The general definition of back pain is pain felt in any part of the back. Back pain can be an annoyance, or it can be excruciating and debilitating. It often results from, among other things, muscle problems and the degeneration of discs between the vertebrae.
For some people, it develops because of muscle problems in the lumbar or lower spine. For others, the discs that lie between the vertebrae become worn out or degenerated. The pain can be acute, sub-acute or chronic, depending on its location in the body and the duration of its existence.
Back pain can occur because of problems in the internal organs which lie in the pelvis, the abdomen, or in the skin that covers the lower back. Back pain in the upper or thoracic area can be a result of problems with the main vessels of the heart, because of tumors in the chest and can also occur because of spinal inflammation.
People with spinal problems can also develop other symptoms related to their condition, such as pain in their hips and buttocks, and muscle spasms and cramps.
The degree and manageability of back pain different from person to person. For instance, an individual can have a large herniated disc and yet feel no pain at all, while another individual can experience a seemingly minor muscle strain, only for it to cause him agonizing back pain.
Additionally, some conditions can cause periodical back pains, sometimes showing up days apart, other times reemerging months after their last occurrence. More often than not, the pain intensifies over time.
The definition of back pain as presented by the patient is critical when dealing with back pain. In such a description, the patient should mention just how widespread the pain is, as well as any other symptom he or she is experiencing. Based on the details of the description, a doctor can recommend the best way to manage the pain.
Common types of back pain include:
- Axial pain – this is also known as mechanical pain. It can be described in a number of ways, like sharp or dull, constant or sporadic. Muscle strain is often the culprit of axial pain.
- Referred pain – this type of pain tends to move around the spine and can vary in intensity, depending on its location. It is characterized as dull and achy. A good example of referred pain is the degenerative disc disease in the lower back. It can cause referred pain to the hips and posterior thighs.
- Radicular pain – causes of radicular pain include inflammation, injury or compression to a spinal nerve root. People experiencing this type of pain describe it as a deep a searing pain. It usually follows the path of the affected nerve into the arm or leg and is at times accompanied by weakness or numbness.
Back pain statistics in the United States indicate that more than 75% of all Americans will experience at least one episode of back pain in their lifetime. These statistics are quite similar to those recorded in most other developed countries.
Three out of four adults will be affected by pain in their back at some time during their life. Additionally, back pain cases are more common in adult women than men. A research conducted by the CDC revealed that close to a third of the female population in the United States suffers from back pain, compared to a quarter of the male adult population.
However, men are more likely to report it if the back pain affects their ability to work. A survey carried out by The American Physical Therapy Association (APTA) found that 31% of men acknowledged that low back pain affects their work compared to 20% of women.
A research study conducted by the University of Michigan found that nearly half of all pregnant women will complain about back pain at some point during their pregnancy.
One out of three adults agrees that back pain affects their daily activities, including sleep. APTA conducted a survey which required over 2600 respondents to share their experiences and habits regarding back pain. 39% of the respondents reported that back pain prevents them from fully engaging in the activities of their daily lives. Among this, 38% noted that back pain affects their exercise and 37% have challenges when sleeping because of back pain. More than half of the respondents reported that their sleep quality was reduced as a direct result of chronic back pain.
More than half of all back-pain cases in the US are from desk workers. This is an interesting fact, essentially revealing that back pain is no longer a problem prevalent among those who spend the better part of their day standing. In fact, back pain statistics from one survey revealed that 54% of all Americans suffering from back pain spend their day sitting.
The majority of the people who complain about back pain suffer from lower back pain, often leading to moments where they are practically incapacitated. It is estimated that 10% of the world’s population suffers from lower back pain (LBP). A recent study by Annals of Rheumatic Diseases revealed that one in ten people globally is affected by lower back pain. This is based on over 100 studies conducted in over 80 countries.
Lower back pain affects almost everyone, regardless of their age; from children to the elderly. Low back pain is a very common reason why people schedule medical consultations. Estimates from the 2010 Global Burden Disease show that LBP is among the top 10 diseases and injuries that account for the highest number of disability-adjusted life year (DALY) worldwide.
Consider the following facts about low back pain:
- In industrialized countries, the lifetime prevalence of common low back pain stands at between 60% and 70%.
- The prevalence rate among children and adolescents is lower compared to among adults. However, statistics are showing an increasing prevalence in this group.
- Low back pain prevalence increases between the ages of 35 and 45.
