20 Oct Recurring Back Pain: Why Does It Keep Coming Back?
What is Recurring Back Pain?
Recurring back pain is when you have the experience of pain in your spine that comes back multiple times over a few months. The Lancet series on low back pain found that recurrence rates vary from 24% to 87% depending on how it is measured. You may wonder why it keeps returning even after you thought you had recovered. You might feel better for weeks or months, only for the pain to appear again after sitting too long, lifting something, exercising or sometimes for no obvious reason at all.
It can be frustrating. More importantly, recurring pain can make you wonder whether something is getting worse inside your spine.
Fortunately, back pain that keeps coming back does not automatically mean your spine is deteriorating.
Instead, several factors can influence whether back pain settles and stays away. These can include your strength, physical capacity, activity levels, work demands, sleep, stress, previous injuries and how quickly you return to your normal activities.
The good news is that understanding these factors can help you take a more useful approach to preventing future episodes.
Why Does Recurring Back Pain Happen?
There isn’t always one simple explanation for recurring back pain.
For some people, an episode begins after a clear event, such as lifting, gardening, sport or an awkward movement. However, in most cases, there is no obvious injury or incident at all. No story to tell.
Your back is constantly adapting to the demands you place on it. Therefore, problems can sometimes occur when those demands temporarily exceed your current capacity.
For example, you might normally cope well with sitting at work, walking, exercising and lifting. However, a sudden increase in any of these activities may challenge your body more than usual, particularly if fatigued.
Likewise, if you’ve become less active because of previous pain, your strength and physical capacity will have reduced. Consequently, activities that were once easy can become more demanding without being readily observable. “I’ve done this job a thousand times before without a problem” is a very common refrain in our offices.
That doesn’t mean your back is fragile. It simply means your current capacity may need to catch up with the demands being placed on it.
Is Recurring Back Pain a Sign of Spinal Damage?
This is one of the most common concerns.
However, experiencing recurring back pain doesn’t necessarily mean that each episode is causing more damage.
The spine is a strong and adaptable part of the body. Like other areas of the body, it can experience changes over time without those changes necessarily causing pain.
For example, age-related changes involving discs and joints are common. These findings can also be found in people who don’t have significant back pain of any kind. So it isn’t just wear and tear.
Therefore, the fact that your pain has returned doesn’t automatically mean that your spine has become more damaged.
Instead, it is often more helpful to ask:
What has changed since the last episode?
Your activity levels may have changed. Your workload might have increased. You may have stopped exercising. Your sleep may have deteriorated. Or perhaps you’ve returned to demanding activities faster than your body was ready for.
These factors can provide more useful clues than simply assuming your spine is getting worse.
What Can Trigger Recurring Back Pain?
Several factors can contribute to another episode.
Changes in activity
A sudden increase in exercise, lifting, gardening, walking or other physical activity can challenge your back.
Equally, doing very little for a long period can reduce your strength and physical capacity. As a result, your body may find normal activities more demanding when you become active again.
Work and prolonged sitting
Long periods of sitting can be uncomfortable for some people, particularly when combined with limited movement throughout the day.
However, sitting itself isn’t necessarily damaging. Instead, regularly changing position and moving throughout the day can help you manage the physical demands of prolonged desk work.
Reduced strength and fitness
After an episode of back pain, it is understandable that you might avoid certain activities.
Unfortunately, if this continues for too long, you may gradually lose strength, confidence and fitness.
Therefore, rebuilding your physical capacity can be an important part of reducing future problems.
Poor sleep and stress
Sleep and stress can also influence how you experience pain.
When you’re tired or under significant stress, your nervous system may become more sensitive. Consequently, the same physical activity may feel more uncomfortable than it normally would.
This doesn’t mean the pain is imaginary. Rather, pain is influenced by much more than the condition of a particular tissue. A topic for another day.
Returning to normal activity too quickly
After pain improves, you may be keen to get straight back to everything you were doing previously.
Sometimes, however, your symptoms have settled faster than your physical capacity has recovered.
