Up to eighty per cent of Australians will experience back pain at some point in their lives and 10% will experience significant disability as a result. 1
Our backs are complex and there are many myths about our backs. One myth is that the back is fragile and you should be careful about how you move? For example, when you pick up things (particularly heavy things), you should bend your knees and squat, hold the object close to your body and stand up using your leg and butt muscles. Various studies cited in Don’t Worry About Lifting Technique 2 indicate that lifting techniques such as squatting do not have any benefit over stooping. The main thing is to keep the object being lifted close to the body.
The back is not so fragile after all and the back given time is capable of resolving some issues. The Clinical Guideline for Noninvasive Treatments for Acute, Subacute and Chronic Low Back Pain 3 identifies that acute lower back pain (lasting less than 4 weeks) and subacute pack pain (lasting 4 to 12 weeks) is often resolved on its own. Many people see relief over time regardless of whether they have physio, do yoga, do Pilates or do nothing. This doesn't mean that this is the case for everyone - some people have debilitating chronic lower back pain (lasting greater than 12 weeks). For chronic back pain, the Clinical Guideline strongly recommends initially selecting nonpharmacologic therapy options including exercise, tai chi, and yoga that result in people moving in different ways. Another recommended option is mindfulness-based stress reduction.
Pain research also shows us that there are many people out there who have significant pain in their backs but there is nothing structurally wrong with them. Others have all sorts of issues such as disc bulges or herniations, bone spurs or other alignment issues but have no symptoms whatsoever. 4 Then there are the people in between. Prominent back surgeon Dr David Hanscom, over years of research, has discovered that a great many of his clients are better off doing meditation and exercises than having surgery. He's even written a book about it. (Back In Control).
One of the reasons we can hurt our back is overloading it when it has not been accustomed to lifting heavy weights. Another reason is doing extreme back bends repetitively over time (extreme being exceeding the usual range of motion your back has). Working in ranges that your back is not used to may also be an issue. This list could go on.
More recent studies 5 show that the cause of some of our back pains can be due to some thickening of the lumbardorsal fascia – connective tissue found in the lower back. The key seems to be to different movements, gradually increasing loads over time so your back adapts and is able to support the loads and motions.
1. Andrew M Briggs and Rachelle Buchbinder, Back pain: a National Health Priority Area in Australia? Med J Aust 2009; 190 (9): 499-502.
2. Ingraham, Paul, 2017, Don’t Worry About Lifting Technique,
3. Amir Qaseem, Timothy J. Wilt, Robert M. McLean, Mary Ann Forciea, .Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166:514–530. doi: 10.7326/M16-2367 (http://annals.org/aim/fullarticle/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice)
4. Maureen C. Jensen, Michael N. Brant-Zawadzki, Nancy Obuchowski, Michael T. Modic, Dennis Malkasian, and Jeffrey S. Ross
Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain
N Engl J Med 1994; 331:69-73July 14, 1994DOI: 10.1056/NEJM199407143310201
5. Wilke J, Schleip R, Klingler W, Stecco C. The Lumbodorsal Fascia as a Potential Source of Low Back Pain: A Narrative Review. BioMed Research International. 2017;2017:5349620. doi:10.1155/2017/5349620. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444000/