- Low back pain will increase substantially as the world population ages, largely because of the deterioration of the intervertebral discs in the older population.
Although anyone can develop back pain, there are certain factors that place some at an increased risk of developing pain in their back. Specific back pain risk factors include:
- Pregnancy – The common cause of back pain during pregnancy is the malfunctioning of the sacroiliac joint. Even though it can be extremely painful, this condition can be successfully treated and will subside once the pregnancy is over.
- An inactive or sedentary lifestyle – this kind of lifestyle hinders us from the proper conditioning that our bodies require in order to meet the demands of the day. Failing to do some basic exercises makes the back to become stiff. The stiffness is usually worse in the morning. Muscles can become tight, weak and painful for the remainder of the day. The discomfort caused by the tight muscles, in turn, deters the person from wanting to exercise.
- Age – this is one of those back pain risk factors that affect the elderly. Older people are more likely to develop back pain than children or younger adults. As a person grows old, the disks between the vertebrae shrink and wear away. The bones start to rub against each other, resulting in stiffness which in turn causes pain. Moreover, the space around the spinal cord narrows as we age. This condition is known as spinal stenosis. It exerts pressure on the spinal cord and the nerves, causing pain.
- Anxiety and depression – There is nothing abnormal about reacting emotionally to the development of pain in your back. Indeed, many people suffering from back pain are anxious to know its cause, how long it will last, and how it is likely to interrupt their day to day activities. The normal healing time for back pain is two to four months. Therefore, many people start to worry if their back pain lasts longer than this, sometimes resulting in psychological distress and depression. Consequently, the distress and depression lead to more pain.
- Weight – being overweight or obese increases your risk of developing back pain. Our spines are designed to carry the body’s weight and distribute the loads we encounter during rest and activity. When our bodies carry excess weight, the spine has no choice but to adapt to the burden. This, in turn, can lead to structural compromise and damage to the spine ultimately causing significant back pain.
- Smoking – smoking cigarettes is not good for any part of the body, including your back. In fact, smoking increases your risk of developing back pain. Smoking can prevent vital nutrients from flowing into the disks in your spine, thus preventing them from being properly lubricated. This can cause you to develop pain in the back.
- Strenuous physical exercise – physical exercise can strain your back, especially if the exercise is performed incorrectly. If the strenuous physical exercises continue for an extended period, back pain may develop.
- Strenuous physical work – strenuous physical work puts extra stress on your back and can put you at risk of developing back pain, especially if you are performing the tasks incorrectly.
- Gender – Available research shows that women suffer from back pain more frequently than men.
- An emotionally or mentally stressful job or career – people with these kinds of jobs tend to develop signs of back pain.
There are many sources and potential causes of back pain. At times, pain that originates from different tissues in the spine can create very similar symptoms. It is difficult to determine the actual back pain causes without using diagnostic procedures that sometimes are invasive.
One possible cause of back pain is an injury in the skeletal muscles of the back. Pain in the muscle tissues can be caused by muscle strains or “pulled muscles”, muscle spasms, or by imbalances in the muscles. In many cases, imaging studies do not support the idea of muscle damage leading to back pain and precisely how muscle imbalances lead to muscle spasms is not well understood by medical science.
In approximately one-third of people with chronic lower back pain, and also for those with whiplash, the fluid-filled synovial joints have been identified as a potential source of back pain. These joints provide cushioning and lubrication for the vertebrae.
There are many other common potential reasons back pain may develop. These include:
- Degenerative disc disease – the discs between our spines shrink or tear as we age. This causes the bones to rub together thus causing pain.
- Spinal disc herniation – spinal discs keep the spine flexible and also act to absorb shock for the spine, but a disc can bulge or break open when damaged. This is what is referred to as disc herniation and can lead to back pain.
- Osteoarthritis – it is also known as the degenerative joint disease and happens when a cartilage and bone break down. It mostly affects middle-aged people and older.
- Lumbar spinal stenosis – this causes your spinal cord to narrow. As a result, significant pressure is added to the spine and nerves. This causes the legs and shoulders to feel numb. Lumbar spinal stenosis usually happens to people above the age of 60.
- Trauma, such as fractures caused by car accidents, falls, strains and muscle sprains are also leading causes of back pain.
- Cancer – tumors in the spinal cord can either expand or weaken the bone. Sequentially, this can lead to spinal fractures, nerve compression or spinal instability. However, back pain causes that are related to cancer are very rare.
