Contributing causes of Back Pain
 
Exercise, good posture, safe lifting techniques and weight control are important to prevent recurring back pain. But there are also other factors that can effect back pain. Back pain can be augmented by lack of sleep, by depression and anxiety, stress, and even by smoking. Aging is also a significant factor.

Aging and Back Pain:
The incidence of back pain increases between the ages of 20 to 65. There are multiple factors involved, but one of the main factors a gradual loss of muscle mass. Strength exercises are the best way, if not the only way, to counteract the loss of muscle mass that goes with aging and prevention of back pain. It's never too late to begin exercising and reaping the rewards. The incidence of back pain actually goes down after the age of 65. This is because the majority of back pain is caused by muscle or ligament strain and people of working age are more likely to suffer from overuse injuries or acute injuries from lifting something too heavy, or moving awkwardly etc. However, the incidence of back pain caused by conditions such as osteoarthritis of the spine and spinal stenosis increases in people over 65.
Besides relieving back pain, strengthening the core trunk muscles, which we teach at our office also improves balance, which helps prevent falls (very Important). Strengthening exercises has been shown to increase bone mass and well as muscle mass, an added bonus. Stretching exercises help maintain mobility by breaking up adhesion in the myofascia and prevent injuries that cause back pain. Back exercises counteracts effects of aging.

Lack of Sleep and Back Pain:
If you are suffering from back pain, lack of sleep will aggravate it for several reasons. It is while we are sleeping that much of our soft tissue repair takes place. Also, lack of sleep causes the brain chemistry to become imbalanced and lowers the body's pain threshold.
People who don't get enough sleep suffer more from chronic pain, including back pain and headaches.
Fatigued back muscles can't adequately support the spine and poor posture may result. When the spine is not in proper alignment, more stress is placed on the muscles, discs, and spinal joints. Fatigued back muscles are much more easily injured and strained, resulting in back pain.
Of course back pain itself can interrupt sleep and the pain may be the total cause of your sleep difficulties.
If you suffer chronic back pain and/or are having trouble sleeping, your doctor may prescribe
a nutritional supplement like calcium and or magnesium to help your muscular tension and  nervous system excitability which will result in a lowered pain threshold. Aerobic exercise can also increase levels of serotonin and improve the quality of sleep. Don't do aerobic exercise too close to your bedtime as your metabolism is raised after aerobics and can keep you awake. Because your body will develop a tolerance to sleep medications, they are not suitable for long-term use. A tolerance to pain medications containing codeine can also develop if they are used regularly, rendering them ineffective. If you have chronic back pain, pain medications containing codeine should be saved for days where your back pain is at its worst.

Depression and Anxiety and Back Pain:
Chronic lower back pain is sometimes linked to depression and anxiety. The exact cause for this is not known but there are many theories. Low serotonin levels are common in both chronic back pain and depression. It may be that fatigue is a symptom of depression and when fatigued, the muscles in the back don't support the spine properly. Mental stress and anxiety can also cause the muscles to tense up (contract), especially in the muscles of the neck and back, and these chronically tense muscles are much more easily injured.  Of course the back pain itself may be contributing to the depression. Chronic pain often leads to feelings of helplessness, and a lack of control over anything in one's life, and this can lead to depression.
Low doses of antidepressants are often helpful in treating chronic back pain. If the depression is the main problem, a regular dose of antidepressants may be required. Aerobic exercise is the preferred way to go because it will increase your levels of serotonin and endorphins - natural substances released by your body that are similar to opiates - and relieves back pain and depression.

Stress and Back Pain:  (Are you stressed out?!)
Stress from the workplace and the home causes the muscles can to tighten up, which reduces blood supply to the tissues, causing lack of oxygen and an accumulation of waste products (such as lactic acid) in the muscles. This leads to fatigue and also can cause or intensify pain. Muscles can actually go into painful spasms. The muscles of the back and
neck are commonly affected by stress. Especially those areas that have already been injured, including old injuries.

Smoking and Back Pain:
It is well known that smokers have an increased rate of back pain (by 43%), especially lower back pain, possibly because lowered oxygen levels in the blood going to the tissues of smokers delays healing. Smokers also experience increased spinal degeneration of the intervertebral discs. There are hundreds of studies that link smoking to decreased health.

Dehydration:
Drinking plenty of water prevents acidic waste products from building up in the muscles. High levels of acidic waste products (byproducts of muscular activity) in the muscles cause muscle irritation inflammation and pain. It is especially important to drink extra water before, during, and after exercise. However, drinking water is important even when you are not exercising - your back muscles are being used all the time (just to sit or stand) whether you realize it or not and acidic waste products can build up in your tissues and need to be flushed out.

Footwear and Lower Back Pain:

High Heels:
Wearing high heels throws your spine out of alignment and can cause lower back pain. Wearing high heels causes the pelvis to arch forward, causing sway back and extra stress on the lower spinal segments. Try to reduce the amount of time wearing heels over 1 or 2 inches high to prevent back lower pain.
Cushioning:
Adequate cushioning in the soles helps absorb shock, which is transmitted up the legs to the lower back, created when the feet hit the ground when walking or running.
Support:
Support features built into the shoe will help correct gait problems that can place extra stress on the entire lower body, these are called orthotics.
The amount of cushioning and type of support and even the shape of the shoe that is best depend upon several factors: your weight, your activity level, your foot type, and your gait style, see doctor Chris Thompson for a thorough evaluation. You'll be glad you did!