Don’t just treat low back pain. Outsmart it.

Low back pain is the most common muscle and joint complaint among U.S. adults. Those who’ve experienced it keenly understand how frustrating it can be. When your back hurts, it’s common to feel pain with just about everything, including sitting, standing, walking, sleeping and moving in general. 

And, when everything hurts, it’s normal for worry to set in. If it hurts to move, logic says you should just stay still. But the unfortunate truth is that most of the time, being immobile makes things worse. Or maybe you take the opposite approach – go on about your daily life and try to ignore the pain. But that doesn’t work either. In fact, the activities of your daily life probably contributed to developing back pain in the first place, so you might be making the problem worse by just pushing on.

So, is there no good solution to low back pain? Resting doesn’t work, and pushing through doesn’t work either – so what does? 

Overcoming back pain starts with understanding it.

There are many types of back injuries, and everyone is a little different. So, unfortunately, there’s no one-size-fits-all approach to relieving back pain. But, one thing that’s true for everyone is that it’s not usually enough just to treat back pain symptoms. You have to have a deeper understanding of what contributes to low back pain to get long-term relief.

Back pain can cause a lot of fear and worry. But, suppose you understand why your back hurts, what’s contributing to it, how to identify a problem before it gets worse and how to keep it under control. Imagine truly having power over your back pain — isn’t that what we all really want?

Let’s review five universal truths that may help you understand why your back behaves the way it does so you can take control of your back health.

1. The anatomy of your back is complicated.

The lower back is made up of five lumbar vertebrae. At each of the five levels, there are multiple places where bones come together to allow movement, also known as joints. Each of these joints moves anytime you bend or twist. Between each vertebra, you also have a “disc.” The disc’s job is to absorb shock and provide a cushion for the spine. 

Injuries to the discs are common – ever heard someone say they have a “slipped” or “herniated” disc? This type of injury happens when the disc material gets pushed out, irritating the surrounding nerves. Because of the complex anatomy of your back, several different structures can be injured. And to complicate matters further, sometimes back pain is felt in the low back, but other times, it can travel down one leg, also known as “sciatica.” 

Of course, you can’t necessarily do anything about the structure of your back. But understanding the basic anatomy can take some of the mystery out of your pain. The human body has a remarkable ability to heal and adjust. So, no matter what’s injured, the chances of recovery are high. Even if an X-Ray or MRI shows arthritis, disc herniation or other scary-sounding things — pictures never tell the whole story. 

2. Your back pain is rarely as bad as it feels.

Pain is a way for your body to sound the alarm that something isn’t right. This self-preservation technique is designed to get your attention so you can make adjustments to allow for healing. The body’s alarm system is often louder than necessary. So even if you are having bad pain, it could be an overzealous warning, and it doesn’t always mean your back is in bad shape. 

Knowing how pain behaves can alleviate stress and worry. The body’s tendency to overreact can be alarming, but knowing this is normal can calm your fears. You may also consider trying breathing exercises and meditation techniques to quiet the body’s alarm system and reduce pain. 

3. Strength matters. 

With almost every movement you make, your lower back joints are moving too.  And because it has so many little joints, the low back allows for a lot of movement. When working like a well-oiled machine, the muscles and joints of the body will work together to allow pain-free movement. But as soon as one of the muscles gets weak, other body parts can start to pick up the slack. This often happens with the low back, especially when you don’t have good core or leg strength.

The flexibility and movement that the low back allows are good when coupled with strength and stability. Ever wonder how gymnasts can be so flexible without getting injured? It’s because they are also extremely strong, which helps protect their body in extremes of motion. 

Maintaining strength in your core, low back and leg muscles is key to ensuring that your back’s movement is “checked” and you’re protected. It’s important to keep the other muscles of your body strong, so your back doesn’t have to pick up the slack. Also, be mindful of your body mechanics when lifting and bending over. Using your legs by squatting or hinging at your hips can help keep your spine straight and reduce the risk of excessive stress on the back. 

