The Three Big Myths About Back Pain

What I want to emphasize here is that we can’t just focus on symptoms like pain.

Instead, we must turn our efforts toward figuring out and fixing the underlying problem causing the pain. Before I explain the primary causes, however, let me start by dispelling a few popular myths.

Myth #1:
You “Throw Out” Your Back

In the course of my work, I’ve taught hundreds of thousands of people my back-pain treatment approach. When I ask them what’s wrong, they almost always say something like, “I was doing X when I ‘threw out’ my back.”

Usually, some physical activity precedes the back pain, like picking up a heavy object, sneezing, bending over, or getting out of bed. The thinking goes, “Well, since I didn’t have pain before the activity, the activity must have caused the pain.” As you’ll see in the next few chapters, the reality is a bit more complicated. In many cases, a physical activity can trigger a pain episode, but by itself, it isn’t the underlying cause.

Consider this example: Let’s say you fill a room with natural gas and then toss a match inside. You could say that the match caused the explosion, but it would be more accurate to say the match “triggered” or ignited the explosion. The better question to focus on is “Where did all that gas come from in the first place?”

It’s very similar with back pain. A physical activity can trigger a pain episode, but it’s not the “fuel” behind it. If you don’t get rid of the underlying problem, then any number of things can “trigger” the pain.

Myth #2:
Back Pain Means Something Is Wrong with the Back

People usually think that if they have back pain, their bodies are suffering from some mechanical dysfunction. “Since my body hurts,” they say, “it must mean something is wrong with my body—something with the bones, the muscles, or the soft tissue that connects them.”

While this is sometimes, if not often, the case, it’s not the only underlying cause of back pain. Other factors that originate in your mind (e.g., stress levels) as well as your diet (unhealthy foods) can cause severe back-pain episodes, even when there’s nothing wrong with your spine, discs, joints, muscles, or ligaments. These factors also can exacerbate physically caused back pain, making it many times more painful.

Myth #3:
The Current Pain Isn’t Related to Previous Bouts

If you experienced a back-pain episode two months ago and another today, you’re likely to think these episodes are unrelated. Perhaps the last time it happened because you sneezed. This time you were moving furniture.

For most people, the trigger that causes their pain episode is different on different occasions. Naturally, they associate the “cause” to the trigger and believe the episodes are unrelated.

In fact, in the vast majority of cases, multiple back-pain episodes are usually caused by the same underlying problem— even if each pain episode had a different trigger.

Let’s consider again the room filled with natural gas—a dangerous situation, no doubt. But the gas is the source of the danger, not the match, static cling, or a cell-phone ring that might create a spark to trigger the explosion.

The same is true when it comes to back pain. Once you’ve created conditions in your body, inadvertently or otherwise, that are ripe for an explosive bout of back pain, any number of things can set off a pain episode. Different activities that may trigger pain are only sparks igniting the gas that was there all along.

There Are Two Types of Pain: Which Are You Suffering From?

Though there are many back-pain conditions, such as sciatica, scoliosis, and a herniated disc, we can narrow them down to two basic categories: nerve-based pain and tissue based pain.

You may have one or the other, or you may have both. Some treatments will ease nerve pain, others improve tissue pain. Some might, in some cases, work for both. But determining the right treatment for your particular case can require some investigation.

This is, incidentally, why so many back-pain sufferers find inconsistent relief. Let me explain the differences between the two types of pain.

As the name suggests, nerve-based back pain is caused by a nerve that’s not happy for some reason. Typically, it’s being pressured, pinched, compressed, or injured in some way— usually by a nearby muscle or bone.

For example, if a nerve is surrounded by or next to a muscle that’s unusually tight and inflexible, that muscle presses on the nerve, causing it to hurt. This is common in sciatica.

If a nearby piece of bone, such as a vertebra in your spinal column, is out of position, it also might press on the nerve, causing pain. These bones themselves may be out of position due to an overly tight or inflexible muscle nearby. In other words, the whole process may start with a tight muscle but end with a nerve that’s irritated by a bone.

Nerve pain often, but not always, is felt as a burning, tingling, sharp, shooting, electrical, or numb sensation, or like “pins and needles.”

Tissue-based pain, on the other hand, originates in the muscles, tendons, ligaments, or other connective tissues in the body. (Most commonly, the pain originates in the muscles.) Think back to the last time you gave someone a neck or back massage. You may recall feeling one or more “knots” in the muscles. These knots are one of the main causes of tissue based pain.

One way to tell if a knot is really a knot, or just a bone, is to see if it exists on both sides of the body in the exact same position. If it appears on both sides, it might be a bone or part of a joint. If it only appears on one side, it’s more likely a knot.

This knot is more formally known as a “trigger point.” I don’t know why it’s called this, but I suspect it’s because if you press firmly on it, it triggers pain. Trigger points also are known to trigger pain in areas of the body other than where they’re located, and this is called “referred pain.”

A trigger point is caused in part by a pooling of toxins in your muscle tissue—which, in turn, is usually caused by imbalances in your diet, excess negative stress, and/or damage to the actual muscle fibers as a result of an injury and/or excessive exercise or physical activity.

If you’re under a lot of stress, for example, your body’s natural tendency is to shift to more shallow breathing and to “freeze” parts of your upper body (clenched jaws and tense shoulders are a few examples).

This “freezing” reduces the amount of oxygen in your body and slows the circulation of blood in certain areas—such as your back. Without the optimal level of oxygen from deep breathing and without natural body movement to keep the blood flowing, toxins get “stuck” within tight muscle tissue. If this is allowed to continue for a long enough period of time, a trigger point develops, causing pain.

Trigger points also might be caused by an imbalance in the diet. For instance, many people who have been led to believe they aren’t getting enough calcium may, in fact, be deficient in magnesium. Without magnesium, the body can’t process calcium as it should. Magnesium also is involved in the muscle-relaxation response, so if the body doesn’t have enough of it, trigger points are more likely to develop.

Since proper muscle function depends on both of calcium and magnesium—and since they depend on each other for absorption into the body’s cells—an adequate, balanced supply (along with potassium and other trace minerals) is necessary for healthy, pain-free muscles.

Studies have shown that supplementing with these nutrients can help ease trigger points.

Another way to really aggravate trigger points is to drink too little water. When you’re dehydrated, your blood doesn’t have enough fluid to flush out all the toxins and other biological waste that your body produces. Under normal conditions, the blood washes away all these waste products, moving them to the liver and kidneys, where they are eliminated from the body.

But if you’re even slightly dehydrated, there isn’t enough water in your blood to do a good cleaning job in the little spaces between the cells that make up your muscles. When this happens, you’re much more likely to develop trigger points—or if you already have them, they increase in size, severity, and pain.

Other types of tissue-based pain, such as pulled or strained tendons or ligaments, also can be caused by overuse. While a sudden trauma or injury can pull a ligament—a very extreme form of overuse—doing the same type of moderate-intensity activity too many times can strain a tendon or ligament, too.

There is a fine line between using and overusing your tendons and ligaments.

Notice how similar types of sharp, shooting pain—a trigger point in the muscle, an inflamed tendon, or a compressed nerve—can be caused by entirely different reasons. As you’ll see in the next chapter, this is quite common. You also will see that if you don’t know what’s causing your pain, you could very easily choose the wrong treatment approach!

You may already have an idea which type of pain you have. If not, you’ll figure it out as you go through this book. For now, just remember that you need to know what’s causing the pain before you can reasonably expect to get rid of it.