Where does back pain come from? Causes & what you can do

Back pain is one of the most widespread health challenges in the Western world and a frequent cause of sick leave. But even though the pain can be intense and debilitating, in the vast majority of cases, it is harmless and temporary. To best manage it, it is crucial to understand where it comes from and what works – and what doesn't.

What is back pain, and why do we get it?

Back pain is an unpleasant sensory experience in the back, most often located in the lower back (lumbago). It occurs when structures such as muscles, connective tissue, ligaments, joints, or nerves become overloaded, irritated, or in rarer cases, damaged. Up to 80% of all adult Danes will experience back pain at some point in their lives, but for most, the pain subsides within a few weeks.

The causes are complex and multifactorial. They can range from a single awkward movement, such as a heavy lift with a twist, to more gradually occurring discomfort from sedentary work, inactivity, or unaccustomed physical strains. Psychosocial factors such as stress, lack of sleep, and general malaise also play a significant role, as they can increase muscle tension and our general sensitivity to pain. It is important to remember that the back is fundamentally a strong and robust structure, designed to move.

Non-Specific vs. Specific Back Pain: Know the Difference

It is crucial to distinguish between two general types of back pain to understand the correct approach. The vast majority of cases fall into the first category.

Non-specific lower back pain

Non-specific back pain, which accounts for about 90-95% of all cases, has no clear and identifiable medical cause such as a slipped disc or a fracture. While it can be frustrating not to have a precise diagnosis, it is actually a good sign. It means there are no signs of serious injury or disease in the back. The pain typically stems from a combination of factors such as muscle tension, ligament overload, or irritation of the small joints in the spine (facet joints). These pains are often functional and significantly improve with movement and time.

Specific back pain

Specific back pain is caused by a demonstrable pathology, meaning a concrete injury or disease that can be identified by a medical examination and possibly imaging diagnostics such as an MRI scan. This category accounts for only a small fraction of cases and may include:

• Slipped disc (herniated disc): Where the soft core of one of the spine's cartilaginous discs (disc) is pushed out and presses on a nerve. Often causes radiating pain, sensory disturbances, or reduced strength in a leg.
• Spinal stenosis: Narrowing of the spinal canal, which compresses the nerves. Symptoms often worsen with walking and are relieved by sitting down or bending forward.
• Osteoarthritis (spondylosis/facet joint arthrosis): Age-related changes in the spine's joints and discs, which can cause stiffness and pain.
• Fracture: Often as a result of trauma (fall) or osteoporosis.

These conditions require thorough medical investigation and a specific treatment plan.

Red Flags: When to See a Doctor Immediately?

Although most back pain is harmless, you should always seek urgent medical attention if you experience so-called 'red flags'. These symptoms can indicate a serious underlying condition that requires immediate action. Be aware of the following:

• Problems with bladder or bowel control: If you suddenly cannot hold urine/feces or have difficulty passing them.
• Numbness in the groin area: Loss of sensation in the area around the anus and genitals ('saddle area').
• Sudden and significant loss of strength: If you experience sudden weakness or paralysis in one or both legs.
• Occurred after severe trauma: Pain after, for example, a fall from height or a traffic accident.
• Constant pain that is not relieved by change of position: Pain that is equally severe, whether you are lying, sitting, or standing.
• Accompanying symptoms: Concurrent unexplained fever, weight loss, or general feeling of illness.

If you experience one or more of these symptoms, contact your doctor or an emergency medical service immediately.

Myths about Back Pain: Is your back really 'crooked'?

The notion of a 'crooked back', 'poor posture', or a small leg length difference as the primary cause of pain is a persistent myth. The truth is that our bodies are rarely perfectly symmetrical, and research has not been able to demonstrate a direct correlation between these small asymmetries and the development of non-specific back pain. Focusing on achieving a 'perfect' static posture can even be counterproductive, as it can create unnecessary worry and fear of movement.

Modern pain science emphasizes that the best posture is your next posture. It's about variation and movement. The back is an incredibly strong and adaptable structure that thrives on being used. Treating it as fragile and vulnerable can worsen the pain experience and lead to avoidance behavior, which ultimately weakens the back.