4. Your back bends forward all the time.

Did you know that the average person bends forward – as in touching your toes or tying your shoes – more than 2,000 times per day? The low back can bend, extend and rotate but most of the stress we place on it daily is forward bending. Not to mention that sitting all day is also considered bending because your spine is flexed, as opposed to being straight as it is when you are standing.

Bending in only one direction is not good for any joint in your body. Think about your elbow — ever fallen asleep with your elbow bent up underneath you? When you wake up in the morning, it might feel like your elbow will never fully straighten again. Of course, it loosens up with time, and you go back to normal. Still, if you spent your day only bending your elbow and never straightening it, it would start to get stiff and painful.

Aim for more balanced movement in your back. Think about the position your back is in when making your bed, putting on your pants and shoes, doing laundry, loading the dishwasher and cleaning your house. Most of our daily activities require us to bend forward repeatedly. So, while you don’t have to quit all of your housework and yardwork, make an effort to take breaks to stretch, straighten your back and even gently bend backward. More balanced movement in your low back can reduce the stress on your joints and discs. 

5. Your back injury wasn’t caused by just one movement.

Unless you had a traumatic injury, you can’t blame your back pain on just one movement. Many people injure their back when trying to lift something heavy. But, just as many people hurt their back doing something super unexciting like picking up a piece of trash from the floor or bending over to wash their face. Rather than blame that final movement for your pain, understand that it was likely just the “straw that broke the camel’s back.” 

Don’t worry. Just as you are not a camel, your back isn’t actually broken. The point is that something was likely going on before that final movement that made you vulnerable to injury. Sometimes, if you think about it, you may be able to recall subtle signs that something wasn’t quite right before that last straw. Blaming your back pain on just one thing is dangerous because you may not consider all the factors that contributed to it, making re-injury very likely.

Look for the signs of a low back problem and try to address it before it gets bad. Subtle signs of irritation in the low back include muscle tightness, stiffness, especially with moving from sitting to standing, and the inability to get comfortable on cushiony surfaces like your couch. Catching these early signs allows you to work on balancing out your spinal movements, performing exercises to strengthen your muscles or simply being more mindful of your activities.

Knowledge is power.

Understanding your back pain is the key to recovery and avoiding the classic back pain re-injury cycle many people fall into. This cycle usually consists of “throwing out” your back, being laid up with pain, slowly getting better, being ok but cautious for a few months and then repeating the whole cycle. Being trapped in this cycle disrupts your physical and mental health because it can feel like your back is a ticking timebomb just waiting to explode.

Understanding the basics of back pain, in general, can help tremendously. Still, unique aspects of your life or health may contribute to your back pain. Talking to an expert and getting a personalized plan can help you maximize your recovery and get to the bottom of your condition.

Try RecoveryOne for back pain. 

RecoveryOne’s experts can help you understand your back pain and get on a personalized program that will help you strengthen weak muscles, improve your mobility and, most importantly, give you the confidence you need to take control of your back pain.

About the Author:

Written by Dr. Jess Cobb, PT, DPT. Jess is a licensed physical therapist with over six years of clinical experience in orthopedics. Jess is also a writer, educator and member of RecoveryOne’s marketing team. She’s passionate about helping people better understand their pain, manage their musculoskeletal conditions and confidently get back to the activities they love

Why you shouldn’t let your back, joint and muscle pain go untreated.

Pain is one of the most common reasons that people seek medical care. But, for most of us, it can take persistent or worsening symptoms to finally admit that it’s time to do something about it. Many of us won’t even consider a trip to the doctor or other professional until the pain starts to impact our favorite activities, day-to-day lives, work or other obligations.

