I’m no stranger to bouts of back pain, and it seems I go through it every winter. When the water is hard and unsuitable for paddling, when the roads are a hazard for cycling even with studded tires, and when the woods’ trails turn into a slick of ice, the only real option for outdoor aerobic activities is to take a walk down the road. Swinging along at a lively pace feels great—or at least for about a hundred yards. That’s when my back begins to tighten up. An hour (and about three miles) later, my springy bipedal stride is reduced to an agonizing tripedal stagger. Still, it could be worse. Much worse. I am very glad I take a walking stick. Without it, I’d have have to crawl on all fours.

Sound familiar? I bet it does. Few of us make it out of our twenties without exclaiming “Oh! My aching back!” at least once. So what can we do about it? Well, first things first. The root causes of back trouble are more than skin deep, so let’s begin by taking a quick peak beneath the skin.

What we call the backbone isn’t really a single bone, of course. If it were, we’d have trouble bending over to tie our shoes, let alone hefting a pack, throwing a leg over the top tube of a bike, or swinging a paddle. Fortunately, our spines are built up from 25 interlocking vertebrae. Having grown up within sight of a railroad grade crossing, at a time when watching the trains pass by was the best free show in town, I can’t help thinking that the vertebrae have a lot in common with the cars in a freight train. Like freight cars, our vertebrae need to hang onto each other. Or else. Couplings connect the cars in a train; facet joints and ligaments link each vertebra to its neighbors. Yet the individual vertebrae, like individual freight cars, also need to rock and pivot. If a little movement is a good and necessary thing, though, it doesn’t follow that more is better. After all, our vertebrae don’t just keep us from folding up like a jackknife with a broken spring, they also protect the most important bit of wiring in our bodies: the nerve bundle we call the spinal cord. This is where my freight train analogy breaks down. Trains don’t often rear up on their hind legs, and on the rare occasions when they do upend, the results aren’t pretty to look at. Our backbone has to stand and deliver all day long, however—a task it accomplishes only with the help of a complex support structure of muscles and ligaments. And that’s the rub. While the manifold causes of back pain are still being hotly debated, it’s a pretty safe bet that injuries to muscles, facet joints, and ligaments rank high on the list of culprits.

This is a good time for a few cautionary words: I’m a hack, not a physician, and I don’t want to play doctor on the Internet. Yes, most back pain is just, well, a pain in the back. It may make it hard for you to get through your day—let alone throw your leg over the bike, wield a paddle, lift a bag of groceries, or take a brisk hike—but it’s not a harbinger of worse things to come. Sometimes, however, back pain is an early warning of serious disease, and occasionally it’s nothing less than a medical emergency. This isn’t a call you want to make on your own. Only your doctor can help you distinguish one from the other. So if your back is troubling you, see the doc, just to be on the safe side. And if the pain is severe, if it radiates down one or both legs, or if it’s accompanied by weakness, tingling or numbness, or by disturbances in bowel, bladder or sexual function—don’t waste time! There’s not a moment to lose. Get to the doc ASAP. If that’s not possible for some reason, head for an emergency room. Pronto. A few hours delay could mean a lifetime in a wheelchair. ‘Nuff said?

Luckily, such emergencies are rare. But that doesn’t mean that everyday back pain is fun to live with, does it? Certainly not. So let’s explore some tested strategies for coping with a bad back. Read more…

 
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