How I Figured Out the Cause of My Back Pain

Back in April 2009, I listed my #1 health goal as ending back pain. I had just gone through another episode of back pain and I was determined to figure out what was the cause. This is post is not about everything I know about back pain. That would be way too long for a blog post. This post is about the steps I took to discover the cause. For me, the process of discovering the cause of my back pain has helped me be more scientific about other aspects of my life, including diet and exercise.

You will need 1 sheet of paper, a pen, and your personal calendar.

Step 1 – Admit You Don’t Know

For over a decade I had assumed I knew exactly what was causing my back pain. Even as late as that April 2009 post, I was still assuming it was “Core, Alignment, Flexibility“. Right before I began designing a fitness plan to solve this problem I began thinking about how I was wrong about some of my dietary choices and how having an open mind improved my diet. What if I was wrong about what was causing the back pain? Although it isn’t important for this post, I had a narrative that I felt explained my back pain. It turned out to be wrong.

Step 2 – Write Down Every Suspect

Make a list of every single reason you could possibly be having back pain. Anything that comes to mind needs to be on the list, even if it is a remote possibility. Posture, mattress, shoes, not stretching, alignment, exercise too little, exercise too much, stress, chair, whatever. Build the list.

Photo by Kevin McDonnell

Step 3 – Remember Past Episodes of Back Pain

Make a list of dates when you had back problems. You will probably need to use an appointment calendar, blog, or diary to help you track down the dates. Get as many dates as possible. The more data you have the better.

Step 4 – Look for Patterns

When I did this exercise I was certain that I would see a correlation between lifting weights and back pain. I always seemed to get back issues after a month or two of consecutive training. At least that is what I thought. The data showed no correlation. Doing this exercise I was able to eliminate some possible causes. My list got smaller. Then I studied the dates and tried to find a common thread. What happened just prior to the onset of back pain?

For me, the common thread was stress, which was dead last on the list I made. Every date that I wrote down was during a period that I didn’t feel in control. The stock market went against me or I got stuck in traffic or something similar. It was at that time that Conditioning Research posted Perspective…back pain which reminded me about Dr. Sarno and his research into connecting back pain with stress. Then I listened to an interview with Dr. Sarno that connected everything for me.

Step 5 – Form Hypothesis and Test

By this point, you should be able to construct a plan and test it. A popular NLP quote applies here:

There is no such thing as failure only feedback.

Keep testing. Isolate primary and any secondary causes.

Last Words

Your back is not your enemy. It is trying to tell you something. Put on your researcher cap and solve the mystery. Don’t assume you know the guilty party. Collect evidence, form a hypothesis, and then test. Be proactive and you’ll solve your back pain mystery.


Add yours

  1. I am glad that my post helped. I still get occaisional back problems. Stress is a huge factor for me. There are other things too which contribute and physical ways of treating symptoms – glute activation etc – but at the root there is a lot of stress. Sarno knows his stuff

  2. @Chris – I have tackled 95% of my pain. I’ve found that glute activation, flat shoes and mobility exercises are supportive of the mind even more than the body.

  3. Very true.

    Posture is a case in point. People make a lot of posture in itself but good posture also has profound mental effects mediated by certain hormones…..

  4. Boot Camp Richard

    Jan 17, 2011 — 11:25 am

    I’ve developed back pain over the last couple of years and am unsure of the cause. I think it is sitting for extended periods of time at my desk, but I’m not sure. I’ll use your system to figure out what is causing it. I hope it works as well for me as it did for you.

  5. @Richard – You may find that sitting for extended periods is a secondary cause. There were probably periods of your life where you sat for extended periods and did not have back pain.

  6. I used to have bouts of excruxiating back pain. Would miss work for days. Could hardly walk down the street. I also used to go a lot of cardio, stairmaster, running, etc. I never understood why I had this back pain issue, I figured it was just an age related thing. I was just under 50 at the time, I think.
    Then I started doing slowburn, ie, HIT style training. I stopped doing cardio. One day, after no running, stairmastering, etc. for over a year, I foolishy decided to test myself by running 5 miles. The five miles was actually easy (so, I proved to myself, at least, that HIT training really does make “doing cardio” a huge waste of time). Unfortunately, my back pain came back with a whammy.
    I learned, from one of the trainers at Fred Hahns Serious Strength studio in New York, that a lot of back pain comes from your lower back muscles going into a sort of spasm. The way to fix that spasm is to work those muscles in a very careful manner, to exhaustion. The exhausted muscles can no longer spasm, and your back pain goes away. (That may not be technically completely accurate but it is more or less what happens).
    So, long story short-running gives me back pain, a careful lower back workout on a medex lower back machine cures it. And not running anymore has prevented it from coming back, for several years now.

  7. @MrFreddy – Amen to your comment about cardio being a waste of time. I’m interested to learn what exercise you used to exhaust your lower back muscles.

  8. @MAS, it was Medex lower back machine, very similar to the Medex Core Lumbar machine.

    I remember the trainer had me use lower weight than I normally had been using on that machine. Other than that, I just worked it to exhaustion. Or pretty close. I felt an immediate lessening of the back pain, and the little bit of pain that was left went away over the next day or two.

  9. @MrFreddy – Thanks for the link. I think my gym has something similar. I’m going to try it out tomorrow.

    BTW, I love your website name.

  10. The Seattle Public Library also has Dr. Sarno’s latest book, “The Divided Mind” available in the ebook and kindle format. Great post Michael. Thanks for sharing!

  11. I had severe back pain on and off for 22 years. After an injury at work, for several years I could walk for hours, but could only stand for 2-5 minutes before my back would go into painful spasms that might last for hours, days, or weeks.

    Then I read Sarno and did the exercises — in my cases, mainly deep breathing and walking to oxygenate the back muscles, stopping treating my back as fragile, and asking “If this pain in (area) was an emotion, what emotion would I be feeling now?” In one month I eliminated 90% of the pain. In 2 months I worked 8 hours standing on concrete with no pain. In the 15 years since then, I occasionally have a bit of pain but don’t worry about it, take it easy for an hour to a day, and the pain goes away.

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