Common causes of back pain.
In order to get back pain you have to strain it in some way. In order to strain your back there needs to be something in the area of the injury that was too tight or didn’t have enough support, or the force of the injury was greater than what your body could handle. In most cases it is the joints of the spinal column (the facet joints) that tighten over time with daily activities and they are easy to strain as this is where the movement takes place in the body. It is a lot harder to strain muscles as they are a lot more flexible and dynamic than joints and can ‘give’ to a fair degree. Joints however can only go so far before they are strained beyond their physiological limit. Once strained they become inflamed and sore. This inflammation then causes adhesions to form around the joints resulting in more joint restriction. They then become more susceptible to being strained again. This then causes repeated exacerbations of the original injury and the pain that was intermittent starts to become more continuous.
Back pain is usually caused by being in an asymmetrical position for too long.
Back pain is not generally caused by traumatic injuries. Indeed it can be caused by trauma but by far the most common thing that people with back pain say is that they don’t know why the pain started, or it came on after a seemingly innocuous incident. The most easily recognised form of back pain is stiffness and pain in the lower back after spending time in the garden bent at the waist for a while and trying to stand back up. This is similar to sitting on the ground for any length of time and finding it difficult to stand up straight.
If your body is stuck in one position for any great length of time it will slowly adapt to that position by stretching into it. The ligaments, tendons, muscles and joints will lengthen and stretch to get comfortable in that position. The problem is that your body will now find it more difficult to come out of this position in a hurry. So when you stand back up it will generally take some time to straighten out or it wont straighten out at all.
It is fairly easy to identify the site of pain and when you visit the chiropractor, part of the spine will still be stuck in the position that you were in that caused the problem in the first place. In summary your body adapts to the position that you are in and it gets stuck there. To correct this condition you will need a chiropractor to adjust the joints, freeing them up so that they are no longer stuck in an asymmetrical position. The longer you wait before seeing the chiropractor the more the inflammation and swelling will set in and the worse the condition will get.
Sitting is a common cause of back pain.
In as much as bending forward while gardening will give you back pain so too will sitting for any length of time. The reason for this is that the spine is in a rounded position and it gets stuck there. When a person sits you will generally sink into the sitting position and in so doing you round your lower back into one long ‘C’ shaped curve that extends from your shoulders to your pelvis. This rounded lower back curve is opposite to what it should be and as your body adapts to this position it will get stuck there and you will find it difficult to stand back up again. It is the same feeling you get after a long drive and you get out to stretch your legs. Office workers with desk jobs will suffer more lower back pain than most other people in the population.
How can I sit without getting a sore lower back?
The only way to avoid pain from gardening or sitting is to avoid rounding your back and not to stay in one position for too long. Make sure you are constantly moving and changing position so that your body doesn’t have a chance to adapt to the position that you are in. When sitting try to do so with your knees lower than your hips. This forces the pelvis more upright and it will make it a lot easier to avoid rounding the lower back. The best chairs to sit on will have a forward seat tilt. If you lower it all the way forward so that your knees are lower than your hips you will find that you don’t have to use the lumbar support because you are actually sitting upright. Also make a point of getting up at least every hour to get movement into the joints of your spine. The other chairs that are good for the spine are the Swedish fitballs, the kneeling chairs, and the saddle seats. All of these chairs are designed so that your knees are lower than your hips.
The computer work station.
How do you set up a computer work station that is friendly to your back? We have already discovered that sitting in a position that has your knees lower than your hips is the best position for your lower back. The chair and desk needs to be set up with this in mind. The height of the desk needs to be at elbow level so that when you are sitting correctly and you are close to the desk, you can comfortably rest your elbows on the desk without raising or lowering your shoulders.
The keyboard should then sit wherever your hands fall. Most people who spend a lot of time at the computer do so without their elbows on the desk. This means that the weight of their arms is being supported all day by the neck and shoulder muscles alone. This will result in neck pain, shoulder pain and headaches. If you hold your arm out to the side for a few minutes your shoulder muscles will start to ache. Eventually you will strain the joints of your upper thoracic spine and your neck, as the strain is transferred into the skeleton, and inflammation and acute pain will result. The monitor should then be placed at eye level so that your head can rest directly over your shoulders. You do not want your head forward of your shoulders as this will cause neck and shoulder pain from supporting the weight of your head.
