Why Do I Keep Getting Lower Back Pain & What Can I Do?

Back pain, just like any other joint pain, has a causative injury. However there are some details when it comes to back pain that are often overlooked that lead to back pain seeming to come and go with a degree of frequency that is certainly not appreciated. In today’s article we’ll explore this in a little more detail as the presence of recurring lower back pain is a sign and often a gentle nudge or ache, that things aren’t quite right. Unfortunately with the business of modern life these minor signals are commonly ignored. 

Why is it common for back pain to come and go?

Back pain often first manifests itself as a mildly intolerable ache in the low back, maybe with some sort of referral symptoms into the leg, often termed sciatica. Unlike other injuries the original back pain is commonly caused by a repetitive strain injury, combined with a lack of good healthy movement habits and substandard muscular strength. This is common, you could even consider it normal but that is only because so many are living a modern life that helps wear our bodies down. 

The issue is that unlike the ankle sprain perhaps, there often isn’t the severe acuteness to the onset. Ankles, for example, aren’t often sore and achy on and off, then you sprain them. It is usually a freak accident with no prior contributing micro injuries, all of a sudden, bang, the injury happens. It is very obvious that the high heels, or curb was to blame. With back pain the “even” is often not like this. Although after many months of back ache warning us there could be an acute “event” like putting the socks on in the morning. Unlike the ankle, this was not the first injury to the back but just the latest insult to a recurrently stressed lower lumbar spine. 

You see, if you are not aware of this, then you do not take steps to counteract the strain on the lower back, you do not make lifestyle adjustments, and do not make the time necessary to prioritize your own health and wellbeing. It’s not just you though, this is common to so many of us!

If we allow injury uppon injury, to stack up in the lower back without addressing these until a more severe event or the natural conclusion of gradually worsening episodes, we find that back pain becomes an all encompassing challenge that often feels overwhelming.

Thinking back to the ankle we have very limited issues to take care of, some rehabilitation and some strengthening and we can get back to normality after the ankle heals up. In most cases there aren’t a variety of forces & circumstances working against our smooth recovery like in the case of a lower back injury.

Why the back pain keeps recurring even after it gets better

One of the major factors with back pain is your strength and stability. Just like the ankle, or any other joint for that matter, the body is always trying to heal, “scab” tissues are forming and the body is trying to repair damaged tissue with healthy tissue. Strengthening is what provides the support and protection during this process as well as patching up the weaknesses that existed before the problem. However, it is often the excessive inflammation in the case of lower back pain, that causes much of the residual symptoms and flare-ups. In the early days, before you’ve had a significant history of back pain, and just a couple of episodes, the back actually stabilizes quite well and starts to go through healing.

Happy days! 

Not so fast…

This is where the back pain is similar to ankle sprains, something that can become more and more common in some individuals. The issue is that pain in the back and ankle dissipates relatively quickly. Healing consists of many parts, two such parts are the stabilisation of the injury and callus formation, the secondary is the remodeling process by which the disorganized tissue or patchwork is then broken down and reconstituted to form healthy strong tissue again. The second of these processes tends to happen in the absence of pain, especially in the early days. Here’s the problem. As soon as the pain goes, the great motivator is no longer hanging over your shoulder every day. The adherence to the rehabilitation and working out becomes an inconvenience that now is more painful than the back or ankle pain. So your consistency slips. Before you know it, a couple of weeks have gone by, and you haven’t done much in the way of your rehabilitation. 

Thinking of the back specifically now, your caution when moving decreases, you start getting back into the hours behind the desk, lifting things poorly and generally not continuing with the good practices that got you this far. 

You see the process of strengthening is one which requires your body to rebuild something that perhaps hasn’t been there before, or in the recent past, it takes time. Not weeks, but months to make significant strength improvements. 

There are no shortcuts, the work needs to be done.

If you don’t complete the process, the very weaknesses that were there before are still present. What’s more, is that often those that aren’t particularly adherent at this point, have also not worked significantly to modify the movements and habits on a daily basis and so these continue to be a factor. 

When we consider that when one begins a new workout, the initial process of learning to move correctly, technically, does not carry much benefit in terms of strength improvements in the tissues. We can see that an often insignificant amount of strengthening has taken place before the person “feels better” and therefore returns to their historic way of life. 

The necessity for time to elapse whilst pain is not present is clear and obvious when we have damaged bone tissue, only because there is a presence of a cast impeding the person, reminding the person that the injury still isn’t back to full strength. With back pain this helpful and inconvenient reminder just isn’t there.

Once you get back pain is it doomed to come and go? 

When we realise the history of our back problem, understanding the healing and remodeling process will help you make wiser decisions that ultimately keep you from falling into the somewhat depressing cycle of back pain episodes that reoccur with increasing frequency and severity. 

Recurring back pain that is triggered by significant trauma, for example a car accident or fall off a ladder is one thing but extremely unlucky and rare. For those that do find themselves with this recurring back pain… 

Take charge of the situation now.

Commit to working to rebuild your body properly this time round.

The journey may not be short, but you’ll find a whole host of additional unforeseen benefits from properly rebuilding your body. Set objective goals for your improvements in strength, in flexibility, in fitness, all of these areas add up. Remember that people often have expectations that are too high for a few weeks or months, but massively underestimate how much progress and improvement can be made over 6 months, a year or longer. 

You do this right, you will get your back in shape for the long term, and keep it that way!

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Comment of the week – Adele

“Back In Shape Helps improve general health as well as back pain. Since starting, my diet has improved, I have lost weight and I am now pain free.”

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4 Steps to stop your back pain coming back

• Identify the true duration of your back problem (not just back pain)

Be honest with yourself, episodes of back pain can come with differing symptoms which often catches people out, for example, a previous episode was localised to the low back, but this one has pain down the leg (sciatica). This is a great example where people FALSELY believe the two to be separate and different, they aren’t. How long has this issue been recurring and this gives you a good idea of the scale of the problem, it also helps you more appropriately set your expectations.

• Evaluate your daily tasks accurately & critically

Your productive practices (exercises) will make up often a fraction 1/15th of your waking hours every day. Your “daily activities” are things which are so easily overlooked that have a huge impact on your recovery. In many cases you can make small changes here that have a significant and positive impact to your long term recovery. Conversely if you do not make changes, you have a huge variety of culprits driving your lower back right towards another relapse.

• Pick a program that has short and long term strategies

People are constantly looking for ways to fix their back pain FAST, why not look for a way to fix it slowly!? Easy come, easy go as the saying goes. Yes there are “strategies” that can be employed to provide momentary relief, some of these are good, others come at a cost and we’ve covered this at great length. A proper program however should consist of short term strategies but focus more heavily on building long term progress and significant enhancements in the muscular competence of the individual. It should progressively challenge your body more and help coach you through the various stages of improvement giving you the tools to continue to do so for the long term.

• Be consistent

Rome wasn’t built in a day and your back pain wasn’t either, take your time, progress at your own pace. Embrace the challenges you find along the way, it is in the overcoming of these challenges that true improvement is locked in. Fixing back pain is not difficult, it’s not rocket science, but it demands consistent effort and diligence to be applied.