But what happens when pain goes untreated? Is it really a big deal to let it linger while you wait to see if it’ll go away on its own? Surprisingly, yes — while it may not seem like a problem to ignore back, joint or muscle pain for a while, it could make it even harder to get rid of and even make your symptoms more severe. This may be both surprising and concerning because so many of us have a habit of putting off treatment for nagging aches and pains. September is National Pain Awareness Month and we’re diving deeper into all things pain, including what it is, how prevalent it is, the science behind it and why getting early treatment is crucial to avoiding complications.  

So why is ignoring pain a bigger problem than we thought? Well, pain comes in many forms, and research shows that it’s actually quite complex. In fact, a whole field known as pain science has grown out of the study and management of pain. When pain lingers, science indicates that it can become more complicated and even more ingrained in both our physical and mental health.

So, what is pain?

The International Association for the Study of Pain defines it as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” According to this definition, pain isn’t just physical; it’s a genuine sensation that can result from your emotional circumstances. The other interesting part of this definition is that pain can be associated with actual or potential tissue damage.

Naturally, we can understand how pain is associated with actual tissue damage — you stub your toe on a piece of furniture, the tissues on your toe briefly get injured, and you feel a familiar pain. But does this definition imply that you can also experience pain at the mere thought of stubbing your toe on a piece of furniture? You may be wondering how “potential tissue damage” can cause pain — stay tuned as we explore this phenomenon.

Nearly 50% of Americans are dealing with musculoskeletal pain.

Many conditions cause people to experience pain, but musculoskeletal conditions like back, joint and muscle injuries are the most common cause of pain and disability in the United States. In fact, an estimated 1 in 2 Americans over 18 suffer from musculoskeletal conditions likely accompanied by pain.

What actually causes us to feel pain?

The answer to this question is not always clear. For years, scientists and medical professionals thought that pain had to be directly linked to actual tissue damage. But recent research has found that tissue damage and pain don’t always go hand-in-hand. We can experience pain without any tissue damage at all. 

Consider this head-scratcher of an example that is quite famous in the world of pain science — a study, originally published in the British Journal of Medicine in 1995, details the case of a builder that accidentally stepped on a large nail that went straight through his boot. His pain reaction was immediate, severe and obvious to his fellow workers and emergency medical professionals. But when he got to the hospital, and medical staff began to evaluate his injury, they found that the nail had gone between his toes and hadn’t pierced his foot at all. 

So how could he have felt so much pain without an actual injury? This is where the experience of pain gets very interesting. Research suggests that many factors beyond actual tissue damage can influence an individual’s experience of pain, including biological mechanisms, pain sensitivity, past personal experiences with pain and emotions. 

The difference between acute, subacute and chronic pain.

When pain first starts, it’s known as acute pain, which simply means that its only been present for a short time, usually no more than a few days. After these first few days, the pain or injury can be classified as subacute for a couple of weeks to months. With minor back, joint and muscle injuries, the subacute phase is often when most of the healing happens, and you start to feel better. But if the pain doesn’t begin to subside during this time, you risk developing chronic pain. 

Chronic pain is defined as pain lasting more than three months. When an injury or pain becomes chronic, it can start to have a long-term impact on your overall health and become more difficult to treat. Chronic conditions can be tough to cope with and are often complicated by other symptoms like anxiety, depression, difficulty sleeping and generalized fatigue. Another big difference between chronic and acute pain is the concept of pain sensitization. 

When you experience pain for a long time, your brain and spinal cord can develop a heightened sense of threat known as sensitization. When sensitized, your body can become overreactive to even the smallest stimulation, distorting your pain perception. In other words, things that wouldn’t usually be painful, now are because your body has become overly sensitive.

Untreated pain can become chronic and complicated.

When pain becomes chronic, you’re more likely to experience sensitization and mental health symptoms that complicate pain presentation and treatment. So, what was once a straightforward pain response related to tissue damage becomes an entangled web of physiological and psychological factors that all need to be addressed for meaningful, long-term relief.

