SAN RAMON, CA – Low back pain strikes hundreds of thousands of people every day. Most will see their GP, who will usually prescribe pain relievers, anti-inflammatories, and perhaps muscle relaxants. Some will call their local chiropractor and receive chiropractic treatment. And then some will try to manage their pain on their own.

The medical literature is full of case studies on low back pain. Why some people develop it, while others don’t, is still open for discussion. There are some risk factors associated with low back pain:

1. Obesity or gradual weight gain in the abdomen

2. Too sedentary lifestyle

3. History of lower back injury

4. Type A personality

5. Smoker

6. History of sports practice

7. Long torso

If you are in one or more of these categories, you are at high risk of developing low back pain. Let’s review the reasoning:

Obesity– when you stopped growing, around the age of 20, your skeleton stopped growing. Their long bones and vertebrae were set large enough to support a naturally lean body weight. Now the only way to gain weight after you stop growing is to gain weight or get pregnant. If the fat settles in your abdomen, it moves your stomach’s center of gravity forward and pushes your lower spine forward in the process. The extra weight compresses the cartilage (discs) in your spine, as well as your hips, knees, and ankles. Over time, it will cause the cartilage to develop cracks. The increased pressure and the spinal arch stick the posterior vertebral joints (facet joints) together, making the vertebrae less mobile. This causes the muscles around the spine to atrophy or weaken. Final score: low back pain and stiffness.

Too sedentary lifestyle. Many of those who work at a desk most of the day fall into this category. You need to move your spine frequently to keep your spinal discs hydrated and healthy, and to keep your spinal muscles exercised and toned so that you can support your spine from the back, sides, and front. Sitting and not exercising produces weak discs and weak back muscles, which can lead to pain.

History of lumbar injury. If you hurt your back during high school or college, it may have healed. But the healed tissue has mixed scar tissue. Scar tissue is what your body uses to close up tissue from torn ligaments, tendons, and muscles. Scar tissue is not as strong or elastic as normal tissue, so if a previously injured area is subjected to heavy load or sometimes sudden movement, it can be re-injured. And this time, since you are older, it may not heal as quickly as it used to and may even become chronic (permanent).

Type A personality. This means that you are often under stress, aggressive, and always “on the go.” Type A personalities have a hard time relaxing. Studies show that this can increase heart rate, blood pressure, and cortisol (stress hormone) levels. These physiological changes are not conducive to back health.

Smokers. Smoking deprives the tissues of oxygen supply. If your work puts a lot of force on your back, the cells that make up your discs, muscles, ligaments, and tendons need oxygen, as your metabolic rate increases. Limited oxygen will make these structures prone to injury. Additionally, cigarette smoke contains at least ten known carcinogens.

History of sports. There is not much surprise here. Any sport that requires jumping and landing will have a tremendous impact on the spine. The spine is designed to handle such activity, but only up to a point. 4-6 years of this can overcome the body’s engineering and cause a breakdown in cartilage and bone.

Long torso. People with an elongated upper body are often more prone to low back pain. The reason is that a long torso means a long spine. With the head at the end of the spine (weighing 10 to 12 pounds) a lever arm is created. Gravity tends to pull your head forward, so if you have a long torso, it will take more force (larger lever arm) from your lower back muscles to stand or sit upright. To help visualize this, imagine holding a stick with a 10-pound throw attached to the end, then leaning it slightly forward. You will feel the strength necessary to continue like this. Now imagine holding a broomstick with a 10 pound throw attached; he will not be able to keep it that way due to the much greater force created.

By knowing these risk factors, you can take immediate steps to help reduce your chances of developing low back pain.

Dan Perez, DC