Some staggering facts about back pain from the American Chiropractic Association…
- Worldwide, back pain is the single leading cause of disability, preventing many people from engaging in work as well as other everyday activities.
- Back pain is one of the most common reasons for missed work. One-half of all working Americans admit to having back pain symptoms each year.
- Back pain accounts for more than 264 million lost work days in one year—that’s two work days for every full-time worker in the country.
- Experts estimate that up to 80% of the population will experience back pain at some time in their lives.
- Back pain can affect people of all ages, from adolescents to the elderly.
- Back pain is the third most common reason for visits to the doctor’s office, behind skin disorders and osteoarthritis/joint disorders.
- Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.
- Most people with low back pain recover, however reoccurrence is common and for small percentage of people the condition will become chronic and disabling.
- Worldwide, years lived with disability caused by low back pain have increased by 54% between 1990 and 2015.
- Low-back pain costs Americans at least $50 billion in health care costs each year—add in lost wages and decreased productivity and that figure easily rises to more than $100 billion.
In 2004, researchers from Northwestern University conducted a study in which they discovered that chronic back pain diminishes 5-11% of the gray matter in your brain per year—the equivalent of 10-20 years of normal aging.
Last year, the CDC revealed that over 50 million Americans have chronic pain at any given time. As a whole, chronic pain costs $635 billion per year in the United States alone, more than cancer, diabetes, and heart disease—combined!
Treatment for chronic pain is often opioids and/or surgery. Opioids are highly addictive narcotics with a number of dangerous side effects. Long term, there is little to no evidence that opioid therapy of six months or longer is effective in treating chronic non-cancerous pain. Add in Tiger Woods and Golden State Warriors head coach Steve Kerr as recent high profile examples of the very real complications of back surgery, and you can see that successful treatment for chronic pain is never a guarantee.
Causes of Back Pain
Trauma and injury are obvious reasons for back pain, and don’t need much explanation. Car accidents, sports injuries, slips, falls, even sneezing! (Yes, I once had a patient who gave herself sciatica from sneezing.)
Emotional stress can do very weird things to our body, including weakening the systems in our body. Whether it’s the immune system (weakening the body’s ability to stave off sickness), the cardiovascular system (emotional stress, particularly anger, can cause arteries to weaken and clog, as well as increase blood pressure and pulse), or the muscular system (taut & tender muscles and muscle spasms).
A sedentary lifestyle often plays a part in back pain. We’ve all heard the old adage that “movement is life.” That’s because it’s the 100% truth. Less than 24 hours after surgery, knee and hip replacement patients are helped up out of bed to begin walking again. The spine has a natural C-shaped curve in our necks and low backs and less dramatic curve going the opposite way in our upper back.
When we sit at a desk all day, slouched and hunched over, we reverse the curves in our neck and low back and we increase the curve in our mid back / upper back. This is problematic because it causes all of our extensor muscles to stretch and tighten for extended periods of time, weakening them; and our flexor muscles are constantly over-activated, doing no favors for anyone or anything except gravity in its quest to pull us down into an even more imbalanced posture.
An example of this would be the neck muscles. Try looking up while simultaneously jutting forth your chin to stretch your front neck muscles. Feel how tight that is? That’s because you’re probably spending too much time looking down at a phone or a computer screen. That’s not a judgement, it’s reality. I’m as guilty of it as anyone, including right now as I write this.
The problem is that when we look down so much, it tightens up and stretches the muscles in the back of the neck, particularly at the top of the neck / base of the skull. The largest percentage of mechanoreceptors in our body exists here, and these muscles connect directly to the base of the skull, C1, and C2. Tension headaches, migraines, even vertigo can arise from dysfunction of these muscles.
And of course, there is pregnancy. Remember earlier how I mentioned a tight piriformis muscle can compress the sciatic nerve and pose a problem during pregnancy? This happens during pregnancy because of the widening of the pelvic bones to prepare for the baby’s arrival. Tight muscles in the rear end come with the territory during pregnancy, but an imbalanced spine resulting from vertebral misalignments (there are always spinal misalignments during pregnancy as the mother’s body changes, repositions, and prepares for a massive physical event) will exacerbate that gluteal muscle tightness. And pregnant women don’t need any more painful aggravation than they’re already experiencing.
In my experience as a chiropractor, back pain is often an effect that stems from a cause at the top of the neck.
A misalignment in the low back or pelvis resulting in back pain is often, if not almost always, compensatory due to the initial misalignment at the C1 or C2 vertebra. A misalignment at this level is called a vertebral subluxation. When a subluxation occurs at C1, C2 will compensate, as will C3, C4, and so and so forth down to the pelvis. This will result in an overall body imbalance giving one the appearance of poor posture, such as one shoulder higher than the other, slight head tilt, pelvic tilt, imbalance of leg lengths, etc.
The spinal imbalance resulting from a C1 and/or C2 subluxation is very often what leads to the unevenly stacked vertebrae lower in the spine. A misaligned L4, L5, or sacrum can directly impact the surrounding tissues, thus increasing pressure against one of the nerves that make up the sciatic nerve, or the sciatic nerve itself, contributing to low back pain, or even sciatica.
Back pain is one of the most common conditions I see in my office, and it is not a condition to be ignored. It is painful, it can be debilitating if left alone for too long, and it is a sign that something is in disarray with your spinal health.