- Infections – bacterial infection can lead to back pain, especially low back pain. Available research shows that close to 40% of the cases of lower back pain are caused by bacteria. Furthermore, statistics indicate that most people with lower back pain caused by herniated disc and swelling in the spine depend on antibiotics for treatment.
- Inflammatory disease and wear and tear of the sacroiliac joint – the sacroiliac joint lies where the spine and the pelvis come together. It doesn’t move much, but it is responsible for moving the weight of the upper body to the lower body. Any inflammatory, swelling or wear and tear in that joint can cause considerable back pain.
- Ankylosing spondylitis – this is also known as spinal arthritis and causes the bones of the spine to fuse together, making the spine rigid. This fusion of spine bones can cause mild or sometimes severe back pain.
The anterior ligaments of the spine are very sensitive and even a very minor injury can cause a great deal of back pain.
Lumbar radiculopathy, also known as sciatica, is the pain in the lower back that radiates to the hip and down the leg due to spinal nerve compression. This is often easy for physicians to distinguish from other types of "non-specific" back pain and can usually be diagnosed without more invasive testing or procedures. Lumbar radiculopathy, or sciatica, causes severe, and sometimes debilitating pain.
Back pain classification plays a major role in the treatment of back pain cases. Back pain types depend on the area of the body in which it is located: neck pain, mid-back pain, low-back pain or coccyx (tailbone) pain. It can also be classified by the length of time it lasts or its duration:
Acute back pain: This is pain that is new and can last up to 12 weeks. It can be caused by inflammation, irritation, tissue damage or injury, a procedure or surgery or by illness or disease. This pain usually ends when the condition causing it is treated or is resolved.
Chronic back pain: This lasts more than 12 weeks. It persists or occurs with a chronic disease such as arthritis or degenerative disc disease. It can be continuous, or it may come and go. Chronic back pain affects some people to the point that they are unable to work, get adequate rest or enjoy their life.
Back pain can also be classified according to its cause.
Non-specific back pain: This indicates that the cause of the back pain is not precisely known, but it is thought to be caused by problems in the soft tissues. The soft tissues include the muscles, ligaments and the fascia (a sheet of connective tissue that covers, separates or holds together organs, soft tissues or muscles).
Back pain with radiculopathy or spinal stenosis
A radiculopathy or spinal stenosis is caused by inflammation, compression or injury to the cervical spine or lumbar spine. This causes pain to the spinal cord in the neck or the spinal nerve roots in the lower back. Arm pain is a common symptom of cervical stenosis, while leg pain and leg tingling, numbness and weakness are the signs of lumbar stenosis. Cervical stenosis with myelopathy is known to cause challenges in coordination.
Of all other back pain types, this is the most prevalent as it affects people between the ages of 45 and 64 and it affects more females than males, with females accounting for 53.69% of all the people with spinal stenosis.
Causes back pain with radiculopathy or spinal stenosis include:
- Herniated disc with nerve compression – this is the most common cause of spinal stenosis.
- Foramina stenosis – this is caused by arthritis or bone spurs and causes the narrowing of the hole through which the spinal nerve exits. It is more prevalent in the elderly.
- Nerve root injuries.
- Scar tissue from a previous spinal surgery.
Back pain with another specific cause
Nearly all (98%) of patients with back pain are diagnosed with acute non-specific back pain that has no serious underlying cause. Back pain that is caused by another underlying disease accounts for the remaining 2% of patients suffering from back pain.
The underlying conditions may include cancer that has metastasized, an epidural abscess or spinal osteomyelitis. These conditions account for approximately 1% of the remaining 2%. The other underlying condition that is frequently responsible for back pain due to another specific cause is disc herniation. Herniated discs most often occur in the lowest two vertebrae of the lumbar spine.
Back pain may occur suddenly and be very sharp, or it may come on slowly and feel dull and achy. It may be felt only with movement or sometimes people experience pain only with sudden movements such as when they cough or sneeze. Back pain may also cause a loss or a change in sensation in other parts of the body, such as numbness or tingling in the arms or legs.
Even though the causes and some symptoms may be very different, most people have experienced back pain sometime in their life, and most often they share at least one of these back pain symptoms, which typically include:
- A constant feeling of stiffness or aching anywhere along the spine, from the base of the skull down to the tailbone.