Therefore, gradually rebuilding strength, movement and activity can be more useful than going from very little activity straight back to full intensity.
Can I Prevent Recurring Back Pain?
You can’t guarantee that you’ll never experience another episode of back pain.
Nevertheless, you can often improve your ability to cope with physical demands.
Regular movement and exercise is a good starting point. A 2021 Cochrane study found clear evidence that exercise is an effective treatment for back pain. Walking, strength training, mobility work and other forms of exercise can all help you maintain physical capacity.
It is also useful to vary your activities rather than spending most of the day in one position.
For example, if you work at a desk, take regular movement breaks. If your job is physically demanding, pay attention to fatigue and allow enough recovery. If you enjoy sport, build your training load progressively.
Most importantly, don’t wait until your back hurts before thinking about your physical capacity.
How Should I Manage Recurring Back Pain?
When pain returns, the first instinct can be to stop everything.
Sometimes, a short period of relative rest can be helpful, particularly when movement is very uncomfortable. However, prolonged inactivity can make it harder to return to normal activity.
Instead, aim to find the level of movement you can comfortably manage.
Walking may be a useful starting point. You may also need to temporarily modify certain exercises, work tasks or recreational activities.
Then, as your symptoms settle, gradually increase your activity again.
This approach can help you regain confidence as well as physical capacity.
Does Recurring Back Pain Need Treatment?
Not every episode requires hands-on treatment. That’s for you to make a judgement.
Some episodes improve with time, normal movement, exercise and sensible activity modification.
However, if your pain is persistent, keeps returning, is affecting your ability to work or exercise, or is becoming increasingly difficult to manage, an assessment can help identify factors that may be contributing.
A thorough assessment can consider your symptoms, movement, strength, physical demands, previous episodes and overall health.
From there, the appropriate approach will involve education and exercise, chiropractic care and a combination of approaches.
The important point is that treatment should be based on your individual situation rather than simply treating the location of the pain.
What If My Recurring Back Pain Keeps Getting Worse?
Recurring pain deserves closer attention when the pattern changes significantly.
For example, we will seek medical assessment if you develop significant or rapidly worsening weakness, new bladder or bowel problems, numbness around the groin or inner thighs, severe symptoms following major trauma, or other concerning changes in your general health.
You should also speak with your GP or chiropractor if your symptoms are persistent, unusually severe, progressively worsening or causing significant disruption to your daily life. It has been found that more than 58% of people with back pain will have sleep disturbance and we all know how badly that can impact your vocational, recreational and personal lives.
In these situations, the goal isn’t simply to manage the pain. It is to make sure the underlying problem has been properly assessed.
Can I Exercise With Recurring Back Pain?
In many cases, yes.
However, the right type and amount of exercise will depend on your symptoms and current physical capacity. We will guide you through this period.
If a particular exercise consistently aggravates your pain, you may need to modify the movement, reduce the load or temporarily choose another activity.
Then, as your symptoms improve, you can gradually rebuild your strength and tolerance.
This is particularly important if you’ve become worried about movement because of previous episodes.
Avoiding movement indefinitely can sometimes reinforce the belief that your back is fragile. On the other hand, a gradual return to activity can help rebuild both capacity and confidence.
Why Does My Back Pain Keep Coming Back After Treatment?
Sometimes people experience relief from an episode but don’t address the factors that contributed to it.
For example, treatment may help reduce symptoms, but your work demands, activity levels, strength, sleep or exercise habits may remain unchanged.
Therefore, symptom relief and long-term management aren’t always the same thing.
Good back pain treatment should consider both.
The aim is not simply to make the current episode feel better. Where appropriate, it should also help you understand your symptoms, restore movement and function, and improve your ability to manage the physical demands of everyday life.
What Is the Best Approach to Recurring Back Pain?
There isn’t one treatment that is right for everyone.
Instead, the most useful approach usually combines an understanding of what is happening with a plan that matches your current abilities and goals.
For some people, that might mean becoming more active.
