Why Does My Lower Back Keep Hurting?
Understanding Back Pain
If you want to know why your lower back keeps hurting you’ve come to the right place. The information you find here will not only help you understand why your pain persists, but it will also help you recognize what you can do to reduce and eliminate it. Right now you may be experiencing lots of back pain and are very limited in the activities that you can participate in. The goal is to reverse that and get back to enjoying all those things you want to do with little or no pain. This goal is achievable, but to do so, you must first understand the nature of injury. This article will help you do that.
When you suffer an injury to your body, there is an injury response that is necessary in order to begin to heal the tissues that have been torn. This is true whether you injure your leg, your shoulder, or your low back. While necessary, this injury response does, however, result in significant changes to the soft tissues in the area of injury. The changes that occur to those tissues include stiffness, weakness, and deconditioning. The extent of these changes depends primarily upon the severity of your injury, but in those who suffer from long-standing low back pain, these changes are quite dramatic. It is imperative that you deal with and address these issues if you want to make any significant improvement in your back pain condition.
This article will discuss four very important concepts about the nature of injury. Understanding these concepts will go a long way in helping you eliminate your lower back pain. These four concepts are: 1) Stiffness; 2) Weakness; 3) Deconditioning; and 4) Injury Threshold. So, if you find yourself asking the question “Why does my lower back keep hurting?” and you want to finally do something about it, then keep reading. If you want to become well again you have to do what it takes to correct these problems. So let’s get started!
Stiffness
First, I’d like to spend some time talking about the issue of stiffness. Whenever tissue in your body is torn, the way that your body begins to repair this torn tissue is by laying in a substance called collagen, which is essentially scar tissue. Your body has an amazing and well-equipped injury response and once tissue is torn it sends healing cells to the area of injury. Some of those healing cells are called fibroblasts and it is these fibroblasts that begin laying in the collagen (scar tissue) to mend what has been torn. But the big problem with scar tissue is that it is incredibly stiff tissue. It is not nice and stretchy like a rubber band but instead is very stiff and unforgiving. Let’s think of healthy back tissues like a rubber band. If you take a rubber band between the thumb and index fingers of both hands and begin pulling your hands apart, the rubber band stretches easily with this movement.
Now let’s replace that rubber band with a piece of paper and begin pulling your hands apart. What occurs after a very short movement is that the paper tears rather than stretching.
This is similar to what occurs in your back after you’ve had an injury. Your body has laid in a significant amount of scar tissue to mend what has been torn, so the tissues in your back are now no longer stretchy like a rubber band, but instead, are stiff like the paper. So with simple movements like bending down to tie your shoe, instead of your back tissues stretching like a rubber band they tear like the piece of paper. This causes additional injury and leads to increased pain, increased inflammation, and increased scar formation. This makes your back stiffer and stiffer as more scarring takes place. It’s like a snowball rolling down a hill that just continues to grow and grow. As your back gets stiffer and stiffer, your injury threshold becomes lower and lower. With time, you seem to be able to do less and less while you experience increasing pain. Is there a solution to stopping this snowball? The good news is that there is indeed a way to make a change.
Scar tissue itself is very disorganized in its structure. If you look at it under a microscope it looks like nothing but a rats nest, with no organization or alignment of the fibers.
But the interesting thing about scar tissue is that, if you put all of the right stresses on the tissue, it has an amazing ability to remodel and become normal tissue again. With the right stretching program, over time that scar tissue will remodel and become more normal tissue again.
It’s important to understand, however, that this process takes time and doesn’t happen overnight. So first, you have to be very consistent with a daily stretching program, and second, you have to be very patient with the process as it takes many months for these changes to occur.
Weakness
The next thing that I would like to talk to you about is the concept of muscle weakness. Muscular atrophy refers to the process of a muscle or muscles becoming both smaller in size and weaker in strength. After a significant injury, one of your body’s natural responses to the injury is to undergo this process called muscular atrophy. It doesn’t matter what part of your body is injured. Whether its an injury to your leg, your knee, your shoulder, your arm, or your back it makes no difference. Following an injury, the muscles in that area of injury undergo significant atrophy. And one of the biggest problems with muscle atrophy is that when a muscle is smaller and weaker, it can be injured much more easily. Its injury threshold is dramatically decreased.
Its important to understand that some of the largest and strongest muscles in your body are located in your back. Strong, healthy muscles are needed in your back because it is one of the highest stress areas of your body. So as we have learned, when the muscles in your back are injured they undergo significant atrophy. These muscles are now much weaker and can no longer tolerate the stress and strain of daily activities. Because their injury threshold is now so low, the weak back muscles are constantly being reinjured no matter what you do. Activities that once were no problem at all, and well below the injury threshold of your previously healthy back, now exceed the injury threshold of your weak back muscles so that these muscles are now being repeatedly injured and aggravated by those activities. The key to improving your back pain, therefore, is to raise the injury threshold of your back muscles by making them stronger and stronger through proper exercises.
One other important thing to understand about muscular atrophy is that while atrophy occurs very quickly and dramatically following an injury, it takes a long, long time to rebuild the size and strength of the injured muscles. It is not something that occurs in a matter of a few weeks. And it certainly won’t occur at all on its own. It takes months and months of consistent and regular participation in a structured strengthening program to make your muscles as strong, or stronger, then they were before your injury or your back pain condition occurred.
