Of all the visits to healthcare practitioners that treat acute and chronic pain, back pain tops the charts.  Spine surgery has become a specialty within a specialty and chiropractic care is one of the fastest growing modalities of medicine.  It is estimated that 80% of us will suffer from some form of back pain during our lives.  Its prevalence is likely rooted in the fact that there are several distinct yet overlapping causes of back pain which complicate the clinical presentation.  This can make it difficult to treat if any one of those underlying causes is left unaddressed.


To begin, we must state the obvious; the structure and musculature of the back houses a very important and delicate aspect of the mammalian nervous system, the spinal cord.  We humans who walk upright have evolved curvatures along the vertebra of the spine that allows for maximum protection yet flexibility of this nerve rich area.  These nerves exit the spine to innervate and receive impulses from every part of the body, relaying information to the brain for processing.  Any trauma to the spine can result in pain, numbness, or if severe, paralysis and death.  Maintaining your spinal health and integrity is therefore a top priority.   This leads us to the first area of treatment of back pain – posture.  


Humans are adapted for eating whole and nutrient-dense foods.  Eating empty processed foods represent a form of malnutrition.  Similarly, holding your body in positions and postures that we are not adapted to composes a different kind of malnutrition.  Strong postural muscles nourish our body with every step.  Our lymph and venous blood are reliant upon muscular contraction to keep our circulation running smoothly.  If we live sedentary lives, adopting postures that do not support our physiology, problems arise.  This is particularly true of the spine which has evolved to maintain three convergent curves along its length.  The lumbar curve (low back) is most susceptible to bad posture if we bend in a way that causes the curve to round outward instead of maintaining its natural inward shape.


Keeping a natural posture (as evidenced by anthropological examination of indigenous peoples who report far less incidence of back pain) is another spoke in the wheel of ancestral health, that is, maintaing the body in way consistent with our evolution.


In line with posture (no pun intended) is the muscular tone which maintains it.  The underlying cause of poor posture is weak and imbalanced postural muscles, originating from a sedentary lifestyle (sitting) full of tasks that are only directly in front of you (desk work).  Strengthening your core muscles to support proper posture is the single best preventative strategy for those with intermittent back pain.


Tight, tense, and overworked back muscles are the counterpart of weak core musculature.  Back muscles that go in spasm and pull vertebra around and out of alignment will keep even the most skilled chiropractor busy in the long-term if this soft tissue imbalance isn’t remedied.  Massage therapists, acupuncturists, and chiropractors or osteopaths trained in soft tissue work can begin the healing process but it often takes a concerted effort by the patient to maintain optimal circulation to the back muscles.  The cheap and easy home remedy that I recommend to patients is the use of a ma roller.  For those suffering from chronic tension in the lower back, I have found the ma roller to be a reliable and effective treatment that can be used for the rest of your life.


Back pain can still plague the most well-aligned, structurally-sound individual.  If the above strategies have not borne fruit with their diligent application, it is wise to investigate neurogenic causes of your pain.  This arena invites us to examine the frustrations and emotional upsets in our lives to understand how these stresses create neurocircuits tied into the brain’s sensory cortex.  Because the spine is a nerve-rich area, neurogenic pain has a particular affinity to the back.  The gamut from acute severe trauma to daily life stresses have the potential to create a neurogenic pain circuit that requires a different array of treatments to be effective.  An excellent resource on the treatment of neurogenic pain is the exemplary work of orthopedic surgeon Dr. David Hanscom in his book Back in Control.


It is important to bear in mind that all of these factors may (and often do) underly chronic back pain.  Poor posture, muscle weakness, muscle tightness, emotional stress and trauma – they may all overlap each other in terms of the their influence.  You can choose to address only one area that you believe to be most influential but keep in mind, you may also need to branch out into other theories and therapies if your pain does not completely resolve with time and patience.

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