The four main causes of back pain

Back pain is complex because your spine is loaded with neuro-sensitive tissues like ligaments, nerves, and muscles that have the primary goal of protecting your spinal cord. But back pain isn’t always due to structural, mechanical damage. 

 

Studies have shown MRI images of people with back pain who have no structural damage, and yet their pain is real. Although back pain often results from structural damage like degeneration or disc herniations, that isn't always the cause of pain. 

 

There are many components that signal pain, and one blog post won't scratch the surface of this topic's complexity. But to simplify it, tissue dysfunction and pain can be boiled down to too much stress without enough recovery. 

 

In order for your body to function well, recover from exercise, build muscle, and be metabolically and emotionally healthy, you have to have a balance between your recovery response, and your stress response. These two systems are called your anabolic (recovery) system and your catabolic (stress) system. 

 

To keep this really simple, your anabolic systems are the processes in your body that rebuild. Think about healing immune cells that rebuild muscle tissue after exercise. This is the mechanism that makes your muscles physically stronger and bigger. This process is key to improving the health and function of your body but is often neglected. 

 

Your catabolic systems are the processes that break tissue down. These processes are equally important as your tissues require maintenance and regeneration in order to stay healthy and strong. An example of a catabolic process is the breakdown of muscle tissue when you are lifting weights. After you lift weights, the catabolic process breaks down the tissue, and the anabolic process swoops in to rebuild it stronger. 

 

Think of your catabolic and your anabolic processes like a scale. In order to have great exercise results, build a stronger, healthier, functional (pain-free) body, these two processes should be even, on average. 

 

 

Pain, tissue dysfunction, and even weight gain/muscle loss happen when those two processes are unbalanced for an extended amount of time.

 

This can happen for several reasons: 

 

1. Stress: emotional or mechanical

 

Stress can cause inflammation in your tissues by signaling chemical changes in your brain and body when it senses a "threat." Stress that is balanced with recovery is a good thing, as we mentioned above in the example of how stress in the form of exercise can build muscle when paired with recovery.  Interestingly, stress can manifest similarly in your body, whether the stress is emotional (stressed out about a relationship) or mechanical (performing an exercise, sitting for too long, etc.). Small amounts of stress are beneficial for the body because you need the catabolic and the anabolic to keep your body maintained. Still, many times stress highly outweighs the healing processes in your body, tipping the scale. 

 

For most people, their back pain is a derivative of a combination of emotional and mechanical stress. 

 

We are spending November getting our spines as healthy as possible in Levo. Get in there if you're struggling with this. 



2. Overuse 

 

One of the biggest mistakes I see in exercise programming is overuse. If you are working a muscle to fatigue or close to fatigue, you are initiating the catabolic process. This is a good thing and will begin the inflammatory processes vital for muscle healing and regrowth. However, the inflammatory process can sometimes take up to 7-10 days before the tissue is ready to be stressed again. 

 

A common misconception is that the more often you work a muscle, the faster you will see growth in that muscle. Trust me, I wish this is how our bodies worked. When you signal that inflammatory process, your tissue is vulnerable and healing. If you stress a healing muscle/tissue, you can continue to spin in that inflammatory process, creating chronic inflammation, compensations, and eventually tissue damage and pain. Not only does overuse lead to pain and injuries, but you won't see as effective results because you are never allowing your body to build the tissue before you break it down again. 

 

I recommend at least two days in between working a muscle group, and sometimes longer. If you're still sore, keep waiting until that muscle feels fresh. You will see much better results in the way your body moves, looks, feels, and functions. 

 

3. Trauma

 

A big reason for back pain is trauma. In this context, trauma means a physical event like a car wreck, a sports injury, or a fall. I won't discuss traumas in detail in this post, but please see a practitioner if you've had an injury. Remember that one part of your body can affect another, so see someone who evaluates your body as a whole, doesn't just look at the part of your body that hurts. See your primary first. Practitioners I recommend: 

 



4. Nutritional, hormonal issues, or dehydration 

 

Nutrition is NOT my scope, but I do know that nutrient or hormonal deficiencies can affect all of your body's processes, including your ability to heal and recover. I highly recommend seeing a functional dietitian or doctor if you think this may be an issue. 



In most people, chronic pain is a mixed bag of all of these components.

 

So, where do you start?

 

Start with one component at a time. This process can be similar to an elimination diet used to test your allergies. If you change everything at once, you don't have any information about the piece that affected you the most. I'm walking you through this in the Levo membership this month, but here's what we'll do: 

 

1. Start with stress

 

Do some breathing/meditation. Does your pain reduce? By how much? If it's significant, do that more often. Try this consistently for a week and see how it changes your experience with your back pain.

 

2. Next, work on mechanical stress

 

Mechanical stress can be from prolonged positioning or exercise stress. 

 

Sitting can especially place compressive forces on the spine. So change positions as often as possible.

 

Take out an exercise that you think might be flaring up your back. If you take out that exercise and feel better, you might have some clues as to what is causing the stress to your spine. This doesn't mean you have to remove it forever, and it doesn't mean a muscle group will get neglected. Contrary to popular belief, you can work almost any muscle group in a "back-friendly" way if you understand exercise mechanics. There are ways to work your muscles without placing lots of force through an already aggravated spine. By removing a triggering exercise, you give that anabolic process some space to do its magic. Some examples of exercises that tend to leave a vulnerable spine feeling worse: (I'm not saying these are "bad" or "wrong," so please don't misinterpret.)

 

  • Deadlifts
  • Good mornings 
  • Glute bridges/hip thrusts
  • Hip band work 
  • Crunches 
  • Barbell squats 

 

We are only doing back-friendly workouts in Levo this month, so join if you aren't sure where to start. Workout like this for a week or two and see how your back feels. 

 

3. After you improve the stress, work on your programming to avoid overuse

 

Overuse doesn't work for most people long-term. The sooner you can eliminate overuse, the faster you will heal and put yourself on a path of creating a stronger body. My recommendation is to implement workout splits. This means you spend each day of the week dedicated to a group of muscles, and spend the rest of the week recovering those muscles. We are doing this in the Levo membership this month in this way: 

 

Mondays are upper body day, where we are lifting heavy

Tuesdays are trunk and core-focused 

Wednesdays are cardio-focused

Thursdays are mobility and meditation (recovery and self-evaluation. I'm teaching you how to locate imbalances within your body)

Fridays are lower body day, lifting heavy weights 



4. Be patient. 

 

If you've tried this for over a month and seeing no progress, it might be time to see a practitioner. Just as your body has taken (many times) years to accumulate damage that finally shows up as pain, it can take months, sometimes an entire year to improve function and fully recover. If you aren't seeing ANY progress (which I find is rare; usually, people see progress within the first month, and significant progress within 12 weeks), consider seeing a practitioner.

 

If you're ready to feel better in your body AND get better exercise results, start your 5-day Levo trial and LET'S DO IT! Click here to learn more.

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