5 (Unusual) Reasons Your Back is Hurting
Back pain is the most common form of pain with virtually everyone suffering it at some point in life. Chronic back pain is a leading cause of disability worldwide. In fact, it’s one of the most common reasons people of working age are forced to leave the workforce (Maher et al., 2017).
Recurring back pain can lower your quality of life in many ways, making it hard to play with your kids, participate in sport, do your job or enjoy social events.
Common symptoms of back pain
If you’re living with it, then you already know what back pain feels like – for you. It can be anything from mild to severe pain and can present in a range of different ways including,
- sharp or dull pain
- local or referred pain (ie., pain down the legs etc.)
- altered sensation (ie., numbness, pins and needles, burning etc.)
- motor weakness (ie., difficulty walking, standing up etc.)
Signs of something serious
While back pain hurts (sometimes a lot!), it usually improves with physio and self-care.
Thankfully, back pain is rarely cause for serious concern. However, if your back pain is accompanied by any of these other signs or symptoms, then see your doctor to rule out anything more serious:
- recent onset of bladder and/or bowel issues (ie., can’t tell when bladder is full, incontinence, etc.)
- numbness in the “saddle” region between your legs
- severe pain at rest/at night
- unexplained weight loss
- history of trauma (a fall, car accident etc.)
5 unusual reasons your back may be hurting
Your back is a complex and marvellous structure of muscles, ligaments, tendons, discs, vertebrae and nerves. It gives you both strength and flexibility, enabling you to stand, bend, sit and move.
Clearly there are more than 5 things that could be causing your back pain! However, you guys seem to love lists so here are 5 significant causes of back pain.
They include some factors you’ll probably already have considered alongside other, deeper issues that you may not have linked to your back pain. Here goes.
We know that high amounts of stress in your life can sensitise you and increase your chance of experiencing pain. Poor work-life balance, financial stress and relational stress are all examples of life stressors that can work to make you more sensitive to a pain state.
A few decades ago, this was pretty controversial. However, we now know that humans are not like cars or buildings; purely structural things that require purely structural diagnosis and treatment. Turns out humans are slightly more complicated than this! Lots of stress in our life that we do not have the capacity to tolerate can cause back pain (Butler and Moseley, 2017).
2. Tissue changes/damage
If you give yourself a sudden disc bulge by lifting something heavy, you’re likely to experience immediate pain. However, if that same disc bulge occurs slowly through repeated overuse, you may not feel pain, even though the damage is certainly there.
We like to use the boiling frog analogy. A frog that jumps into boiling water will jump out immediately. A frog that jumps into tepid water that is very slowly heated to boiling won’t jump out. It will remain in the water and will be cooked to death.
This morbid analogy illustrates why people can have lots of tissue change/damage (ie., disc degeneration, disc protrusion, disc fissures, spondylolisthesis etc.) and experience no pain (Brinjikji et al., 2015). By the way biologists have shown the boiling frog illustration to be false so you frog lovers need not worry – it’s just a metaphor!
3. Poor sleep
A poor night’s sleep can make your back pain experience much worse! Sleep expert and neuroscientist Dr Matthew Walker writes, “Sleep loss not only amplifies the pain-sensing regions in the brain but blocks the natural analgesia [pain-relief] centres too.”
This means you produce more pain and block less pain when sleeping less than 7 hrs per night.
By the way, neurological impairment can be detected with 100% of individuals who sleep less than 7hrs. You may feel fine getting less sleep than this, but you are demonstrably impaired regarding reaction time, critical thinking etc. PhD candidate Adam Krause says, “The results [of a recent study] clearly show that even very subtle changes in nightly sleep — reductions that many of us think little of in terms of consequences — have a clear impact on your next-day pain burden.” (Laytham-Powell 2019)
4. Your beliefs
This one probably surprised you a little but it makes sense when you think about it more. Your beliefs affect everything in your life – your fears and anxieties, your exercise routine, your daily habits and much more. There are a lot of poor beliefs that can also sensitise us to a pain experience. Some common examples we hear in the clinic include,
- hurt equals harm
- exercise and activity causes wear and tear / is bad for our joints (e.g., jogging is bad for knees, deadlifts are bad for the back etc.)
- getting older inevitably means pain will get worse
There are lots of examples like this. If you believe that sitting a lot causes back pain but have to plonk yourself in a chair all day to do your job, then you’re likely to make yourself more sensitive to the effects of sitting. It’s a self-fulfilling prophecy.
5. Movement habits and posture
We have a whole host of habits that can be both good and bad for us and can be triggered by lots of things. Some of my friends feel a strong desire to smoke that’s triggered when they drink, go out to a bar, hang out with certain other friends etc. Context, environment, emotions can all be triggers for that habit. Those with bad habits are usually advised to avoid these environmental triggers when attempting to break the habit.
What does any of this have to do with back pain you ask? Well, we can look at pain as the same thing. Sometimes we unknowingly move in a certain manner that becomes associated with a pain state. Some common examples are bracing, guarding and breath holding when bending forward. When we do this it’s almost like we “learn” pain. Researchers call this a “neurotag” – a linking of neurons that fire together with some physical, emotional or cognitive trigger/s. We often teach patients to move differently to break the habit or teach you a new way of moving that is not sensitive, does not involve fear, or is not associated with hyper-vigilance.
What can you do about back pain?
So there you have it, 5 possible reasons for your back pain. Of course there are a lot more reasons someone can have pain – remember we humans are complicated creatures and pain always involves a myriad of confounding variables.
Are you experiencing recurring back pain? Sycamore is here to help. We can help assess and treat injuries or help keep you injury-free. Book online or call us on 3046 1700 to make an appointment today.
All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion.