Does Back Pain Mean Something is Damaged?
When your back hurts, one of the first thoughts that may come to mind is: “Whoops, what did I injure?" Maybe you bent over and suddenly felt a sharp pain. Maybe you woke up stiff and can barely put your socks on. Or maybe your back has been bothering you for months, and a Google search now lists words like; disc degeneration, bulging disc or arthritis.
It is understandable to read those words and assume that something in your back is worn out or permanently damaged. Believe it or not, the good news is that back pain is usually more complicated than that.
Pain is not simply a message traveling from an injured muscle, joint or disc straight to your brain. It is better understood as an output of your nervous system. Your brain and nervous system take in information from the body, your previous experiences, how sensitive the area has become, your activity level, sleep, stress and many other factors before producing the experience we call pain (Hartvigsen et al., 2018).
Sometimes there is irritated tissue involved - a joint can become sore, a muscle can be strained, a disc or a nerve can become irritated, and so on. But after an injury, or sometimes after pain has been present for a while, the nervous system can become more protective and sensitive. In that situation, movements that are normally safe for you may start to hurt much more than we would expect.
This does not mean the pain is imaginary, but that the body’s alarm system may be turned up higher than it needs to be.
A simple way to think about it is like a smoke alarm. A smoke alarm is useful because it warns us about danger. But if it is overly sensitive, it may start going off when you are simply making toast. The alarm is real, the noise it makes is real, but it does not necessarily mean the house is burning down.
So where does chiropractic care fit in?
When your back is painful and guarded, simply being told “exercise more” is not always very useful. Sometimes the first step is helping the area feel safe enough to move again. This is where chiropractic care can be helpful.
Hands-on chiropractic care, including joint mobilization, or adjustment when appropriate, can help reduce pain and stiffness for some patients and improve how their brain is perceiving their joints and muscles.
We can think of hands-on care as creating an opportunity. If treatment helps calm symptoms and allows you to move more comfortably, we can then use that opportunity to restore motion, build strength, improve coordination and gradually expose your body to activities that have become difficult.
In other words, the goal is not to make you dependent on someone repeatedly “putting your spine back into place.”
The goal is to help your nervous system become less protective while your body becomes more capable.
Something you can try at home:
One of the simplest things you can try during an episode of back pain is comfortable walking. Start small, you might walk for 5-10 mins at an easy pace - you don’t need to think of it as a workout.
The idea is to show your body that natural, slow-paced movement can be safe while slowly rebuilding your tolerance.
Pay attention to how you feel during the walk and afterward. If 5 mins feels good, try 7 or 8 mins the next time. If 10 mins leaves you significantly more painful for the rest of the day, shorten the walk and rebuild more gradually.
A little stiffness or mild discomfort does not always mean you are causing damage. Your back is not something that needs to be feared forever because it once hurt. For many people, recovery means calming things down when necessary and then gradually teaching the body that movement, lifting, and everyday life can be safe again.
Your Next Step
If back pain is stopping you from working, exercising, sleeping comfortably, or doing the things you enjoy, book an appointment with us for a consultation.
We can evaluate your symptoms, check your movement and neurological function, determine whether imaging or referral is appropriate and necessary, and help you understand what may be contributing to your pain.
From there, we can build a treatment plan that may include chiropractic care, movement, and individualized rehabilitation based on what your body actually needs.
Our goal is not simply to make your back feel better for a few hours.
It is to help you understand your pain, move with more confidence, and build a body that is better prepared for the things you want to do long-term.
- Dr. Kaiyu Li
References:
Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., Halabi, S., Turner, J. A., Avins, A. L., James, K., Wald, J. T., Kallmes, D. F., & Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 36(4), 811–816. https://doi.org/10.3174/ajnr.A4173
Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., Hoy, D., Karppinen, J., Pransky, G., Sieper, J., Smeets, R. J., & Underwood, M. (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356–2367. https://doi.org/10.1016/S0140-6736(18)30480-X
Liebenson, C. (Ed.). (2020). Rehabilitation of the spine: A patient-centered approach (3rd ed.). Wolters Kluwer.