Another cause of neck pain that occurs while sitting at the office desk is holding the phone between your ear and your elevated shoulder. Again this will feel fine while you are in this position but your body will adapt to this asymmetrical position and get stuck there. This can result in a torticollis if done often enough.
Sleeping is a common cause of back pain.
Finally, one of the most common causes of back pain, and/or neck and shoulder pain is sleeping. There are two typical presentations of pain at night.
- Pain that starts not long after going to bed.
It is very common for pain to start not long after going to bed. In this situation the bed or the position that you are lying in is not the cause of the pain. Here, the pain is worse than during the day time because inflammation and swelling is often greater at night time when your body has a chance to heal. Movement often keeps inflammation at bay and when you lie down the inflammation process increases. There are also less distractions while you are trying to sleep and this often makes the pain feel much worse because you are a lot more aware of it. - Pain that occurs after being in bed for a few hours or upon getting up.
The type of pain that comes from poor sleeping habits will be more symptomatic first thing in the morning and will ease as the day goes on. It will present as either a stiff and painful neck (torticollis) or lower back pain. If you tend to go to bed pain free and wake up with pain, the cause of the problem is either the position that you are sleeping in, or the cause is what you are sleeping on.
Sleeping positions
The only position to sleep on that will not cause pain and stiffness is sleeping on your side and alternating between the left and right side. If you sleep on your stomach or back you will eventually wake up with a stiff lower back and you will eventually get a sore neck. When you lie on your back the lumbar spine tends to flatten and this causes the back to be stiff and painful if it stays in that position for too long. When you lie on your stomach the lumbar spine develops a greater curve than normal and this will cause pain and stiffness if it is left in this position for too long.
If you sleep on your back or your stomach, you will turn your head to one side while you sleep. If your neck stays turned to one side for too long your body will adapt to this position and get stuck there. This is the same feeling you get if you have been sitting on a long bus or train trip and you have been looking out the window for a long time. It feels stiff trying to straighten the neck. The only difference with sleeping is that you stay in this position for hours at a time. This is the most common cause of a torticollis.
The mattress
If the position that you are sleeping in is on your side and you are still waking up with pain then the cause is most likely to be the mattress that you are sleeping on. An inner spring mattress that is older than 3-4 years will have lost is ability to support your weight. The springs within the mattress will only last for a few years. This is true even if you have a 10 year guarantee on the mattress. The guarantee is given on the fact that the bed will not fall apart but it will not guarantee the springiness of the springs. When buying an innerspring mattress do so knowing that you are likely to replace it in 3-4 years. The only way of getting around this is to buy a latex mattress – as a rubber material, latex will hold is shape and support for longer. Just beware of buying a mattress with a pillow top (or comfort layer) made of foam or other material that will sag. The safest option for a pillow top is one that has latex in it rather than foam which will lose its support within months of buying it. Remember just because it is comfortable in the shop doesn’t mean that it will be comfortable in six months time. The firmness of the mattress will depend on the comfort level of the individual. You don’t wont a bed that is too hard or too soft. You should be able to lie on the bed and feel level.
The other thing that will cause pain is the type and shape of the pillow that you sleep on. Good neck support is essential for a good night sleep. The pillow is not used to support the head as much as the joints of the cervical spine. If the pillow does not support the neck properly you will wake up with a stiff and sore neck. The right pillow is dependent on which position that you sleep in. As we have already discussed sleeping on your back or stomach is no good for your neck or your lower back. This means that you need to find a pillow that will support you while you are sleeping on your side. The pillow needs to be contoured so that your neck has as much support as your head. You need to lie on your side so that the pillow keeps your spine neutral. If you lie on your side and the pillow is too low you will feel like your neck is dropping to one side too far. If it is too high you will feel like your neck is propped up too high. The difficulty in finding a good pillow is in finding one that is the right height for the individual and one that is the right firmness to give proper support. For more information on good pillows check out the latex pillows we stock.