Deconditioning
The third concept that I would like to discuss with you is the issue of deconditioning. What often occurs after you injure your back is an extended, prolonged period of inactivity. This occurs either because you are told by your doctor not to do anything if it hurts, or because you just don’t know what you’re supposed to do. So after the onset of your back pain, you spend weeks, months, and more sitting around doing almost nothing. As a result, you might gain weight, you lose muscle definition, your aerobic fitness level drops, and perhaps you start feeling depressed. This is what is known as deconditioning syndrome. This syndrome ends up affecting nearly all the systems in the body. Your heart, your lungs, your muscles and bones, your digestion, and your emotional state are all impacted. Unfortunately, developing deconditioning syndrome is almost a certain setup for reinjury. This reinjury might be to your back, or it might be to a completely different part of your body. The reason for this is because of significant reduction in the injury threshold of not just your injured back but to all of the tissues in your body.
The good news is that by recognizing the existence of deconditioning syndrome, you can be prepared to deal with it. The key is developing an exercise plan around your injury, in this case, your low back pain condition. It is absolutely vital that you participate in a non-impact aerobic fitness program even though you continue to experience back pain symptoms. This non-impact aerobic fitness exercise might include stationary bicycling, a swimming/water aerobics program, or brisk walking on an elliptical trainer or treadmill. The purpose of this program is to improve and maintain your cardiovascular fitness, and to prevent a dramatic decline in the injury threshold of the other tissues in your body. A consistent exercise program will also help you maintain a more ideal body weight and help prevent the onset of depression that can accompany injury and prolonged pain.
Injury Threshold
Finally, let’s talk about the concept of injury threshold. When you injure the tissues in your back it is because you have exceeded the injury threshold of that tissue. When this happens the tissue tears. Every tissue in your body has a certain level of ability to tolerate stress and strain without injury to the tissue. This certain level is considered the injury threshold of that tissue. Any activity below this threshold will not result in any type of injury to the tissue.
If the stress of an activity exceeds this threshold, the tissue will fail and tear and injury will occur. The extent of the tearing and the extent of the injury is based upon how far above the injury threshold the stress goes. The farther beyond the threshold, the greater the injury.
In healthy, resilient tissue the injury threshold is very high, meaning it takes a lot of force to injure the tissue. The reason that professional athletes train so vigorously is to improve the health of their tissues and raise the injury threshold so that they can tolerate the rigors of professional sports. When people are inactive and sedentary, the injury threshold of their tissues drops significantly and they are much more susceptible to injury. Similarly, following any type of injury, there is also a significant drop in the injury threshold of the tissues in the area that has been injured.
This drop in the injury threshold is the direct result of the 3 significant changes that have occurred to the injured tissues. With injury to your back, the tissues become stiff, weak, and deconditioned. As we have learned, stiff, weak, deconditioned tissue doesn’t do well at all. The injury threshold of your back becomes so low that it takes next to nothing to reinjure it. As little as bending down to tie your shoe the wrong way can retear the tissues in your back. This results in not only significant increased pain and muscle spasm but also more stiffness, weakness, and deconditioning. This, in turn, leads to an even lower injury threshold. It’s just a never-ending vicious cycle. The problem just grows and grows and before you know it you’re dealing with horrible chronic pain and you’re no longer able to do any of the things you want to do. That’s because your low back is now so stiff, weak, and deconditioned that your injury threshold is rock bottom. But there is a way out. Addressing the issues of stiffness, weakness, and deconditioning is the key to healing and recovery. If you want to become well again you have to do what it takes to correct these problems. The rehabilitation exercise program that you will find on this website is your pathway to recovery. It will restore the elasticity to your tissues, restrengthen your muscles, recondition your body, and raise your injury threshold. This will restore the health to your tissues and allow you to return to all those activities that you want to do with little or no back pain.
Final Comments
Really the best thing you can do for yourself when dealing with your low back pain is to think of yourself like a professional athlete. What does every single professional athlete do after they have been injured? They rehabilitate their injury and the program starts almost immediately. They participate in an extensive and prolonged rehabilitation exercise program in order to restore the elasticity to their injured tissues and make the muscles in the area of injury as strong, or stronger, than they were before the injury. Some athletic injuries are serious enough that the athlete is out of competition for the rest of the season. But that whole time they are out, they are rehabilitating like crazy. If they didn’t do that, and they just sat around and waited for the injury to get better on its own, they would never play again. And if they tried to play without going through the proper rehab program, they would immediately injure themselves again, and probably worse than they did the first time. That’s because without proper rehabilitation the tissues remain stiff, weak, and deconditioned and the injury threshold remains very low. Sitting around and doing nothing never happens with injured athletes and it should never happen with you. You have the ability to restore the elasticity to your tissues, to regain the strength of your muscles, to recondition your body, and to dramatically raise the injury threshold of your injured back.
Right now you may be at a place where you are in a significant amount of pain and you are unable to do many of the things that you enjoy and want to do in life. Your goal is to reverse that and return to doing all of the things that you want to do with little or no pain. The only way to reverse that is through a proper rehabilitation exercise program. There is no medication that will do that, there are no injections that will do that, there are no surgeries that will do that. The only way to restore the health to your tissues and to your body is through proper exercise. You can do it! You just need to get started, stay consistent, and remain patient. It takes a long time to raise the injury threshold of your tissues. But stick with it and that change will come!