injuries or conditions like osteoarthritis.
AlloVitae Knowledge Key:
While there is no way to turn back the clock or heal arthritis, it's all about managing and maintaining activity levels and movement variability. Keeping the muscles strong, downregulating pain, and maintaining mobility are the critical aspects to managing stenosis. In some cases, surgery might be necessary to release a compression point on a nerve, but following any sort of corrective procedure, the same rules will apply as managing arthritis.
Symptoms of spinal stenosis:
Pain, numbness, or tingling in the back, legs, or arms
Weakness or heaviness in the legs, especially when walking
Pain that worsens when standing or walking and improves when sitting or bending forward
Difficulty maintaining balance
AlloVitae recommendations:
Regular screenings by a medical provider to assess and track changes in nerve compression or irritation
Maintain a healthy body weight to reduce stress on the spine
Engage in low-impact exercises like swimming, cycling, or walking to keep the joint flexible
Use isometric strength progressions initially to develop strength in the lower body without irritating the back
Focus on improving the quality of your soft tissue through foam rolling, vibration, massage, and light mobility/stretching work to begin to untangle deficiencies and dysfunctions and reduce pain
Improve coordination and movement variability slowly, and focus on activities that promote balance and control
Conclusion: Managing Your Back Pain
Back pain can arise from many different causes, ranging from lifestyle factors like poor posture to more serious medical conditions like herniated discs or spinal stenosis. Understanding the cause of your back pain is essential in effectively treating and managing your symptoms, and improving the underlying issues.
The spine is at the core of your body, and pain or dysfunction can greatly impact the quality of your life. If you’re experiencing chronic back pain, it’s important to consult with a healthcare provider to determine the cause and receive appropriate treatment if necessary. In the meantime, introducing and/or maintaining diligence with the AlloVitae functional trio of strength, mobility, and coordination, focusing on good posture, staying active, and taking steps to protect your spine can help reduce the risk of back pain and improve your overall spinal health, and change your life for better!