Most people will experience back pain at some point in their lives. Your spine is the central pillar of your body, providing a stable base for your limbs as well as being the highway for your nervous system. Attached to it are dozens of muscles large and small, many of which we can barely detect day to day but we still depend on to be fully functional. With so many overlapping structures and systems, there’s a lot that can go wrong.

The good news is that back pain is rarely due to serious structural injury and nearly all back pain gets better with the correct treatment or even by itself. Back pain usually is not a result of damage to your spine, rather the pain is coming from otherwise healthy parts of the spine that, for some reason, aren’t able to function properly. Sometimes, this is a result of an acute injury from an activity or exercise, but a lot of the time the cause is more habitual.

Repetitive activity or prolonged positions can very gradually overload structures in your back, making them more sensitive or prone to injury. If, for example, a muscle that’s meant to provide short bursts power is instead being used to provide stability for hours on end while you sit at a desk, it will eventually get overloaded and cease to function properly. The body will then use pain to warn you that this muscle is fed up with the work load and needs to take it easy for a while.

The human body is very adaptive. It is proficient in its use of compensatory movement patterns in response to injury, where it uses alternative structures during movement to overcome an underlying weakness and/or to divert load away from injured tissue.

However, the body can occasionally be over-adaptive, with the compensations remaining in place even after soft tissue healing has occurred. This can prolong the presence of symptoms as it limits the body’s ability to re-distribute forces evenly throughout the spine. Correction of abhorrent movement patterns to allow for activation of normal muscle activity will help redistribute spinal load. Normal movement = normal back, so keep moving!

How we treat and prevent back pain

When I treat someone who’s suffering from back pain caused by overloaded structures and/or compensatory movement patterns, the first step is to do a detailed analysis of their overall movement patterns: squatting, lunging and – most importantly – walking. This will help us hone in on which particular muscle groups are likely to be dysfunctional and then we can individually test these muscles to confirm whether they are under or overactive. The exercise prescription chosen will be based on these outcomes and tailored specifically towards correcting the individual dysfunction.

Occasionally, back pain is caused by an inflamed structure such as an intervertebral disc, joint or adjacent nerve root. Symptomatically, such pain can be hard to tell apart from pain caused by movement dysfunction, so it’s important to get a clinical examination from a physiotherapist so that they can prescribe the appropriate treatment. Examination tends to be more helpful than x-rays and MRI scans, as the spinal abnormalities these reveal may not be related to the pain at all.

While acute inflammatory back pain can be very disruptive and upsetting, we must not underestimate the body’s ability to heal. Skin is a great example of this: you cut your knee, it may bleed profusely initially, scarring occurs and the skin returns to normal. The tissue in your spine follows similar physiological patterns. Where physiotherapy can help is in providing programmes that offload the injured region to allow for optimum healing.

In terms of preventing back pain, nothing is better than movement. The more your back is moving normally instead of being stuck in a chair all day, the more its muscles will be activated, which will help to evenly distribute spinal load. Remember, normal movement equals a normal back, so find a sport or activity you enjoy and keep moving!

Whether you want to get rid of back pain or prevent it, we can provide holistic treatments that provide you with long term benefits rather than a quick fix, leaving you with a better understanding of your body and how to look after it. If you’re suffering back pain, and would like us to help you, then get in touch by emailing us at enquiries@physiolondon.co.uk  or calling 020 7093 3499.

Jack Mest

B.Sc Physio, MCSP, MHCPC