Why does my back hurt?

Understanding why your back hurts is the most important thing you can do to help it.  With very few exceptions, back pain does not happen because you did something to it.  It is not because you are old either.  Back and neck pain will most often occur because you did not learn to take care of your spine and keep it in good enough shape to handle what you do to it. 
Our spines, just like every other body part, require some attention to stay healthy.  It is not that complicated once you understand some simple anatomy and physiology. 
All of us start out in life with a spine, made up of lots of moveable bones (24) with lots of other moveable joints attached to it (72+).  These joints are held together with thousands of small, medium and large muscles, tendons and ligaments.  These joints (where 2 or more bones connect) provide the potential to move just like any other joint in our body.  Just like any joint in the body, they must move to stay healthy.  Motion is essential for joint health.  Motion keeps muscles strong and coordinated, stretches tendons and ligaments, pulls nutrition and fluid in and out of tissues and the disks of the spine.  A healthy spine is one that has perfect mobility among all of these joints, muscles, tendons and ligaments with perfect balance, range of motion and coordination.  In 20 years of clinical practice, I have never seen a "perfect" spine.
When any muscle, tendon or ligament gets overstretched either suddenly of slowly over time, a sprain/strain injury will occur.  This is what an episode of neck or back pain is.  The muscles surrounding this injury will tighten up or spasm to protect it from re-injury much like a splint or cast.  These injuries can be very mild (crick or catch), moderate or severe depending on how much tissue damage occurred.  Inflammation (fluid) begins to accumulate in the tissues over 12-72 hours (never apply heat) and then the body begins to heal the tissues injured.  This healing process will always involve some amount of fibrotic and scar tissue being laid down.  Once the healing begins, the muscle spasms, inflammation and pain will gradually go away most of the time no matter what you do.  This is what at one time was called a self limiting episode of back pain. 
Today we know that calling this episode of pain a "self limiting" condition was wrong.  Today this is considered an episode in a chronic degenerative process.  The effect of the scar tissue and adhesion's that remain after the episode of pain sets off a cascade of functional problems that spread throughout the spine over time. 
Scar tissue will never go away, and since it is dense and fibrous tissue, it will limit normal motion of the tissues and associated joints. (leave a cast on your elbow for 10 years and see what happens)  This abnormal and limited motion is what causes joint degenerative arthritis over time.  Lost motion over time causes the muscles to weaken from lack of use (atrophy), tendons and ligaments tighten and get shorter.  Fluid turnover in the joint decreases because motion pumps fluid in and out of those tissues.  The disks of the spine will begin to dehydrate and ultimately, the joint will begin to develop bone spurs in an attempt to fuse it together.  Immobilize any joint in the body and this process will happen.  This is a slow, progressive, chronic degenerative process that we do not feel happening over time.  See Joint complex dysfunction. This is also known as  Vertebral Subluxation Degeneration.  Also see proprioception to better understand some of this.
The spine is made up of a chain of 72+ joints and they all move and contribute to your daily life of sitting, walking, working, sleeping, driving, tying your shoes, brushing your teeth etc.  Once one area in your spine goes through this episode, it will no longer participate in these activities normally.  The tissues and joints above or below this healed injury now try to move more to compensate which puts more stress on them.  Eventually, these tissue get the next strain, sprain injury and go through the same process.   And so goes the life of a spine.  Over our lifetime, these "episodes of pain" will typically become more frequent and more severe as we gradually lose flexibility and motion along this chain of joints.  When we are younger, these tissues above and below the injury compensate somewhat successfully until they are damaged, thus we do not notice this loss of flexibility as much.  But over time, these repetitive strain/sprain injuries add up, and we wake up one morning when we are 60 and think, what happened to me, I used to be so flexible. 
So what to do about this?  Just remember move it or lose it.  The only Doctor that is trained to identify and treat this pathology is a Chiropractor utilizing Spinal Manipulative Therapy.
Chiropractors stretch and move tissues around joints that you can not to restore normal motion.
James D. McLelland D.C.
Chiropractor
Chiroworksva.com and Physical Medicine
Chiropractor Richmond, Chiropractor Short Pump, Chiropractor Glen Allen



Author: James D. McLelland D.C.
Source: Chiroworksva.com and Physical Medicine