- A stabbing, sharp pain centered in the lower back, upper back or in the neck. This type of back pain is more likely to occur after strenuous exertion or after an episode of heavy lifting. *Note* Pain in the upper back can also indicate a heart attack or other life-threatening condition.
- A persistent ache or feeling of heaviness in the lower or mid-back region. This back pain is more likely to occur after standing or sitting for long periods.
- Pain radiating from the lower back into the buttocks, shooting down the side or back of the thigh into the calf and foot.
- Lower back pain that is made worse by standing up straight. This is one of those back pain symptoms that people often ignore.
Consequences of chronic back pain: The Terrible Triad
When chronic back pain reaches a point where it interferes with the normal activities of life, people sometimes become the victim of a vicious cycle. They become engulfed by the back pain, leading to mental depression and irritability. This often leads to difficulty sleeping, which makes the back pain and depression harder to manage. This condition is sometimes called the “terrible triad” (because there are three components) which are suffering, sadness and sleeplessness.
In an attempt to stop their pain, some people become dependent on medication, while others seek questionable treatments or multiple surgical interventions. Often, the lives of family members can be just as emotionally unsettled as the one whose life has been disrupted by chronic back pain.
Chronic back pain drains a person’s energy, wearing them down and sapping all their enthusiasm. Typically, a person experiencing chronic pain will limit their social interactions as their way of trying to reduce their stress.
For many, chronic pain brings with it depression-like symptoms if left unchecked. These symptoms include reduced or lack of interpersonal interaction, difficulty in concentrating on minor tasks, and an unfulfilled desire to live a simple life.
Therefore, these people choose to stay isolated or notably quiet. Chronic back pain can also push its victims towards sleeping for long hours in their attempt to find relief from the pain.
Furthermore, recent studies have revealed that chronic pain can affect the brain and the nervous system. It causes the brain and the spinal cord cells to deteriorate faster than normal, aggravating some depression-like symptoms.
For this reason, people with chronic back pain find themselves with a limited ability to focus on tasks at hand or process multiple things at once. Sometimes they also struggle to react to the things that are happening around them.
You will need a back pain diagnosis from a doctor in order to determine what is causing your back pain and give you the appropriate prescription for pain relief medication. During the process, your doctor will most likely need the following information:
- Your medical history: This includes members of your immediate family who have back pain or other problems with their back. Some conditions, such as osteoporosis and scoliosis, have a genetic potential.
- The history of your current condition: This includes details about when your back pain started, what first brought about your back pain, the severity of your pain at this time and what the pain feels like (burning, tingling, stabbing). Your doctor will also want to know if your back pain has changed since its onset, and he may ask other questions. His examination may cause some discomfort, so the doctor wants to know as much as possible about your pain prior to his exam.
- Physical examination: The doctor will evaluate your heart rate and blood pressure, which may be elevated due to your back pain. He will also listen to your breath sounds and your heart. He will examine your spine, feeling for areas that are tender or painful and checking for abnormalities.
- Neurological examination: The doctor will assess for function and sensation. Sometimes physicians use the pin-prick test to determine if the sensation is equal on both sides of the body. He may ask you to walk, bend and perform other movements to check your flexibility, function, and range of motion, and the doctor will also test your reflexes to see if these have been affected by the cause of your back pain.
Following a thorough physical examination and review of your symptoms, your physician may order special tests. The following diagnostic tests are used to help in the back pain diagnosis process:
- X-rays: X-rays are able to show how the bones are aligned and whether there are any broken bones that might be causing back pain. They can also detect the presence of arthritis. X-rays do not usually reveal problems with the spinal cord, discs or muscles.
- Magnetic resonance imaging (MRI): This test uses strong magnets and radio waves to provide detailed images of your body. It can show problems like herniated discs or problems with tendons, ligaments, nerves, muscles, tissues or bones that may be the reason for back pain.
- Computerized tomography (CT scan): This test uses special x-rays, taken at various angles, to show the doctor cross-section images of your spinal canal which are very detailed.
- Bone scan: This test can detect compression fractures that are caused by osteoporosis (brittle bones). These fractures can cause back pain without a fall or other traumatic injury. A bone scan can also detect bone tumors. A radioactive dye is injected into a vein. The dye collects in the bones, and a special camera is used to take detailed images that are then used for diagnosing back pain.
- Electromyography or EMG: During this test, a needle is inserted through the skin into different muscles to check for electrical impulses. This test can help to confirm nerve compression that occurs when a spinal disc herniates or when the spinal canal is narrowed (spinal stenosis) and causes back pain.
