A constant, dull ache. A sharp or stabbing pain. A tingling or burning sensation. If you have chronic back pain, it can feel like you’re in constant discomfort or you’re waiting for the hurt to return. And you’re probably wondering exactly how you got here.
Do you just have a “bad” back? Did you move funny and cause an old high school sports injury to flare up? Did that slip and fall on the ice last winter do some lasting damage?
The truth is that most chronic pain especially in the lower back, is caused by underlying conditions. Sure, an awkward movement or a fall can trigger pain, but those events aren’t usually the root cause.
So, what are some of those underlying causes of chronic back pain? Let’s start by defining what chronic back pain is. Then we’ll talk about chronic back pain causes and how you may be able to find lasting relief.
How chronic back pain symptoms differ from acute back pain
Chronic back pain symptoms typically come on gradually and are long-lasting, sticking around for more than six weeks. As we mentioned, chronic pain usually isn’t caused by a specific event or injury – nor does it just go away or heal itself without medical treatment.
This is different from acute back pain, which usually comes on suddenly and goes away within two to six weeks. And because chronic pain is long-lasting, it often causes you to avoid physical activity or compensate in other ways, which can actually make your pain worse in the long run.
How common is chronic back pain?
Pretty common. Research shows that eight out of 10 Americans will experience some sort of back pain during their lifetime. Of those who have back pain, one tenth (about 8% of the total population) deals with the chronic kind.
The underlying conditions that can cause chronic back pain
People often think that a single event or injury is to blame for their chronic back problems. But the truth is that a single cause usually can’t be identified, rather there are several underlying conditions that can contribute to chronic pain.
1. Muscle deconditioning
Muscle deconditioning – also called muscle atrophy – is one of the most common causes of chronic back pain. Muscle deconditioning happens when your back muscles lack the strength and stability to support you properly, leading to wear and tear over time.
Some deconditioning naturally occurs as we age – which we’ll get to a little later – but lack of physical activity is the biggest contributor.
If your back is hurting or you recently injured yourself, you’ve probably started taking it easy or avoiding certain activities. In the short-term, modifying your activities or avoiding things like heavy lifting are often recommended to help your back heal.
But too much inactivity can cause muscles to shrink and weaken. When this happens, the muscles in your back may no longer be able to support ligaments and vertebrae as they normally would – which can lead to pain or make you more prone to injury.
2. Improper posture or body mechanics
Bad habits can stress your spine and strain the soft tissue surrounding it. And over time, this repeated stress can break down the structural components of the spine.
While posture or body mechanics are part of every movement you make (or don’t make), your work environment can have a big impact. If your job requires regular lifting or repetitive movement, proper mechanics are your best defense against chronic back pain.
For office workers, when you sit at your desk for long periods of time without stretching, it can cause your hip flexors to tighten. Over time, this can cause hips and hamstrings to weaken, leading to lower back pain. If you notice yourself hunching over your keyboard several times per day, you may be developing kyphosis. This excessive curving of the spine is often associated with chronic back pain.
What’s the best sitting position for lower back pain?
There isn’t a “best sitting position” for lower back pain. In fact, it’s a common myth that sitting posture impacts neck and back pain. However, if you feel pain in your back while sitting, there are several things you can do to feel more comfortable.
- Choose the right chair – Much like how there is no best sitting position for lower back pain, there also isn’t a “best” chair to prevent back pain. Choose a chair that feels comfortable for your back. You could also try sitting on an exercise ball for part of the day.
- Try using lumbar support – Sometimes, the lower back needs a little extra support. To help relieve lower back pain while sitting, support your back by sitting with a small pillow, rolled up towel or lumbar roll in the curve of your back.
- Take breaks – Make sure to take regular breaks throughout the day to walk around, stretch and get your body moving. Taking a break from sitting every 30-60 minutes can help you feel more comfortable. Even something as simple as walking to the bathroom or getting up to grab a cup of coffee counts as a break from sitting.
- Add more movement to your day – Try to be more active in daily life. Park in the back of the parking lot so you have a longer walk into the building, take the stairs more frequently and exercise.
3. Genetics and aging
As we get older, our bodies change – and aches and pains can become more common. We lose muscle strength and disc space within our spine.
Of course, this natural aging process can be accelerated by the other chronic pain-causing conditions we talk about in this post.
4. Traumatic events
Events such as car accidents, falls on ice, trip-and-fall accidents and other high-impact events can speed up the aging process on the spine and trigger chronic pain to flare. These events can lead to overcompensating on movements because of the injury.
5. Overuse and repetition of everyday activities
Every day, the little things we do can have a big impact on the amount of stress we put on our bodies. Examples include:
- Driving or sitting for long periods of time
- Repetitive motion activities such as walking, bending over, exercising or typing
- Lifting both small and heavy objects, including kids
- Sleeping in an odd position or on an old mattress
6. Chronic neck and back conditions
Though back pain can be scary or uncomfortable, it’s rarely serious. Many times, back pain begins to develop with simple, everyday movement rather than an injury or condition. These are often caused by stress, tension, fatigue, inactivity or a new activity that makes your back sensitive to movement. Most of the time, this type of back pain resolves within a couple of weeks.
