Back Pain: An owner’s Manual

As a spine specialist physician (and a spine patient myself), I have three take-home messages.

  1. First, back pain is common, but manageable.
  2. Second, back pain originates for many reasons, varies significantly in how it looks and feels in each individual, and is usually episodic.
  3. Third, a healthy back is attainable by taking a deliberate approach.

Why is back pain so common?

Specific parts of our spine develop wear and tear, and pain may develop after an injury, repetitive strain, or due to the effects of aging (i.e. arthritis). There are nerves that carry pain signals from structures like the discs, bones (vertebra), and joints. We experience pain when these structures are irritated. The irritated structures will usually calm and pain will typically improve. However, recurrent episodes are common, so it’s important to adopt a regular exercise program to minimize the frequency, severity, and intensity of these episodes.

Back pain is not a singular entity

A person is vulnerable to back pain based largely on their behavior and, to some extent, genetic factors. Risk factors that can be modified include sedentary behavior, being overweight or obese, and smoking. There are also systemic medical disorders for which back pain may be a symptom. Back pain may be sharp or dull, localized or radiating. Spinal conditions may be associated with radiating symptoms into the arms or legs, and some people develop arm or leg numbness or weakness. If you experience spinal pain associated with arm or leg pain, numbness or weakness, seek medical attention.

A healthy spine is like a good offensive line on a football team.

The offensive line makes the quarterback look good by playing a critical, supportive role, yet rarely claims the limelight. Similarly, when your spine is working well, you don’t give it a thought. The trouble arises with our 21st century lifestyle, which often favors sedentary behavior, leading to weakness of the muscles supporting the spine and postural changes that contribute to spinal pain. The pursuit of back health should first start with deliberate attention to the modifiable behaviors that reduce the risk for back pain, and then continue with the guidance of a wellness-minded, health professional such as a personal trainer, physical therapist, or physician.

Physical activity in pursuit of back health

If you experience back pain, consider seeking out the attention of a physical therapist. A physical therapist specializes in biomechanics. After an individualized evaluation of your particular mechanics, your physical therapist will tailor a specific stretching and strengthening approach for you. At PRO Sports Club, a physical therapist can work alongside your personal trainer and/or Pilates instructor to create a comprehensive program.
I, myself, have sought physical therapy for back pain, and continue a customized exercise program that has made me fit enough to pursue my fitness goals. Exercise is medicine. As Ben Franklin once said, “An ounce of prevention is worth a pound of cure.

By Garrett S. Hyman, MD, MPH
Lake Washington Sports & Spine

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