- Blood Tests: If the doctor suspects an infection is causing your back pain, he or she may also order blood tests.
Where to go for help
Back pain can affect every area of your life. To effectively manage back pain, you need to find relief from your symptoms, but treatment also involves getting support for you and your family. A plan that includes many different approaches is often the best way to ensure you get all the help you need. Pain management programs are often offered on an outpatient basis. Skilled professionals working in many different areas make up the pain management rehab team. Members of the team to help with back pain may include:
- Physical and occupational therapists
- Orthopedic and neurosurgeons
- Orthopedists and Neurologists
- Psychologists and Psychiatrists
- Nurses, Social workers and Case managers
- Vocational counselors
Many back pain management programs are held in hospitals, rehab facilities and in pain clinics. Their goal is to help you regain the highest level of independence and function possible. These programs are based on your individual needs: your pain, your diagnosis, and condition. Your involvement in the back pain program is vital to achieving a successful outcome.
Pain management techniques
Pain management techniques can help to reduce both chronic and acute back pain. Some ways to relieve back pain may include:
- Over-the-counter (OTC) medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or naproxen
- Stronger analgesics (pain pills) may be prescribed by your doctor to provide relief from back pain. These may include narcotics. Narcotics are only used for severe back pain because they have potentially harmful side effects and a strong potential for abuse and addiction.
- Prescription antidepressants are also helpful for some people with chronic back pain. These medications help by increasing the body’s supply of serotonin and norepinephrine. Serotonin is a neurotransmitter that can be helpful in regulating the brain’s pain pathways.
- Heat and cold applications: These can help decrease back pain and stiffness.
- Physical and occupational therapy: Skilled therapists use treatments such as exercise, massage and whirlpool baths as well as instruct in effective ways to reduce stress on muscles and joints and decrease the risk of further injury.
- Exercise: This can significantly decrease back pain caused by spasticity, inflammation, problems with spinal alignment or muscle weakness
- Localized electrical stimulation: This treatment involves relieving back pain through the application of short pulses of electricity to the nerve endings lying just under the skin.
- Injections: Medications such as steroids are sometimes injected directly at the site of back pain or inflammation
- Emotional and psychological support for those suffering from chronic back pain: This may include:
- Psychotherapy and group therapy
- Stress management, relaxation training or assertiveness training
- Behavior modification training
Surgery for back pain is completed only in extreme circumstances. Surgery may be an option in cases of persistent pain and nerve compression that may lead to muscle weakness, for example in the case of a herniated disc. Some examples of surgeries for back pain include:
- Fusion: In this procedure for back pain, two bones of the spinal column are joined with a bone graft between them. The bones are splinted with surgical hardware such as metal screws, plates or cages. Individuals who have this procedure completed are at greater risk of developing arthritis in the adjoining vertebrae.
- Artificial disc: In this procedure for back pain, an artificial disc is inserted to replace the eroded natural cushion between two bones of the spinal column.
- Discectomy: In this procedure, the portion of a disc that is pressing against or irritating a nerve is removed.
- Partially removing a vertebra: In this procedure for back pain, a small part of a vertebra that is compressing nerves or pinching the spinal cord is removed.
- The origin of back pain is at times unknown and imaging studies may fail to show its causes. Most episodes of back pain eventually resolve without serious complications. The majority of back pain problems are caused by inflammation, especially in the first two weeks to three months. This is the phase referred to as the acute phase.For people aged 50 and above, structural changes of the body are common even as radiographic degeneration signs begin to emerge. Interestingly, it is around this time that clinically, back pain often subsides. During this time, the pathological changes taking place in the discs may cause low back pain.However, the pain eventually disappears when the deterioration of the discs is complete and there no longer is any movement taking place between the person’s vertebrae, bringing stability to that area around the spine.Infrequently, back pain can indicate a serious underlying medical problem. For example:
- Loss of bladder and/or bowel control accompanied by back pain or progressive weakness in the muscles of the legs is often a warning sign of a problem that is potentially life-threatening.
- Extreme back pain occurring with other symptoms of a serious illness, such as a fever or unexplained loss of weight, may indicate a serious medical problem.
- Back pain following trauma, such as a motor vehicle accident or a fall may be a sign of a broken bone (fracture) or another serious injury.
