Why Does Your Back Hurt and What Can You Do About It?
Saying “I have back pain” is a bit like saying “my car is making a noise.” It could be serious, or it could be nothing serious, and only a specialist can tell for sure. But if you have back pain, especially in the lower back, you’re not alone: by some estimates, 75% of us have experienced lower back pain at least once in our lives, often for no apparent reason.
I can’t diagnose your back pain over the internet. However, I can tell you about common causes of back pain and offer general strategies to help you feel less pain.
Back pain does not always mean injury.
We tend to think of pain as a sign of damage to some part of our body that needs treatment. But this isn’t always the case. In approximately 90% of cases of back pain, there is no visible damage . This doesn’t mean the pain is imaginary—there may be physical causes that aren’t visible on X-rays or MRIs, and other factors can also contribute to the pain.
Doctors and scientists once considered pain to be a simple signal sent from damaged body parts to the brain. Now, it’s more accurate to say that pain is a perception created in the brain in response to various factors we experience. Tissue damage may be one such factor, but our perception of pain is also shaped by our expectations, fears, and other processes occurring in our brain and body .
You may feel the pain more acutely if you’re stressed or anxious about it. This increases the stress, making the situation worse. Or perhaps you saw a doctor about something that was bothering you, and it turns out the problem was actually quite minor, and you’ll be fine. In this case, it’s perfectly normal for the pain to subside afterward, even if nothing physically changes.
Clearly, there are back problems that are physiological in nature and treatable, so it’s definitely worth getting checked out to rule out serious issues. But if you just have occasional back pain and your doctor says there’s nothing serious, what should you do?
A strong back generally contributes to a healthy back.
According to a 2021 meta-analysis of studies that included all types of exercise, from strength training to Zumba, exercise generally helps people with low back pain feel better.
If you experience daily pain, the first step shouldn’t necessarily be finding the “best” exercises to relieve it. Instead, focus your efforts on finding something you can do without pain, or at least without making it worse. A physical therapist can help you with this process, especially one who specializes in sports medicine or has experience working with active individuals. (Some physical therapists prescribe exercises that are too simple to be effective, especially for older adults; this is a recognized problem in the industry.)
There’s still controversy about which exercises are best for preventing or treating back pain. Some physical therapists focus on core work, believing that having strong, deep core muscles, such as the transverse abdominis, is crucial for back protection. With this approach, you might frequently perform exercises like the “dead bug” and “hunter dog,” as well as practice drawing your belly button toward your spine.
Another school of thought is that the core muscles are only a small part of the overall picture, and that the primary focus of training should be on strengthening the back muscles themselves. This approach will likely emphasize free weight exercises like deadlifts, bent-over dumbbell rows, and lunges. When performed correctly, these exercises also engage the core muscles; you need to engage your core muscles to stabilize your spine during deadlifts or squats, and this is as important a core workout as any exercise on a yoga mat.
In fact, muscle pain is normal.
It’s natural to be concerned about protecting your back. After all, if you ‘ve heard a million times that you shouldn’t “lift heavy objects with your back,” you might worry that any pain after lifting or bending means you’ve injured something.
But your back also has muscles, and they can become tired or sore with repeated use—just like the muscles in your arms or legs. You wouldn’t be surprised or concerned if your hips ached after a tough squat workout or a run. Your lower back muscles can ache after deadlifts at the gym or even after a long day of standing and walking, which you’re not used to.
Sometimes people mistake this common pain for an injury and worry that the deadlift has seriously damaged their back. But before you panic, try treating your back as you would any other sore muscle : apply gentle heat, walk around a bit, and try foam rolling or massage. Muscle pain usually subsides slightly with physical activity and typically resolves within a few days .
Exercises and stretches that are helpful for people with back pain.
What exercises can I do to prevent back pain and possibly relieve existing pain? Again, it’s best to consult a professional to determine exactly what’s best for you, but here are a few strengthening and stretching exercises that are often recommended:
Core strengthening exercises
Back Strengthening Exercises (with Barbells, Dumbbells, or Kettlebells)
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Deadlift or Romanian deadlift
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Rack pull or block pull
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Single-leg squats or your favorite regular squats