31st March 2021

In this video I’m going to talk about the causes of back pain and why does it hurt? How is the mind and body involved? What are the 5 key things to consider? Where’s a good starting point for treating and overcoming back pain?

Hi guys, Carl Green here Fitness 4 Life Physio and I’ve been empowering people to overcome their pain and health and fitness problems since 2002. Please like and share this post with others, take a look at the links in the description to learn more, and also don’t forget to subscribe so you don’t miss any future posts.

About Back Pain

Back pain is a big topic and really common problem, so I’ve made this video longer than usual to give you lots of information all in one place, so stay tuned and I hope you find it really useful.

Back pain can be described in lots of way, generally people describe it as achy, sharp or stabbing pains, stiffness, tightness and weakness in the mid back or thoracic spine which is the forward curve between the shoulder blades, or lower back or lumbar spine in the inward curve at the bottom of our spines. Sometimes pain can spread to the ribs, thighs and buttocks.

Triggers for irritating back pain can vary, you can get back pain when sitting or still, back pain when exercising such as weight lifting, body weight exercise like lunges, balance and core exercises, Pilates, yoga and so on, holding positions for example, or you can get back pain on bending, lifting during daily tasks or self-employed and employed manual or desk work.

Effects of back pain

Pain can lead to reduced physical activity, and the longer this it goes on, the more likely you are to become unfit, low in mood, depressed or anxious. This can make the pain worse and recovery even harder. It’s a viscous cycle sometimes, but it doesn’t have to be this way.

I have treated hundreds if not thousands of people with back pain one to one, and also through group sessions, in the NHS and privately, in specialist occupational health settings, and chronic pain services as well.

I have also suffered and overcome chronic pain myself personally, giving me an even greater understanding as a expert patient as well as a professional. You can learn more about me and my background on my website.

Common questions

Some of the common questions I receive are:

I didn’t have an injury so why does it hurt?
Why hasn’t it gone away?
Is it because I’ve put on weight or body fat?
Is it because I sit or exercise too much or not enough?
Is it due to stress?
What about posture, do I need to be re-aligned or manipulated?
Is it just part of manual or office work?
Do I need stronger pain killers?
What specific part of my back is the true cause is it muscles, bones, discs or nerves?

Five key things to consider

As I have said, back pain is a massive topic and to cover all those questions one by one on a video like this would take many hours, and wouldn’t be specific enough for your situation to really help anyway. So, I had a good think and I’ve come up with 5 main things for you to consider, which I hope you find really useful and clear up some of the thoughts around back pain to help you make a really great start in going forward.

1. Back pain can come in many forms and can be very confusing or worrying

There are lots of diagnostic terms and labels for causes of back pain. If you rely on an untrained eye, an inexperienced or money focused professional, or “doctor Google”, you can easily be misled and become anxious about having something more serious. Sadly I see this every weekly, all the time and for years, and it needs to change. We need to be giving people the right information, so here I am trying to do that. Otherwise it can cost people lots of unnecessary time and money, and delay recovery, so I’m really passionate about trying to help people with this. I don’t want this to happen to you, so please get in touch if you think you may be falling into this trap and I’ll help try to get you out.

2. How do we diagnose the cause of your back pain?

Forming an accurate diagnosis takes much more than asking where the pain is, looking at your posture, feeling your back or taking x-rays and MRI scans.

Myself, or any other professional you see, should have several potential causes on our minds when we’re talking to you. We’ll ask lots of questions about your symptoms, body, thoughts and feelings, medical history, and lifestyle in order to put all the clues together to come up with the most likely cause of your problem.

We will also screen for other potential symptoms and changes you may not have thought about and they may not seem relevant but to us we’re trying to pick away at some of the potential reasons why you’ve got your pain. We’ll then use physical assessment to see how your respond to difference movement and physical stimulus and see your reactions, and then put this information together with what we’ve asked you about to see if the two match up.

3. What conditions can cause back pain?

Firstly, I just wanted to clear up one thing that people sometimes get confused or misled about, and that is sciatica. Sciatica is different to back pain. You can have both at the same time but they are different conditions.

