By Mike DuBose with Surb Guram, MD
Back pain is a highly prevalent condition worldwide and affects people of all ages and backgrounds. The Global Burden of Disease Study reported 65% of adults experience back pain during their lifetimes which is a leading cause of disabilities. Older individuals are more susceptible due to age-related degenerative spinal changes, while younger adults and adolescents may experience problems due to lifestyle factors, injuries, or conditions from birth. The symptoms range from mild discomfort to severe, debilitating pain, impacting daily activities.
I don’t have a history of back problems but occasionally, experienced temporary issues by picking up heavy weights improperly but in mid-2024, all that changed! Upon seeing an unknown box located in the rear of my closet, I pulled it out with my body positioned sideways. Suddenly, significant pain was felt. Of course, I wasn’t initially concerned since my back pain would ordinarily go away in a few days, but this time, it was a different story! Days later, I could hardly get out of bed because of severe pain and extra-strength, over-the-counter meds were ineffective. I didn’t know how to remedy my unusual situation that was worsening!
Let’s explore my real-life recovery journey based on engaging with different healthcare professionals and the latest research! This first section will review various causes of back pain which is essential for developing effective treatment and prevention strategies.
Poor Posture is a significant contributor, particularly in today's sedentary lifestyles. Slouching, spending excessive time on computers or smartphones, standing/sitting too long, or watching television for extended periods can place undue stress on the spine and supporting muscles. Eventually, strains can lead to chronic pain and discomfort. Gravity works against us by pulling the body downward and forward which accelerates joint degeneration.
Muscle and Ligament Strains often occur due to sudden movements, lifting heavy objects incorrectly, or engaging in activities that strain back areas which can lead to microscopic tears in the muscle fibers or ligaments.
Injury and Trauma from a car or other accidents falls, or athletic activities can cause severe back pain. Shock to the spine, such as fractures, can damage the vertebrae, its 24 small discs, or surrounding tissues, leading to pain, inflammation, and potentially long-term complications. Friends who played high school and college sports complain about these agonizing injuries as they age.
Lifestyles, such as lack of exercise, result in weak back and core muscles, decreasing space between our joints that resist pressure. This can lead to poor posture and increased vulnerability to strains or injuries. Being overweight places additional stress on the spine which contributes to structural problems and pain. Smoking reduces blood flow to the spine and inhibits the body's ability to deliver nutrients to the discs, increasing degeneration and back pain risks.
Psychological Factors, including excessive worry, long-lasting anxiety, and depression, can cause or exacerbate back pain. Chronic stress creates back muscle tension, spasms, and tightness while making the body more sensitive to pain. Mayo Clinic reported that long-term over-activation of the nervous response system and stress hormones, like Cortisol, can disrupt many of the body's processes. This places you at a higher risk of many traumatic, painful health problems.
Medical Conditions such as kidney stones can radiate to the lower back and mimic musculoskeletal suffering. Spinal infections can cause painful inflammation. Statin prescriptions lower cholesterol levels, but they can induce side effects such as muscle, joint, and back pains. Though less prevalent, cancer and tumors in the body’s rear area can result in significant misery. Pregnancy, of course, is a backbreaker but the pain usually diminishes after delivery.
Spinal Disks act as vertebrae cushions, absorbing shock and facilitating movement. When discs herniate or bulge outward, they can press on nearby nerves, causing rear pain that radiates down the leg (known as sciatica). Disc herniation can result from aging, wear and tear, or sudden spinal trauma.
Arthritis can affect the spine and contribute to back pain. Osteoarthritis causes cartilage breakdown between the joints, including those in the spine, leading to pain, stiffness, and reduced mobility. Rheumatoid arthritis may generate painful inflammation in the joints.
Skeletal Irregularities that develop during growth stages or from birth defects, affect spinal alignment and place uneven, painful pressure on the vertebrae and surrounding muscles.
Osteoporosis is a condition characterized by weakened bones that are more susceptible to fractures. When this condition affects the vertebrae, it can lead to compression fractures which can cause severe back pain and contribute to a stooped posture over time. This condition is more common in older adults and individuals with low bone density.
Back pain has many potential causes, ranging from issues like muscle strain and poor posture to more complex factors such as arthritis, spinal abnormalities, and serious medical conditions. Identifying the underlying causes of back pain by experts is crucial in determining effective treatment approaches. By understanding these causes and taking proactive steps to maintain spinal health, individuals can reduce their risk of experiencing debilitating back pain and enjoy improved overall well-being.
If you suffer back pain, don’t accept your condition as permanent or think it is just a part of the aging process. While it may take time, experiment with different strategies in seeking relief! The following are treatment options to consider, with your healthcare professional’s input, before major surgery. Some of them worked for me and my back pain has disappeared.
Exploring Different Back Pain Treatments
Finding effective treatments for back pain depends upon its severity and accurate diagnosis. Let’s examine the research to address back pain before seeking surgery. Ensure to discuss the following treatment options with your medical providers as partners.
Over-the-counter pain Medications (OTC) help manage back pain. Anti-inflammatory meds like Aleve, Motrin, and Advil can reduce swelling. Advil created a “Dual Action” product specifically designed for back pain that includes Ibuprofen Advil (250MG) and Acetaminophen Tylenol (125MG). Warning! Mayo Clinic recently reported that researchers have determined patients taking blood thinners should avoid Ibuprofen and Acetaminophen can damage livers if taken daily for more than two weeks. Talk with your doctor about taking them to avoid problems.
