16 May My Back Just Goes – Understanding Back Pain

It has become a common trend over recent times for people to refer to their back as “just going” or “it just went”, but what does this actually mean?

As previously discussed, the majority (80%) of incidences of back pain are non-specific in nature, meaning that exact origin and reason for the pain is unknown. Further to the unknown origin of the pain, it is often everyday activities that trigger or exacerbate our pain.

For example, picking up the children, unloading the dishwasher and in severe cases simply putting on shoes and socks leads to the feeling that “my back just goes”.

But what do we know, and why does it feel like “my back just goes”?

Back pain has been the topic of great debate and intense research scrutiny, in my first blog we began to explore some of the reasons why back pain can be recurring in nature. Today let’s dig a little deeper.  Anatomy, when we look at a back, more specially, a spine there is three layers of muscles; deep, intermediate and superficial.

The deepest layer of muscle attaches directly on the vertebrae and provides stability, not movement to the spine. The intermediate and superficial layers are responsible for moving our spine.

Research has clearly documented numerous changes to muscles of the spine, including  changes in fibre type, fatigability of the muscles, control of the muscle, and a reduction in the size and strength of the muscles.

So how does all this result in “my back just going”?

The changes that occur to the little muscles of the spine lead to us compensating with other muscles, muscles that make us move not stabilise the spine. So when we ask too much of these muscles,  often while doing everyday activities, the back flairs up becoming inflamed, angry and sore.

Research is yet to clearly demonstrate whether the changes in function of the spinal muscles directly results in back pain or is a consequence of back pain.

Despite this uncertainty, it has been comprehensively show in RCTs (randomised control trials) and international guidelines, such as NICE  (National Institute for Health and Excellence UK) from 11 countries, including Australia have demonstrated  that exercises targeting back strength reverse many of the muscular changes, and importantly, significantly or completely eliminate back pain.

What can you do to stop back pain? 

Hopefully by now I have not lost you talking about anatomy and literature. Now let’s look at what you can do?

• Continue to exercise gently, ensuring it  feels good.
• Remember exercise is medicine.
• Maintain usual activities and work.
• Consider your posture and work habit, take regular breaks.
• If the pain persists consult a professional. An Accredited Exercise Physiologist will spend time with you to gain an understanding of your pain and contributing factors then design an exercise program tailored to your needs and requirements.

Take home  message: You don’t need to suffer alone!

Back pain is common. In fact, one of the most common health problems in Australia, more prevalent than asthma, hypertension and arthritis. While there is still a lot to be learnt about back pain, the abundance of quality research and international guidelines assist therapists in providing high quality treatment. If the pain persists more than a week or two without improvement, seek the help of a professional.