Everything You’ve Ever Wanted to Know About Back Pain

To figure out the cause, we first need an understanding of how the back works. Basically, your back is made up of interconnecting nerves, bones, muscles, ligaments and tendons, all of which can be sources of pain. Your back is comprised of a large, complex group of muscles that support the trunk and hold the body upright. They also allow the trunk to move, twist and bend in multiple directions.

Our friends at Cedars-Sinai Medical Center explain that there are three main muscle groups found in the back. First, the extensor muscles, which allow us to stand and lift objects. Flexor muscles are attached to the front of the spine and include the abdominal muscles. They allow us to flex, bend forward, lift and arch the lower back. Lastly, the oblique muscles, which are attached to the sides of the spine and help us rotate the spine and maintain proper posture. Sometimes, straining the aforementioned muscles and ligaments can cause back pain. These strains can come about through chronic stress (caused by bad posture), tight muscles and certain exercises—like sit-ups and boxing—which can be harmful if done incorrectly.

Outside of muscle strain, back pain can also be caused by scary-sounding stuff like bulging or herniated disks. “Disk” refers to the rubbery cushions situated between the individual bones (vertebrae) that stack up to make your spine. “[A herniated disk] results when a crack in the tough outer layer of cartilage allows some of the softer inner cartilage to protrude out of the disk,” says Randy A. Shelerud, M.D. “Herniated disks are also called ruptured disks or slipped disks, although the whole disk does not rupture or slip.” A bulging disk, on the other hand, is a result of wear and tear on the back. “Over time, disks dehydrate and their cartilage stiffens. These changes can cause the outer layer of the disk to bulge out fairly evenly all the way around its circumference—so it looks a little like a hamburger that's too big for its bun.”

How can you tell if you’re dealing with a disk issue? Symptoms are often more severe than a run-of-the-mill strain and can include pain and sensations that have nothing to do with the back, like a tingling radiating down the legs and into the feet, sudden weakness in one or both legs and bowel or bladder problems. If you’re dealing with any of these symptoms, head to a back specialist, who will likely order tests (like an MRI, CT scans or X-rays) to diagnose the issue.

On top of those potential culprits, back pain can also be caused by plain old overuse. (Back pain, after all, affects around 80 percent of adults at some point in their lives, according to the National Institute of Neurological Disorders and Stroke.)

1. Stretch—a Lot

Yoga and stretching can help manage and prevent back pain. On the yoga front, we checked in with Sarah Sumner, a yoga instructor at Laughing Lotus, a studio with locations in New York, San Francisco and New Orleans, for three poses she recommends for people with back issues—and the ones to avoid. If you don’t have a mat and yoga strap laying around, we also consulted Callista Costopoulos Morris, DO, a sports orthopedic surgeon with the Geisinger Musculoskeletal Institute in Pennsylvania, for five super-easy stretches that should quell back pain. Try child’s pose to target the smallest muscles in your back and stretch out your hamstrings on a daily basis—not just when you’re in pain.

2. Apply a Topical Treatment Like Capsaicin Cream

Capsaicin is the ingredient in chili peppers that makes your mouth feel hot when you eat them. When it’s incorporated into creams and patches, it can be an effective tool for relieving—not curing—pain caused by joint conditions like rheumatoid arthritis, migraines, fibromyalgia or plain old muscle strains. Capsaicin cream is typically available without a prescription, and doctors will usually advise you to apply it to wherever you’re experiencing pain a few times a day. There haven’t been many studies on the efficacy of capsaicin creams and patches, but the research that is out there is pretty promising. A 2016 University of Michigan study found that, for people with lower back woes, capsaicin reduced pain more than a placebo. (The authors of the study did note that additional research is needed.)

3. Try Massage

We know what you’re thinking: Oh hi, spa day. But not so fast—the type of massage matters. One promising technique is myofascial release therapy, an alternative medicine therapy that claims to treat pain by relaxing contracted muscles, improving blood and lymphatic circulation and stimulating the stretch reflex in muscles. It’s a therapy that’s often used in massages and focuses on pain from myofascial tissues—the tough membranes that wrap, connect and support your muscles. There haven’t been a ton of studies conducted on the efficacy of myofascial release therapy, but one study published in the Journal of Bodywork and Movement Therapies concluded that myofascial release is emerging as a strategy with a solid evidence base and tremendous potential.

4. Consider Balneotherapy

OK, so this is kind of just a fancy term for taking a long bath, but stay with us. Balneotherapy is a form of hydrotherapy that involves spending 20 to 30 minutes in a bath. This could be mineral-enriched water that occurs naturally in some places (like hot springs) or tap water that’s been enhanced with salts, oils or mineral-rich mud. Dating back to ancient Greece and Rome, balneotherapy has been touted as an effective treatment for back pain, as well as a way to quell psoriasis, promote circulation and even brighten skin. A study in the journal Rheumatology found that, “Even though the data [is] scarce, there is encouraging evidence suggesting that spa therapy and balneotherapy may be effective for treating patients with low back pain,” while adding that more studies are necessary. Will balneotherapy make your back feel better? Possibly. Will you feel cozy and relaxed? Definitely.

5. Talk to Your Doctor

If you’re looking for a treatment with a little more concrete scientific backing, check in with your doctor. (That isn’t to say the above methods are unsafe—they just haven’t been studied as thoroughly as others.) Your doc will likely suggest a course of action that could include over-the-counter pain medication, physical therapy, cortisone injections, muscle relaxers and if all else fails, surgery. In terms of alternative treatments—aside from yoga—some people also find relief from chiropractic care and acupuncture.

1. Do the *Right* Exercises

If certain gym routines can cause or exacerbate back pain, others can help prevent it. Here are some back-strengthening exercises recommended by the Office of Disease Prevention and Health Promotion. And as a general rule of thumb, always consult a professional before attempting a new movement to make sure you’re doing it right. We’re not saying you have to shell out hundreds on a trainer, but if you’re unsure at the gym, it’s always beneficial to ask someone who knows what they’re doing to take a look at your form and offer any corrections.

2. Work on Your Posture

Mom always told you to sit up straight, but somehow you still find yourself hunched over your computer ten times a day. Bad posture can wreak havoc on your back, so we asked Dr. Kellen Scantlebury of Fit Club Physical Therapy and Sports Performance Center to give us a few easy ways to straighten up. His easy-to-implement tips include switching the shoulder you wear your bag on periodically, investing in an elevated computer stand at work and uncrossing your legs and keeping your feet flat on the floor. It’s tough at first, but sitting with crossed legs all day can be bad news for your lower body and spine.

3. Switch Up Your Sleep Position

Sorry, stomach sleepers: When you sleep face-down, it can put stress on your lower back and neck. Try sleeping on your side with a pillow between your knees, or on your back with a pillow under your knees. And if you absolutely must sleep on your stomach, try taking the pillow out from under your head and putting it under your pelvis instead.