Heat and Cold Therapies provide “temporary relief” but won’t eliminate back pain. Heating pads relax muscles and improve blood flow while ice-numbing exposure can reduce inflammation. Heat therapy did nothing for my pain but ice packs applied 20 minutes every few hours daily were my go-to medicine, combined with (OTC) medications. Research indicates everyone’s responses are different so try both heat and icing alternating methods. Amazon sells excellent, inexpensive icing products, including large belts that can be worn around the home. Wear thin skin covers, like t-shirts, to avoid burns. You can also purchase OTC-cold/heat menthol patches with pain-killing-lidocaine at pharmacies.
Massage Therapy manipulates muscles and soft tissues to alleviate tension, promotes relaxation, improves circulation, reduces muscle stiffness, and relieves lower back pain.
Acupuncture, an ancient Chinese medicine technique, involves inserting thin needles into specific body points. It stimulates the body's natural healing response and can be effective in relieving chronic back pain. My physical therapist used a similar method, called dry-needling, to fool the brain into sending natural healing medicines to my back. Studies verify that dry-needling increases blood circulation and reduces pain.
Chiropractors specialize in spinal manipulation and adjustment techniques to align spines properly which can relieve nerve pressure and reduce back pain.
Regular Exercises, such as brisk walking, swimming, or cycling, can strengthen muscles, improve flexibility, and support the spine. Use caution about overdoing exercise while you’re in pain. Daily activity and remaining mobile are important. Certified personal trainers, in collaboration with healthcare professionals, can also help strengthen back muscles. Visit www.dubosefitness.com for more information.
Maintaining Healthy Weight through diet and exercise can eventually reduce back strain while decreasing risks of chronic pain.
Yoga and Other Treatments focus on strengthening core muscles, reducing stress, improving flexibility, and promoting relaxation. These practices help reduce back pain and prevent future episodes by improving posture and body mechanics. Mind-body techniques such as mindfulness (Being aware of our postures, pulling, sitting, lifting), meditation, and relaxation techniques reduce stress. Psychology Today reported listening to your desired music releases dopamine chemicals which can improve moods, reduce pain intensity, and increase pain tolerance. When I am writing and researching, I always find this to be true when I crank up my favorites.
Rest means getting a full night’s sleep on comfortable, supportive mattresses. Strategies include reducing strenuous activities to improve healing processes, but bed rest only is not recommended. In other words, “Take it easy!”
Herbal Supplements, such as top-selling turmeric, have anti-inflammatory properties and may help alleviate back pain. However, in August 2024, The Washington Post shared researchers’ warnings about its use including the possibility of liver damage.
Proper Ergonomics at Home and the Workplace help prevent back pain by promoting good posture and reducing spinal strain. Using supportive chairs, adjustable standing/sitting desks, and lifting objects properly can minimize injury risks. After extensive reviews, I purchased the Amazon Ergo3d Mesh office chair which provides great back and spinal support, but you’ll need someone skilled in assembly. My 10-year-old mechanical engineer grandson put it together in two hours! Ensure that you never sit for more than 30 minutes at a time and keep moving!
Discontinue Smoking can improve blood flow and increase the body's ability to heal injuries.
Visit Your Physician (preferably Internists) if pain is severe, persists for more than four weeks, and other methods have failed. Doctors will conduct various tests, such as MRIs, to evaluate your condition. Muscle relaxants or opioids may be prescribed to relieve muscle spasms but limit them because of serious side effects and potential addiction. Other options might include Epidural Steroid Injections, Nerve Blocks, Spinal Cord Stimulation, and Radiofrequency Ablation.
Physical Therapy is a cornerstone treatment for back pain which I strongly support! It focuses on strengthening spinal muscles, improving flexibility, and correcting posture. Therapists often employ techniques such as stretching exercises, manual therapy, and targeted strengthening activities to reduce pain and improve mobility.
The Bottom Line: Managing back pain is a process that requires comprehensive, individualized approaches, pinpointing underlying causes, and overall health. While conservative treatments, like physical therapy, exercise, and OTC medications are often effective, individuals may require advanced interventions and surgery. These procedures have improved in recent years, especially when followed by physician-approved exercise programs. Complementary therapies and lifestyle modifications play crucial roles in reducing pain. Pinpointing back pain causes and developing correct treatment strategies are slow processes (My healing took two months). What works wonders for some may be less effective for others! While back pain may not be cured, in many cases, it can be managed. Don’t give up!
Special thanks to my awesome back pain team: Internist Surb Guram, MD, Jennifer Britt, APRN and Columbia, SC Rehabilitation Clinic’s physical therapy professionals Rohini Grewal, DPT and Dori Reinhart, RPTA.
Dr. Surb Guram, MD is a board-certified internist and a graduate of the University of South Carolina School of Medicine. He is a partner with the SC Internal Medicine Associates in Irmo, SC (www.scinternalmedicine.com) and has practiced internal medicine in the Midlands for 30+ years.
Write to Mike at mike@grantexperts.com. Visit his nonprofit website www.mikedubose.com and register to receive his monthly articles or Daily Thoughts plus free access to his books, including “The Art of Building Great Businesses.” The website includes 100+ published articles he has written on business, travel, and personal topics, in addition to health research with Surb Guram, MD, and our beloved pets with David Hurst, DMV.
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