Why Does My Back Pain Come Back?

This is one of the most common questions I get from new patients that come into my office.  They tell me that they have had back pain in the past, they have received physical therapy, chiropractic, medicine and or many other of the wonderful treatments that helped their back at the time but, now the pain is back.  Invariably, the question comes out "Why?"

The answer to this question can be a difficult one as no two patients are the same and there can be many different reasons why the pain came back; you started working out again and re-injured the area, you "over-did-it" at your job or at play, you are getting old, or you are out of shape.  These are all valid answers to the question but they all typically tie into one reason: YOUR BACK MUSCLES ARE TOO WEAK!

I know, I know.  You go to the gym 3-5 times a week and workout, right?  Well, if you are like most of us the answer to that question is; "Um, No."  Even for those of you who can answer yes to that question you typically have the same problem.  When we do workout, we typically do not workout the core muscles.  When we do workout, most of us workout what I like to call the "Show" muscles.  For men, we want to workout our biceps or, work on our pecs to give us a tone chest.  We want the big broad shoulders and they six pack abs.  We work out the big bulk muscles that we think make us look appealing.  Women always want to tone.  They do exercises to give them tone arms and legs and a flat stomach.  While, there is nothing wrong with this, we are always forgetting some of the most important muscles in our body.  The core muscles are what are called deep muscles of the body.  Our body is made up of layers.  When we workout the way we are used to, we typically only work the big bulky muscles that are in the outermost layer but we neglect the deep muscle layers that are important to our posture and balance.

First lets talk about what a muscle is and what is its main function.  Muscle is a specialized tissue in the body and there are actually several kinds of muscle tissue.  One of the jobs of muscle is to help make our body move as well as provide a place for storage of some essential nutrients such as proteins, calcium, iron, and many other vitamins and minerals.  Most skeletal muscles (these are the kind of muscles we use to make our body move) go across a point where two bones come together, called a joint.  When a muscle contracts, it shortens its length and moves the insertion (the bone that the muscle is attached to) towards towards the origin (the bone that the muscle came from.  This movement happens at the joint the muscle crosses over and lets us do many things from very simple movements like bending your elbow to very complex ones like running and jumping.  When a muscle is weakened, it cannot create enough force needed to move the insertion bone and movement is limited.  This is especially important when we are talking about weakness to our core muscles.

The main job of the core muscles is to move the very important joints in our spine.  They allow us to stand up without swaying back and forth.  When these muscles are weak, they must work harder so that we can keep doing all the same motions we are accustomed to doing.  When the muscles struggle to work, they will not only affect the muscle tissue itself but also the tissues that make up the joint it is in charge of moving.  When tissues do not work properly they begin a process called inflammation.  The tissue gets injured, and becomes swollen, red, hot, and painful.  When this happens in the back, we get back pain.

This brings us back to why your previous treatments didn't help the pain to stay away.  Most of the above mentioned treatments only treat one component of the injury: the muscle or the joint.  The key is to treat them both.  You need to make sure your joints are moving properly and not getting stuck in place.  One of the best ways to ensure your joints are moving properly is to have them adjusted.  This will ensure you are having proper motion.  The second thing you need to do is to make sure you are strengthening the muscles that cross that joint as they control the movement of the joint.  These two things must be done in combination to ensure your core is strong enough to prevent the injury from coming back.  So what are some good exercises to strengthen these core muscles?  You will have to check back and read my next post where we will talk about some of the best exercises to strengthen the core.  See you then!