- The ribs connect with the vertebrae in the thoracic spine by two joints which connect to each side of the spine. A dysfunction in these joints can cause pain in the upper back.
- Individuals who have other medical conditions that place them at increased risk for spinal fractures, such as multiple myeloma or osteoporosis, require prompt medical attention when they develop back pain.
- Individuals who have a history of cancer also require prompt medical attention when they develop back pain. Especially if the cancer is one that is known to metastasize, or spread to the spine such as prostate, breast and lung cancer.
Research suggests that degenerative disc disease and lumbar disc herniation, two conditions that are often said to be the cause of back pain problems, do not necessarily occur more often in people with pain than in the general population. Furthermore, the research suggests that the mechanisms by which degenerative disc disease and lumbar disc herniation cause pain are not known. Other research reports suggest that in many cases, it is not possible to identify the cause of back pain.
Some studies have suggested that psychosocial factors like stressful family relationships and job stress may more closely correlate with back pain than abnormalities in the body's structure which are revealed in medical imaging studies and X-rays.
Additionally, research has shown that painful kidneys can cause back pain. The pain is usually quite lateral, at times just low enough to be considered as low back pain. This further underscores the need for a medical checkup when you experience back pain.
All the same, experts say that very rarely is the back pain a symptom of a serious problem like a broken spinal bone, an infection or cancer.
Meanwhile, there are many conditions which are not considered dangerous but can still cause severe back pain. Take a muscle cramp for example: it can cause serious pain yet it is still not considered dangerous.
Knowing how to prevent back pain can save you from unnecessary pain. Here are a number of steps you can take to reduce the risk of developing back pain:
- Exercise: Regular exercise not only helps to build strength and endurance, it also helps keep your weight under control which can help prevent back pain. Most experts agree that low-impact aerobic exercises are the best because these activities avoid straining or jerking the back. Exercises that help strengthen the back and abdominal muscles, core-strengthening exercises, will help protect your back. Flexibility exercises, targeting the flexibility in your upper legs and hips may be beneficial also to reduce the potential for back pain. Talk with your doctor or other healthcare professional before beginning any exercise program.
- Stop Smoking: Back pain occurs at a significantly higher rate among smokers compared to non-smokers of the same weight, height, and age.
- Maintain a healthy weight: Being overweight also increases your risk of developing back pain. The more overweight you are, the greater your risk of having pain in your back.
- Maintain good posture when standing: Keep your pelvis position neutral. To do this, keep your back straight with your head facing forward. Balance your weight equally on both feet, with your legs straight.
- Maintain good posture when sitting: To reduce your risk of back pain, your seat or chair should have adequate support for your low back, armrests and ideally, it should be able to swivel if you are working. When you are sitting, keep your knees and hips level and your feet flat on the floor. If your feet don't rest on the floor, use a small footrest or footstool to prevent back pain. Ideally, you should be able to sit straight up with good support in the "small" of your back. (the lumbar spine area). When you use a keyboard, your forearms should be horizontal with your elbows at right angles.
- Lift properly: The key to preventing back pain when lifting is to lift with your legs, not your back. Keep your back straight, with your feet shoulder-width apart. Place one foot slightly in front of the other to keep your balance and bend from your knees, not from your waist. Hold the object close to your body, maintain your back as straight as possible and tighten your abdominal muscles. This will pull your pelvis in. Remember to not straighten your legs before you lift. If you do, your back will be forced to do most of the lifting. Never lift and turn or twist at the same time. If the load is too heavy, prevent back pain by getting help. While lifting, keep your eyes focused straight ahead. Don't look up or down. This will keep your neck in a straight line with your spine and prevent back strain and back pain.
- Move objects correctly: It's is easier on your back to push objects than to pull them across the floor.
- Wear the proper shoes: High heels put the strain on your back. Shoes with no heel are better for preventing back pain.
- Drive and ride correctly: To prevent back pain when travelling, make sure to have proper support for your back. Make sure the rear-view mirrors are positioned correctly so you can avoid twisting. The pedals should be squarely under your feet. If you are travelling long distances, take frequent breaks to get out of the vehicle and walk around to avoid back fatigue and back pain.
- Rest right: The how to prevent back pain formula may be connected to how and where you sleep. The mattress on your bed should be able to support the weight of your buttocks and shoulders while keeping your spine straight. Keep a pillow under your head, but it should not force your neck into a sharp angle, which can cause upper back pain.