None of this information is meant to scare you or make you run out to the doctor whenever you have the slightest pain. Sometimes a pain response is a good thing; it can be our body’s way of warning us and protecting us from further tissue damage. And some things in life just hurt for a short time, like stubbing your toe, bumping your funny bone or burning your hand on the stove. With these injuries, this tissue damage is obvious and barring any complications, the pain subsides as the tissue repairs itself. 

Pain is a bigger cause for concern when the reason for it is unclear, or it doesn’t get better even after the tissues have healed. If you have a new back, joint or muscle injury and your pain isn’t consistently improving after a couple of days to weeks, getting early treatment can help you heal faster and prevent it from becoming chronic or coming back in the future.

But what if you already have chronic pain or pain lasting more than three months? Is it a lost cause? Absolutely not. Chronic pain is treatable but usually requires a more comprehensive approach. Working with professionals to help you begin addressing the physical, mental and behavioral aspects of your pain is a great way to tackle a chronic back or joint condition.

RecoveryOne can help.

Online back and joint care from RecoveryOne is designed to help ease pain and get to the root cause. With over 200 research-based recovery programs, RecoveryOne offers solutions for the various types and stages of back, joint and muscle pain. So whether you have a new injury or you’ve had pain for a while, RecoveryOne likely has a personalized program that is right for you. 

RecoveryOne’s programs can help you expedite the healing process for acute and subacute injuries so you can start feeling better faster. Getting early treatment can help you avoid chronic pain and limit the impact an injury has on your life. RecoveryOne also offers professional support with certified health coaches and our physical therapist support team. For chronic pain, RecoveryOne’s multidisciplinary approach, including health coaching, professional advice and personalized exercise therapy, can help you uncomplicate your pain and get on a path to a healthier you.

And, the best part — for eligible members, RecoveryOne is available at no additional cost and can be conveniently done from the comfort of home. To get started, check to see if you’re covered today.

About the Author:

Written by Dr. Jess Cobb, PT, DPT. Jess is a licensed physical therapist with over six years of clinical experience in orthopedics. Jess is also a writer, educator and member of RecoveryOne’s marketing team. She’s passionate about helping people better understand their pain, manage their musculoskeletal conditions and confidently get back to the activities they love

Arthritis risk increases with age, but joint pain doesn’t have to

Many people think joint pain and arthritis are inevitable in aging. For this reason, being told you have arthritis can feel a little bit like a lost cause. But what if it’s not? Read on to explore available arthritis treatment options, debunk a few arthritis myths and learn why you may not be able to blame your joint pain on old age anymore.

What is arthritis?

Arthritis is pain, stiffness or swelling in the joints. A joint is a part of the body where bones come together to allow movement. There are over 300 joints in the human body. Most of the body’s major joints have cartilage, a cushion-like structure between the bones that promotes smooth movement and prevents friction. Arthritis can cause damage to the bones and cartilage within the joint. 

According to the Centers for Disease Control (CDC), in 2015, over 23% of adults in the U.S. were diagnosed with some form of arthritis. By 2040, the CDC projects that this number will increase to nearly 26% of U.S. adults. And these statistics reflect only adults who have been to their doctor for a formal diagnosis – the number of U.S. adults with arthritis is likely to be even higher.  

To complicate things further, there are over 100 different arthritis-related joint conditions, the most common being osteoarthritis (OA). According to the CDC, OA affects over 32 million Americans, is a leading cause of disability and was the second most costly condition treated in U.S. hospitals in 2013. It’s the most common cause of joint pain and the type of arthritis most people are familiar with. 

OA is associated with general wear and tear of the joint, which happens more as you get older. It’s also possible for OA to come on earlier in life because of a previous injury. With OA, the joint’s cartilage can break down over time, causing swelling, pain and damage to the bone surfaces. When the cartilage wears down enough, the bones can rub on each other — hence the phrase “bone-on-bone” that many people use when describing arthritis. OA is very common in weight-bearing joints and joints that allow a lot of movement, including the neck, back, hands, knees, hips and feet.