Why does my back hurt?
Most back pain is the result of inflammed and restricted joints. This is a very similar situation to having a twisted ankle. That is, a twisted ankle is a swollen joint that results in sharp pinching pain when bumped and has very limited movement.
When a joint is inflammed the swelling present impedes normal joint movement. The inflammation further restricts normal movement by laying down adhesions or scar tissue around the joints.
Chiropractors identify these joint restrictions by finding vertebral segments that are inflammed and painful. The chiropractic adjustment restores normal joint movement by freeing up joint restriction and breaking scar tissue around joints. This allows the joint to work normally. Swelling subsides from the joints as there is no longer as much joint and ligament tension in the area.
Facet Joint Subluxation Model
Notice in the animation below that the top two vertebrae are moving normally. The subluxation (vertebrae with abnormal movement) is occurring between the bottom two vertebrae. In this model the swelling exists within the facet joints at the back of the vertebrae.
Intervertebral Disc Subluxation model
In the model depicted below the swelling exists within the intervertebral disc.
The chiropractic adjustment restores normal movement to the bottom two vertebrae. The inflammation present within the joint does not go away immediately, however the adjustment allows the joint to move freely and normally so that tissue healing can occur and normal function can be restored.
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Dr. Marc Croker – Chiropractor
PH: (02) 9683 6110
32 Short St (cnr Albert St),
Parramatta NSW 2150
Do you have any specific questions about back pain and how it is caused? Perhaps why a particular job or activity makes you sore. Are you wondering if chiropractic can help? Are you unsure about getting adjusted? Ask away and I will do my best to help.
I was in a car accident a few years ago. I hurt my lower back. I have been in pain since. I do a lot of driving, probably about 20 hours a week in a bad seat and small company car Iam forced to use. My lower back into my butt always hurts when I am sitting. While standing or walking it is ok. Doctor says it is L4-5 disc herniation. MRI few years back showed no herination, but some degenerative conditions. Doctor says discs move all the time. Any suggestions??
Hi Tony. One of the most common causes of lower back pain is spending prolonged time sitting. Having been injured in a car accident in a sitting position it follows that you are most likely to feel pain in the same position in the future. The most likely scenario is that the joints of your lower back have been overstrained and have become inflamed and restricted in their movements. This is known as facet joint syndrome or facet joint subluxation as described above. It is not uncommon to have pain only when in a sitting or flexed spinal position and have no pain when standing or even bending backwards. The disc can be involved however disc injuries usually have pain that spreads into the leg below the knee and there may even be pins and needles or numbness. Disc injuries are not that common either. The buttock pain will either be a referral from the inflamed facet joints in the lumbar spine and/or it will be the result of muscle spasm of the gluteal muscles. Chiropractic manipulation, massage and stretching would be sufficient to alleviate your condition on the provision that you are taught how to sit properly so as not to cause recurring lower back pain.
Hi,
I find I have a sore lower back if my mattress is soft or moderately firm. The only time I wake up with no pain is if I have slept on a very firm mattress. Is that generally common? How would my back react if I propped a pillow under my moderate mattress to firm it up? I find I wake up with a sore lower back, but by the time I walk to work (about a 15 minute walk). It is usually fine.
Thank you
Hi Adam,
The key to waking up without back pain is simply to sleep in a very neutral position, change sides throughout the night, and to have a bed that supports your body well. The bed needs to be firm to resist your weight and to keep your spine as neutral as possible. The problem is that a bed can be too firm. Some people will get sore shoulders and hips from sleeping on a very firm bed from too much pressure, whereas others will need more firmness to keep their body neutral. It can be an expensive lesson to learn which bed is best for you, not to mention which bed is right for your partner as well. I have heard of people using sheets or towels below their mattress protectors to prop up a moderate mattress to give the mattress a bit of extra resistance. This can work well when one partner wants a softer bed and the other needs a firmer bed.
The other thing about back pain is that it is usually caused by being in one position for too long. Obviously a 15 minute walk is enough movement in the lumbar spine to free it up and alleviate the pain. Perhaps try changing sides more often during the night and your back may not feel as stiff and sore in the morning.