There are many health conditions that can lead to back pain, and the more you learn and experience, the more you realise there are even more options or causes out there. I’m going to talk about some of them in relation to systems of the both,

So in regard to inflammatory causes of back pain, and the most common I come across is ankylosing spondylitis.

Neurological causes of back pain can include Parkinson’s and strokes due to how these can affect our movement.

Joint problems such as spondylolisthesis, changes to vertebral discs (slipped, prolapsed, protruded, bulges etc.) can be a cause of back pain but not always, osteoarthritis and hypermobility.

Injuries like fractures, muscle tears, cartilage tears, dislocations, and sprains or strains or repetitive tissue stress problems like tendinopathies.

If you have had pain longer than 2-3 months then you may have what we call persistent or chronic pain, and lots of other things may be influencing your pain and we call this central sensitisation, which is a huge topic on its own.

You may also be experiencing referred pain from organs in body, or very very rarely something more serious or sinister.

4. We are living and conscious beings, not machinery

It is not as simple as saying “what structure isn’t working?”. Our bodies and minds are involved in pain and they have to adapt and respond to what we do with them, changes to them and the environment, and can also become affected in various ways by injury or illness.

5. How have you been thinking and behaving?

Are you providing the right level of physical and psychological stress and stimulation to adapt effectively?

Do you regularly do things to keep your mind and body healthy, and fit enough to cope with life’s physical and emotional demands?

Do you develop or maintain bodily sensations and perceptions (see my previous post on this topic) and challenge or manage negative self-talk and emotions to try and focus on the things you are in control of and can do differently to try and help yourself?

Summary and take home messages

It isn’t easy to figure out the cause of back pain, even if you have the knowledge to consider all the potential conditions, things involved, influences in your life and diagnosis. But it is very easy to get confused or be misled when trying to find answers and treatment.

If you have back pain and want to help yourself get better, then please consider a few sessions with me, someone you can trust, who is an appropriately qualified and experienced professional. We’ll assess the bigger picture and finer details for your situation. Have a look at my other services as some of those may be interesting for you. Also the blog (you can subscribe (below) to receive notifications of free information I create like this video. I’d hope to support you to find an empowering way to keep you fit and healthy, enjoying life and in less pain.

I’d encourage you now to think about your situation and what stresses and stimulations you give your body and mind in a daily and weekly basis, and how might they be affecting you at the moment.

If you’d like further help, please get in touch and take a look around my website. I’m more than happy to help you, as I’ve said this is a big interest of mine, so even if it is a quick check in or to ask me a question or something, and I hope to help more of you soon.

Thanks for tuning in.

Carl Green, Fitness 4 Life Physio

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  • I am a part of a stroke group and Carl is giving us training and therapy on zoom. He has a real understaning of what it is like to have a stroke and give us the appropriate exerecsie for our needs. He is a patient and very calm person and always ready to help. Thanks Carl

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  • Loving Carl's Zoom stroke exercise class. There are always options available to make the exercises suitable for everyone. Highly recommend his weekly class. Thank you Carl.

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  • After an ankle injury sustained Mountain biking that just would not seem to heal, Carls expertise helped to diagnose what was wrong and get me back to regular training. He prescribed and demonstrated exercises, explained the benefits of each and really helped me to understand the reasons why we were doing them. Progress was seen immediately, and although its still not quite as good as before the injury, i was able to avoid surgery which would of entailed a much longer healing time with no guarenteed results. If you are looking for a friendly and knowledgeable physio look no further!

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  • I went to see Carl after tearing my hamstring at rugby . He went above and beyond to help get me back to fitness , initially so I could go away snowboarding then when I returned continuing to get back to full fitness . I would recommend his Knowledgable services to anyone

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  • I certainly recommend Carl's online Stroke rehab class. It's convenient connecting to Zoom weekly and Carl is reassuring and knowledgeable in this work. I've been with the class for 1 year plus.