Good news: everyone ages, but not everyone has joint pain.

The risk of developing OA increases as you age. But we all get older, so why do some people have more arthritis than others? And, why do some lucky people manage to avoid joint pain altogether?

Research suggests that aging is just one of many factors contributing to arthritis and joint pain. There is no question that your muscles and joints change as you get older. But the human body has an amazing ability to adjust and restore balance to reduce the impact of these age-related changes. So it is possible to have minimal joint damage when you get older if you give your body the care it needs to make those adjustments.

It is also possible to have signs of arthritis (as seen on imaging like an X-Ray or MRI) and not have any joint pain. One study published in the British Journal of Medicine found that 43% of people over 40 had obvious knee joint or cartilage damage on imaging without any reported knee pain or injury. This number increased to almost 75% for individuals over 70. Other studies have found similar outcomes for the spine and hip. 

So, as expected, more people get arthritis as they get older – but not everyone does. And more importantly, even when imaging shows arthritis in a joint, many people still have no pain. 

So, if getting old doesn’t necessarily cause joint pain, what does?

Genetics. You may be more likely to get painful arthritis if it runs in your family.

Previous injury or surgery. Injuries in your youth can show up again as you get older. This is particularly true for major joint injuries or previous surgeries, which can contribute to early-onset or more severe OA.

Obesity. Being overweight or obese increases your risk of arthritis and joint pain. Additional body weight places increased strain and stress on the joints.

Weakness. The muscles surrounding your joints work to stabilize them. So, muscle weakness can cause your joints to become unstable, causing more strain and increasing your risk of injury and arthritis.

Poor mobility. Arthritis can cause swelling, stiffness and reduced range of motion in your joints. Often, this increased stiffness is a protective reaction by the body to reduce the risk of injury. A stiff joint experiences stress differently and often develops further irritation and joint damage.

More good news: Joint pain can get better.

One of the reasons arthritis is so defeating is because it seems like nothing can be done about it. But now we know that it’s possible to have arthritis and NOT have joint pain. So, you may not be able to get rid of your arthritis, but you can decrease your joint pain. 

Here are some things you can try:

  1. Be active: Moving can help reduce joint stiffness and improve physical health.
  2. Physical therapy (PT): PT can help by addressing some of the major factors contributing to joint pain, including swelling, weakness, joint stiffness and poor postural habits.
  3. Weight loss: losing weight can help reduce the strain on your joints.
  4. Medications: over-the-counter anti-inflammatories, medicated creams and other prescription medications can help reduce joint pain symptoms.
  5. Supportive devices: using a cane, walker, brace, or other devices can help reduce joint stress, improve your stability and reduce pain.
  6. Surgery: total joint replacement surgery can remove the damaged joint and decrease pain.

RecoveryOne for joint pain

Just because you have arthritis doesn’t mean you have to live with pain. But if you do have pain, resist the urge to simply blame it on old age. Chances are that there are other factors at play. RecoveryOne offers convenient, online physical therapy with proven exercise programs and 1-on-1 health coaching to help address these contributing factors and get you on the right path to recovery.

RecoveryOne’s joint care programs are designed to help you get stronger, increase your mobility and help you get back to the things you love. Start by talking to a licensed physical therapist to better understand your unique condition and figure out which program is the right fit for your joint pain. And, because you can do RecoveryOne entirely online, you’ll be able to fit exercises into your schedule and make your program work for your lifestyle. 

About the Author: 

Written by Dr. Jess Cobb, PT, DPT. Jess is a licensed physical therapist with over six years of clinical experience in orthopedics. Jess is also a writer, educator and member of RecoveryOne’s marketing team. She’s passionate about helping people better understand their pain, manage their musculoskeletal conditions and confidently get back to the activities they love!