Back Pain: Causes and Prevention 13 Jan 2008

By Fitness Expert Nash Jocic

Back pain is probably one the most common self-inflicted conditions that troubles millions of people on a regular basis. It is important to remember that the majority of back problems, both acute and chronic, are self-inflicted and usually caused by long-term bad habits in nutrition and/or physical conditions. Inactivity, bad posture, over exposure and over use of the back muscles, incorrect back movements, obesity, and poor nutrition are some of the major factors that contribute to back pain. Over a period of time, these factors disturb the synergy of the bodily systems and the synergy within the muscular system.

As is often the case, major health problems arise from a poor lifestyle. The way that we eat, walk, exercise, think, understand the world around and inside of us (our mental state, our beliefs, our preferred sources of information, etc.), establish our life style. And that lifestyle creates a consistent living environment even for our backs. If we are suffering from back pain or any problems in this area of the body, the message should be clear: our lifestyle needs tuning.

Back pain usually comes as a consequence of accumulated strain or injury over a certain period of time. Constant abuse of the parts of the back or the whole area creates a spasm in some muscles or inflammation of connective tissues that manifests itself as back pain.

Before we look into actual reasons for particular back problems, let’s first understand what the back consists of and how the back functions.

The back is a complex structure and consists of these elements:

- Spine
- Connective tissues
- Muscles
- Nerves 

All of these tissues have to work in synergy, and that means they have to be developed and maintained in a certain, rather perfect balance.

The spine itself is made of 33 vertebrae, plus the spinal cord and shock absorbing disks. Ligaments hold the vertebrae and discs together. Tendons connect muscles to the vertebrae. Muscles support and move the whole spine structure by being connected with the vertebrae. Nerves are mainly concentrated in the spinal cord although they reach out from the spinal cord to the rest of the body.

Inflammation of the soft tissues (nerves, connective tissues and muscles) and/or deformities of the bone structure are usually caused by long-term muscular imbalance. Muscular imbalance means that some of the crucial supporting muscles of the spine are weaker than the others, therefore disabling the stability of the spine. Depending on their location, muscles that are out of balance can cause different deviations of the spine that can result in serious back conditions. Although all the muscle groups on the body are of great importance, when it comes to a healthy and pain-free back, we must draw attention this time to the muscles that are directly involved in moving and supporting the spine. They are:

The abdominal muscles
The paravertebral muscles
The psoas muscle
The gluteus and
The ischiotibial muscles

ABDOMINAL MUSCLES extend from the lower margin of the ribs to the upper pelvis, protecting inner organs. When the front portion of the abdominal wall “anterior rectus” contracts, they bring ribs near the pelvis frontward, bending the spine forward. The abdominal muscles placed on the lateral portion of the trunk are called “oblique” and “transverses”.  

PARAVERTEBRAL MUSCLES extend throughout the back of the trunk. They unite the posterior lower portion of the ribs with the pelvis, and attach vertebrae one on top of the other, and then with the scapula.

PSOAS MUSCLES extend from the last thoracic vertebrae along the five lumbar vertebrae to the thigh, crossing the pelvic region. When contracting, the leg is brought forward near the vertebrae until the chest touches the knee. When flexing the spine forward, the psoas is more efficient than abdominal muscles, in terms of movement.;

GLUTEUS MUSCLES extend from to pelvis to the posterior part of femur, forming the buttocks. When contracting they pull the leg backwards and outward. The gluteus and other pelvic muscles, such as the pyramidial, maintain a dynamic tension within the pelvic waist, providing stable support to the spine.

ISCHIOTIBIAL MUSCLES extend along the posterior part of the thigh, from the back of the pelvis to the knee. During back extensions, the glutei and the ischiotibial muscles cooperate with paravertebral muscles. If ischiotibial muscles are shortened, the lumbar area is constantly arched more than normal (known as lordosis) and may result in paravertebral muscle contraction.

As I have consistently advocated, all of these muscles have to be developed in proportion and balance, and only as such can they offer adequate spinal support and movement. Even when a single one is underdeveloped, it can cause imbalance, putting strain on other muscles and dismantling the synergy necessary for a healthy and strong spine.