Hi, I have had lower back pain for a few weeks now, it doesn’t hurt when I am standing up or moving around, just when I lay down. I had a very soft mattress before which I loved, I figured it was that which was causing my back ache! I like to sleep on my tummy which I can’t do anymore. I now have quite a firm mattress but my back is still hurting. I have never had back pain before, I have turned 33 and my body seems to be falling apart… what can I do, haven’t slept properly in weeks!
Hi Bonnie,
Even though you are pain free all day you actually have an injury to your lower back which will probably need treatment before the pain subsides. A firmer mattress often enhances the pain as there is more pressure on painful inflamed joints. Sleeping on your stomach will over exaggerate you lumbar spinal curve and cause more lower back pain so it is good that you cannot do this anymore on the new mattress. Once you have treatment to your lower back you will find that the firmer mattress that you have will better support your spine and you shouldn’t get any ongoing problems unless the position that you lie in is too far from a neutral spine. It is also common for people in their early to mid thirties to start experiencing back pain. You lose flexibility and your body becomes less forgiving as you get older. The best way to combat this is to exercise regularly and include stretching as a part of your weekly routine. Hope this helps.
Hi, I’ve bought a new bed, it is similar to my previous bed, which had become a bit saggy, in that it has pocketsprings and a pillowtop. I’ve found that when I sleep in it, I woke up with pains in my lower legs and tingling in my lower legs and feet. I also had some lower back pain and discomfort. After two nights of sleeping on the bed I had problems walking and bending. Walking around in the morning did not alleviate the pain, in fact as the day went on, it slowly got worse!. I wentback to using the old bed, and my back slowly improved back to normal, but just tried the new bed again with a mattress topper, as the sales guy reckoned the bed could be too firm and that would help. Unfortunately it hasn’t. One night later and I am feeling some back pain and the tingling and pain in my lower legs is back again. As the day has progressed, the back pain is getting worse. Should I just get rid of the bed and chalk it up to experience, or is there anything else I can do to help? I have stayed in hotels before and in the morning have had a sore hip or shoulder, which I can walk off, but I have never had the leg pains and tingling before.
Thank you
Hi. The thing to appreciate with back pain is that if your back has been sore in the past and the pain goes away, the injury itself may still be there. This means that your back is hyper sensitive to being re-injured. The only way of being sure that the mattress is causing your back and leg symptoms is to see a chiropractor, have any spinal problems corrected and then retry sleeping on the mattress again. If the pain doesn’t come back then it means that the mattress was simply a trigger for your back and leg symptoms and not necessarily the only cause of the problem. If the pain does come back then it means that the mattress is not supporting your back properly.
The other thing to consider is that if your old mattress is “a bit saggy” then you may have developed some spinal dysfunction from the old mattress and the new mattress is actually better for your back but your back cannot adapt to the new mattress. If your spinal dysfunction was corrected by a chiropractor you may then find it easier to sleep on the new mattress and less on the old mattress.
The presence of leg pain and tingling is enough reason by itself to get professional help for your injury. Tingling in the leg may be a sign of a lumbar disc bulge which once herniated are often very difficult to treat. You should also consider other stressors to your back…in particular sitting for long periods is one of the most common causes of lower back pain.
Hello,
It seems as if no matter how i lay, i still get stuck in the position and my back pops when i turn to a different position, i have limited movement when trying to lean back wards to stretch. I am very stiff in the mornings, accompanied by the pops when i get up, very sore and stiff, I changed my mattress 2 years ago, I have a body pillow that i use to sleep on my side to put my leg on to straighten my back while i sleep.the pain wakes me up at night when i change positions.
any suggestions would help,
thank you,
cassie 27 years old, ht 5’8 150 pounds semi active
thank you
thank you..
Hi Cassie,
The fundamental cause of back pain is that there is stiffness somewhere in the vicinity of the pain which is leading to a sprain/strain injury. Pain and stiffness go together without fail when it comes to mechanical musculoskeletal pain. With stiffness in your back something has to give and for you this is manifesting as joints “popping”. This means that there are hypermobile (loose) joints in your back which are moving excessively. You need to see a chiropractor to restore normal movement and function to your back so that you no longer feel stiffness and pain. It will also eliminate the popping in your back. Once this is achieved you should find it much easier to get a good nights sleep. Sometimes the mattress can play a part in causing lower back pain but you will only know this after you have treated the back pain itself.
