What to do when your back hurts?

July 13, 2023

Back pain can be scary. The spine’s an important structure and when it hurts it’ll affect every part of your day.

Back pain can also be really confusing, research shows up to 90% of back pain is what is referred to as “non-specific”. What that means is that there’s no explainable structure causing the pain.

As frustrating as the confusing nature of pain can be, ruling out damage is definitely the best outcome. This probably leaves you wondering what should you do when your back hurts?

Research investigating the relationship between changes in spinal movement and changes in pain or activity limitation found a number of interesting characteristics of back pain.

We’ve known for a while that people with back pain move more slowly through a reduced range. They also tend to have less variability in their movement meaning that they have to move their back in a certain way.

What more recent research has shown us is that as these movement patterns change, so too does pain and activity limitation.

What does this mean for your back pain? For most back pain, you need to provide a bit of proof that your back is actually in good shape.

This will often involve you moving the way you feel “you shouldn’t” – bending it, twisting it, doing things relaxed that you’d often feel like you need to brace for.

A great analogy for this is “the George Costanza Principle” – one which I stole from one of the great clinicians Greg Lehman.

For those who aren’t Seinfeld fans, George Costanza comes to the realisation that every instinct he’s had is wrong, then the opposite would have to be right.

Jokes aside, this is a great principle to have when treating your back and will take you on the first big steps you need to take for rehabbing it.