Movement is the Best Medicine: How to Get Started

The most effective and evidence-based method for managing most non-specific back pain is to stay active. Previously, bed rest was recommended, but today we know that it often worsens and prolongs the pain course, as inactivity weakens muscles and stiffens the back. The goal is to break the pain spiral by gradually resuming normal activities.

• Start gently: Begin with short walks several times a day. Movement stimulates blood circulation and 'lubricates' the joints.
• Gentle exercises: Simple mobility exercises like 'cat/camel', where you alternately arch and round your back on all fours, or gentle knee-to-chest stretches can relieve stiffness.
• Listen to your body: It is normal to feel some soreness when you start moving again. Work within an acceptable pain threshold. The principle is 'movement with caution', not 'pain at any cost'.
• Strengthen your back and core: Once the worst pain has subsided, it is a good idea to start specific exercises that strengthen the muscles around your back and abdomen (your 'core'). A strong core acts as a natural corset that supports and stabilizes your spine.

Relief in Everyday Life: Heat, Massage, and Support

While movement is key to long-term recovery, heat, massage, and periodic support can provide effective, temporary pain relief. These methods can help to alleviate symptoms, making it easier for you to stay active.

The soothing effect of heat

Heat therapy is a well-known method for relieving muscle soreness. Heat increases blood flow to the painful area, which can help relax tense muscles and remove waste products. It also has a pain-reducing effect by 'distracting' the nervous system. A warm bath, a hot water bottle, or a heating pad can provide noticeable relief.

The role of massage in pain relief

Massage can be an extremely effective method for releasing muscle tension that often arises as a reaction to pain. By working on sore muscles, massage can reduce pain, increase mobility, and promote a sense of relaxation. Touch can also stimulate the release of the body's own painkillers, endorphins. For targeted relief of specific muscle knots, a MassageGun X can be a practical tool, allowing you to apply deep, pulsating massage exactly where you feel the soreness.

The importance of relaxation and support

During periods of acute pain, support can be beneficial. An advanced massage chair like our Pharaoh Neo, which we offer as an official partner for Body Friend, can provide such a break. With its advanced body scanning and specialized back programs, it can deliver a deep massage that relaxes the entire back and lower back. Features like the 'Zero Gravity' position completely relieve the spine of the body's weight, which can provide an immediate feeling of relief and a much-needed respite from the pain. This should be seen as a supplement to active treatment – a tool for comfort and well-being that can make it easier to get through difficult days.

Conclusion

Back pain is a complex and individual experience, but for the vast majority, it is fortunately harmless and temporary. The key to managing it is knowledge: understand that your back is strong, drop the myths about 'poor posture', and recognize movement as your most important ally. Supplement with soothing methods like heat and massage to manage symptoms and improve your quality of life. By taking an active role, you can in most cases safely guide your back back on track.

Would you like to experience for yourself how targeted massage and optimal support can contribute to your daily well-being? You are welcome to visit one of our over 20 showrooms in Europe or explore our selection of advanced massage chairs on our website.

Sources

• Sundhed.dk. "Acute Low Back Pain - Lumbar Pain." Accessed via: [https://www.sundhed.dk/borger/patienthaandbogen/knogler-muskler-og-led/sygdomme/rygsoejle-og-rygmarv/ondt-i-laenden-akut-laendesmerter/]
• Gigtforeningen. "Lower Back Pain." Accessed via: [https://www.gigtforeningen.dk/viden-om-sygdom/ryg/smerter-i-laenden/]
• World Health Organization (WHO). "Low back pain." Fact sheet, 2023. Accessed via: [https://www.who.int/news-room/fact-sheets/detail/low-back-pain]
• Kumar, S., Beaton, K., & Hughes, T. (2013). "The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews." International journal of general medicine, 6, 733–741. Accessed via: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3772691/]

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Disclaimer: The information in this article is for general information only and should not be construed as medical advice. Always contact your doctor or an authorized healthcare professional for a personal assessment and guidance regarding your symptoms.