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  • I am a part of a stroke group and Carl runs a Zoom class every Thursday after. He is a qualified instructor in all forms of exercise including Stroke Rehabilitation. He gives us gentle movements that he explains what benefits they have. Non of the exercises are strenuous and he can tailor then to each individual. Each month we have an assessment lesson where we all fill out a private form that no one else can see. looking over the forms for the last few months I can see although it be slow a steady improvement. I would strongly recommend Carl and his rehabilitation classes to anyone who wants to make some improvement there improved mobility. A big Thank you Carl

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  • Carl provided a fantastic sports massage service, saw him twice during a recent visit to Felixstowe, he was flexible around my arrival time, was super organised, punctual and massage was spot on. Would not hesitate to recommend Carl for anyone needing Physio / Sports Massage in the Ipswich / Felixstowe area.

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  • Carl is the physiotherapist at our Stroke Club. He is cheerful, warm and approachable. He is always thinking of new and fun ways to help us maximise our potential after stroke. His patience, humour and expertise makes him a valuble, well loved member of the team. He is highly recommended!

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  • Carl helped me when I had inflammation and sharp pain in my Achilles, he diagnosed me straight away and started treating the pain immediately which was a massive relief. Carl gave me specific exercises to work on inbetween sessions which I still include in my workouts today. Carl was very professional and extremely knowledgeable, his treatment room was comfortable and his booking system was easy to use. His service was very personal which I found lacking when visiting other physios . Would highly recommend

    Sean Ryan Avatar Sean Ryan
  • I am a part of a stroke group and Carl help us every week. He is very professional and never boring. He has a calm manner, and varies our program every time and he always create different ways to make exercise fun.

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  • positive review  I became a client of Carl's earlier this year after suffering a calf injury playing rugby. After the extremely professional assessment; medical history, previous injuries, level of physical activity, current physical stats etc. I was given a detailed but easy to follow plan of rehabilitation. No pressure was put upon me to have any follow up appointments; literally my choice if I felt the need for further treatment. I took the opportunity to book a further treatment straight away. Through the careful management of my injury by Carl, sports massage, specific area exercise and monitoring by him, I was able to resume playing rugby again within an incredibly short time frame that I didn't think would've been possible. I can thoroughly recommend Carl for anything from a small niggle to major injury as you'll be seen by the best.

    Stephen Barrett Avatar Stephen Barrett
  • positive review  Carl was my supervisor for a time whilst working in MSK physiotherapy in Suffolk. He's always put alot of time and effort into teaching and helping me to understand all things physio related and how best to manage tricky patients. Working with Carl has helped to develop my clinical reasoning skills, handling, and confidence and he is a physio that even with my own six years experience, I would still seek out and value his opinion and advice

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  • positive review  Carl did my assessment before referring me to a neurologist when he discovered that physical therapy was not the appropriate course of action. Although unable to assist me with an exercise program, he took the time to go through all of my history, did a thorough physical assessment before making any assumptions and compiled a great referral report which sped things up for me afterwards. Professional attitude, knows his stuff and a friendly guy, highly recommend!

    Chris Stennett Avatar Chris Stennett
  • positive review  Carl has helped me and other Stroke survivors to keep active and gives us the exercises we need to keep us moving. Carl is very good and I would recommend him without hesitation.

    Adi Stannard-Smith Avatar Adi Stannard-Smith
  • positive review  I saw Carl when I had Sciatica and was in a lot of pain. He was extremely professional, knowledgeable and helped when the pain was at its worst. He gave me some great after care advice as well which I still use now and am pleased to say I am still pain free. Would highly recommend and would use again myself.

    Martin Cumberland Avatar Martin Cumberland
  • positive review  I am a part of a stroke group and Carl is giving us training and therapy on zoom. He has a real understaning of what it is like to have a stroke and give us the appropriate exerecsie for our needs. He is a patient and very calm person and always ready to help. Thanks Carl

    Brian Sheppard Avatar Brian Sheppard
  • positive review  I saw Carl when I was suffering from plantar fasciitis. He sorted out a rehabilitation programme, demonstrated excellent understanding of my needs to get back onto the netball court as quickly as possible and explained clearly what exercises would help. He is knowledgeable about many sports and injuries, as well as being available for advice around training and strength and conditioning. I will certainly seek out his advice in the future.

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