The single most common reason for lower back problems is definitely either inactivity or too much of the wrong kind of activity that puts strain on a particular part of the back. Most popular sports (or games as I prefer to call them) put pressure only on a certain part of the body, or a certain part of a muscle group. Proper weight training however takes care of the body as a single unit, engaging all the muscle groups, and more importantly, all of the muscles with their full biomechanical functions. In weight training, disproportional physical development is not an option, nor is disproportionate single muscle development. It is not just that disproportionate muscular development is a common result of sports like running, football, tennis, etc., but disproportional single muscle development is as well. In such sports the emphasis is on the lower body more than on the upper body. Over time the weaker upper body becomes much weaker than the lower body creating the imbalance, that among other things, often contributes to back problems. And this is not the end of the story. People who believe that running by itself is enough to develop the leg muscles properly are very wrong. Unless you perform the full joint rotation with the maximum muscle engagement, the single muscle or group of muscles will never develop optimally.

Take running, for example. Some parts of the quadriceps will develop more that others simply because that activity never gives you the full knee joint rotation that squats do. This is because only certain parts of muscles involved with running will strengthen, leaving others weaker. That imbalance will prove very costly in the future, as most experienced runners are very aware of. This simple example should clarify the impact of incorrect choice when it comes to selecting the right physical activity and expecting superior results from it. More examples of sports that offer only limited benefits include playing football three times per week or going for a jog with your partner after work. The reality is that the risk to benefit ratio of these activities is very high. Most of the common and popular sports will give you no more than social benefits and a feel-good factor, while potentially leading to long term injuries and a false impression of real achievement. Only weight training can lead to complete and proportionate muscular development that promises a much better future for your back.

Improper nutrition is the second major cause of back problems. Our fast lifestyles and lack of discretion in choosing the right foods has created eating habits that are silently killing millions of people around the world. Our eating habits are depleting our bodies of essential macro and micro nutrients, and these deficiencies are creating numerous health conditions that culminate in diseases like cardiovascular problems, hormonal imbalance, diabetes, allergies, bone diseases, tooth decay etc.

In regards to back problems, nutrition is of course directly involved. Due to protein deficiencies, which most people suffer from, the muscle tissue and supportive muscular mechanism of the spine and back become heavily compromised. Remember: only a strong back is a healthy back! And having a strong back is simply impossible without strong muscles - muscles that are constantly fed with enough high quality protein. Over a period of time, protein deficiency guarantees back problems!

Lack of protein in one’s diet creates cravings for sugars - simple sugars as well as complex sugars (carbohydrates). Over consumption of carbohydrates is the quickest way to become overweight or obese. Extra body weight in the form of metabolically inactive tissue (fat) is a pure burden for the spine and back, not to mention other body systems. Carrying extra weight will definitely overstress the back causing many unwanted health problems.

Minerals and vitamins, as micronutrients, are of extreme importance for a healthy back. They help maintain bone density, connective tissue strength, and proper absorption of proteins and essential fatty acids. They work in synergy with macronutrients. A diet poor in vegetables and fruit is a diet with a massive lack of essential minerals and vitamins! In our everyday modern diet fresh vegetables and fruits have become a rare component. People very rarely eat them and overeat processed foods which are full of carbohydrates and fats. Only a balanced diet, full of fresh vegetables and fruits, and high in protein and essential fats will allow the body to buffer acidity and preserve calcium within the bones. An acidic environment drives the calcium out of the bones and into the blood, in order to neutralise acidity and maintain the blood PH at around 7. The loss of calcium from the bones makes them brittle and weak.

In order to maintain a healthy back, and live without back pain, regular correct exercise and healthy eating have to become a habit. Only weight training, properly programmed and conducted, will allow the body to develop and maintain a proportionate muscular system, strong enough to support the skeleton during every day activity. In combination with weight training, healthy eating that consists of high protein foods, essential fats, fresh vegetables and fruit will support our energy needs without the fear of weight (fat) gain. It will also supply the body with the essential components needed for the constant repair of tissues and allow us to gain necessary strength. Never forget: Only a strong back is a healthy back!