For others, it could involve strengthening, changing work habits, improving exercise technique or addressing factors that have been limiting their recovery.
Sometimes, hands-on care can be useful as part of the process. In other situations, assessment by your GP may be more appropriate. We can help you make this decision.
The key is to avoid simply repeating the same response every time the pain returns.
Instead, ask what you can learn from the pattern.
Three Questions to Ask When Back Pain Returns
The next time your back pain returns, consider these three questions:
- What has changed?
Think about your activity, work, exercise, sleep and general health since your last episode.
- What can I comfortably do right now?
Rather than stopping everything, identify movements and activities you can manage and build from there.
- What can I change this time?
Consider whether you need to rebuild strength, modify your workload, change your exercise routine or seek professional assessment.
These questions can shift your thinking from “What’s wrong with my back?” to “What can I do to improve my capacity?”
When Should I Get My Recurring Back Pain Assessed?
If your back pain keeps returning, you don’t necessarily need to worry. However, repeated episodes can be a good reason to have your situation properly assessed, particularly if they are becoming more frequent or affecting your lifestyle.
An assessment can help determine whether your symptoms are consistent with a common musculoskeletal problem and whether chiropractic care is appropriate.
It can also help identify situations where another form of healthcare assessment would be more suitable.
At Northcote Chiropractic Centre, we look at the whole picture rather than simply treating the painful area.
Our aim is to help you understand what’s happening, identify the factors that may be contributing and develop an appropriate plan for getting you back to the activities that matter to you.
The Bottom Line on Recurring Back Pain
Recurring back pain doesn’t automatically mean your spine is wearing out or becoming damaged.
Instead, repeated episodes can be influenced by changes in strength, fitness, activity, workload, sleep, stress and physical capacity.
Therefore, rather than becoming fearful every time your back hurts, try to understand the pattern.
The goal isn’t to promise that you’ll never experience back pain again. Rather, it is to improve your physical capacity, confidence and understanding so that you’re better equipped to manage it when it occurs.
If your recurring back pain is becoming a regular problem, an appropriate assessment can help you work out what may be contributing and what your next step should be.
Frequently Asked Questions About Recurring Back Pain
Why does my back pain keep coming back?
Back pain can return for many reasons. Changes in activity, strength, workload, sleep, stress and physical capacity can all contribute. Recurring pain doesn’t necessarily mean that your spine is becoming damaged.
Is recurring back pain normal?
Recurrent episodes of back pain are common. However, the pattern matters. If symptoms are becoming progressively worse, occurring with significant neurological symptoms or substantially affecting your daily life, seek appropriate professional assessment.
Can exercise help prevent back pain from returning?
Regular physical activity and progressive strengthening can help improve your physical capacity. However, the right exercise depends on your current symptoms, abilities and goals.
Should I get an MRI if my back pain keeps coming back?
Not necessarily. Imaging isn’t automatically required simply because back pain has returned. A clinical assessment can help determine whether imaging or further medical investigation is appropriate.
Should I see a chiropractor for recurring back pain?
A chiropractor may be appropriate for some people with recurring musculoskeletal back pain. However, treatment should be based on an individual assessment. Depending on your symptoms, a GP, physiotherapist or another healthcare professional may also be appropriate.
Can recurring back pain be permanently fixed?
There is no guarantee that back pain will never return. However, improving strength, physical capacity, activity levels and confidence can help you manage future episodes more effectively.
Where Does This Article Fit in Our Back Pain Series?
This article is part of our Fear and Confusion: Understanding Your Back and Neck Pain series.
If you’re trying to understand your symptoms, you may also find these articles helpful:
- What Is Causing My Back Pain?
- Do I Need an X-Ray or MRI for My Back Pain?
- Is My Back Pain Something Serious?
- Should I Rest or Stay Active When My Back Hurts?
- How Do I Know Which Treatment Is Right for Me?
Understanding your back pain is often the first step towards knowing what to do next.
If your back pain keeps coming back, don’t simply assume that you have to live with it. Understanding the pattern can help you make better decisions about your health and your next step.