This sort might be relieved by over the counter (OTC) painkillers as paracetamol and if a stronger 1 is necessary, a non-steroidal anti-inflammatory drug (NSAD) as ibuprofen or one that demands a prescription a mild opiate as codeine taken with paracetamol or NSAD. Medications for treating back pains are:The non-steroidal anti-flammatory medicines, the generic ibuprofen with brands like naproxen and ketopropen, inhibitors as COX-2 also known as celocoxib, acetaminophen which taken to relieve acute discomfort varied muscle relaxants, opioids analgesics and steroid injections.
Hi Florentina,
Medication for pain relief is certainly necessary at times to make it through the day. If you have an injury and medication removes the pain then you have no way of knowing if your activities are aggravating your injury. Pain is your body’s cry for help. It is important to identify and treat the cause of the pain so that the injury can heal properly. Otherwise that pain continues to return and you end up taking medication for months if not years. Most sprain / strain injuries with heal within 6-8 weeks. If you haven’t had any therapy and your pain is still requiring medication one month after your injury then you will need some form of physical therapy to resolve your injury properly. Most injuries will require treatment to achieve maximum healing.
Hi Mark
I am an extremely fit and active person (I run 5 times a week and regular cyclist) and have never suffered from lower back pain. This morning I was getting ready for work putting on some makeup in the bathroom when I got sudden shooting pain in my lower back.
It is now 5 hours later and I cannot stand up straight without pain. If I’m sitting there is some lower back discomfort, but to stand and walk causes an extremely painful electric-shock like spasm in my lower back.
I have taken some ibuprofen and panadol, but it has gotten worse since this morning.
Should I try to straighten out my spine or stretch it?
Thanks
Trish.
Hi Trish,
It is difficult to give advice without a thorough medical history and physical examination however based on your report I would not advise trying to straighten your spine or stretching it. The most likely cause of your pain is either acute inflammation of the facet joints in your lower lumbar spine or you have a disc bulge in your lower lumbar spine. Your pain is not likely to be muscular as it hurts to bend backwards. There are no back muscles that pull when you bend backwards. You are therefore compressing some swelling from an inflammatory process in the lower back and this is causing your “electric-shock like spasm”. You would be best to put some ice on your lower back (for 10minutes at a time, but not directly on your skin) to reduce any inflammation that you can, and get some chiropractic therapy to correct the dysfunction in your lumbar spine. As you have only had the pain since this morning and there is no pain in your legs, your symptoms should resolve quickly if you don’t delay getting treatment.
Thanks Mark. You were spot on – bulged disc. Seems to have come from issues with the hip flexor and psoas?
I have since had treatment and am much better – its great to be vertical and pain free. Makes you appreciate the days when you are fit and healthy!! Still not running yet but hopefully I will be give it a gentle go tomorrow.
Thanks so very much for your advice, you helped me get through a very painful day at the office! Pity Parramatta is not closer to Perth and I could have called on you for treatment!!
Cheers, Trish.
I started to felt back waist pain around 2 months ago. Previously i had been facing alot of computer for doing assignments, watching movies, i admit that i have a non proper sitting position. i hunched. Now my back waist starts to felt hurt when i bend down, like collecting my something. I also felt pain when im just sitting down on my chair. I felt relieve when i lay on the bed. Can i know what is ur opinion that happened to my waist.thanksss
One of the most difficult things for your spine to endure is sitting for long periods. Slouching offers the least resistance to gravity and expends the least amount of energy but the trade off is that your normal lumbar lordosis (spinal curve) reverses. This essentially strains the facet joints, and the lower lumbar discs resulting in an inflammatory process and pain. The most effective way of returning normal movement to your spine is chiropractic manipulation. The best way of preventing this from returning in the future is to sit with your knees lower than your hips and do what you can to avoid slouching.