In some cases, chronic neck and back conditions can cause back pain and other uncomfortable symptoms. Some of these conditions include:
- Degenerative disc disease (spondylolysis) – A type of osteoarthritis that affects the discs in the spine. Over time, these discs can thin and dry out, which may cause back pain. However, it’s important to note that disc degeneration is not always painful. In fact, many people who are diagnosed with degenerative disc disease won’t experience neck and back pain.
- Herniated disc – Also called a ruptured disc or slipped disc, a herniated disc occurs when a bump forms on one of the spinal discs. While many people with this condition do not experience back pain, a herniated disc can sometimes put pressure on nerves near the spine, which could be painful.
- Myofascial pain – Myofascial refers to the muscles and connective tissue in the body. Sometimes, the muscles, tendons and ligaments around the spine can become strained and cause pain. Muscle strain may be painful and disruptive in some cases.
- Pinched nerve (cervical or lumbar radiculopathy) – A pinched nerve in the cervical or lumbar spine occurs when there’s compression or inflammation of the nerve root. In addition to pain, this can cause numbness, tingling or weakness in the extremities.
- Spinal stenosis – This is a condition where the spine narrows, putting pressure on the spinal cord and nerves.
- Spine arthritis (spondylosis) – There are dozens of small joints between the bones of our spines. Like any other joint in the body, these joints can develop degenerative or inflammatory changes that cause pain in the neck or back. This condition is called spine arthritis.
A doctor can talk with you about your symptoms and test for chronic conditions that may be causing you pain so they can help you find the best treatment.
7. Injuries
Injuries to the back can cause a wide range of uncomfortable symptoms, including back pain and a limited range of motion. In many cases, injuries that receive proper care heal in time, and there is relief from painful symptoms. However, sometimes injuries like spinal fractures, stress fractures or sports injuries don’t heal as expected. This can cause long-term pain and other chronic issues.
If you suspect that you didn’t heal after an injury to your back, consider making an appointment with an orthopedic specialist.
What causes chronic lower back pain?
If you’re wondering why your lower back hurts, you’re not alone. According to the Centers for Disease Control and Prevention (CDC), lower back pain may be the most common type of pain adults in the U.S. experience.
Common triggers for back pain may include poor sleep, stress, tension, worrying, low mood, inactivity, and new or different activities. Managing these factors can help prevent pain. If you have a flare-up, try to stay calm, relax and keep moving.
You can get relief for chronic back pain without surgery
Surgery can be an effective option for long-term pain relief. But there’s not a lot of data to support that surgery is the best solution for curing back pain.
Generally, surgery is only recommended after nonsurgical treatment options have stopped working.
The best treatment for chronic back pain is movement, which may sound weird. When your back hurts, you usually think it’s time to take it easy, so you avoid certain activities or movements because you think it will help you heal faster. But the less you move, the more you’ll experience that muscle deconditioning – and your pain will probably get worse.
So, how do you heal your chronic back pain? You need ongoing active physical therapy.
Heal by moving through active physical therapy
Active physical therapy involves movement-based activities like stretching, range-of-motion exercises, and targeted spine strengthening and conditioning exercises.
The movements and exercises are designed to address those underlying causes of chronic back pain so you can strengthen your back, condition your muscles and improve your mobility.
Meet TRIA Neck and Back Strengthening Program: A leader in active physical therapy programs
Your active physical therapy program needs to be intensive and specifically designed to strengthen and condition your back and core. And early on, you need specialized equipment that can help you target those specific muscles. That’s where TRIA Neck and Back Strengthening Program can help.
We opened TRIA Neck and Back Strengthening Program nearly 30 years ago, and we’ve worked with more than 200,000 patients in that time.
Our active physical therapy program for back pain focuses on spine strengthening. Through this program, you’ll start by doing an intake with a doctor or a physical therapist who specializes in spine care. They’ll work with you to determine your best treatment plan. Then you’ll start working one-on-one with a physical therapist who specializes in helping people heal chronic pain.
Want to learn more about TRIA Neck and Back Strengthening Program? Watch this short video.
Your therapy will happen at one of our facilities that features state-of-the-art medical exercise equipment. Programs range usually from six to 12 weeks, but it all depends on your progress and your goals. You’ll learn about what chronic pain is and how the brain processes it. You’ll also focus on body mechanics such as proper lifting, standing and sleeping – all the things that can contribute to back pain but that you may not think about.
No matter what the cause of your pain is, our goal is to help you get long-term relief without needing surgery. If you’ve already had surgery – such as a fusion or decompression – and are still experiencing activity limitations, we also have programs built around post-operative patients.
Since our programs are intensive and last for several weeks, it’s a good time to use your flexible savings account (FSA) dollars or your insurance–especially if you’ve already met your deductible for the year.
Don’t wait to get relief: Learn more about your chronic back pain treatment options
If you have chronic back pain, chances are you’re experiencing more than aching discomfort.
You’re not able to pick up your kids or grandkids. You’re missing out on your favorite activities. You’re not living your best life. And an active physical therapy program can help get you back to it.
To learn more about the TRIA Neck and Back Strengthening Program, schedule an in-person or video visit consultation.
Ready to heal your chronic back pain?