What Causes Back Pain? You Might Not Have Thought of These 3 Back Pain Tips.

Back Pain Relief

What causes back pain? Besides the common causes of back pain like lifting something too heavy or shoveling 10 inches of spring snow from an 80 foot driveway (been there, done that), here are insights about what causes back pain that you may not have thought of.

#1 Smoking.

idea tips What Causes Back Pain? You Might Not Have Thought of These 3 Back Pain Tips. | Denver ChiropractorSorry, no sugar coating here. If you smoke, quit. Smoking reduces the amount of oxygen in the blood which can contribute to hypertension which affects all tissues including the health of muscles and discs. Smoking doubles the risk of a person suffering from severe back pain, according to statistics presented at a medical conference on back pain held in Haifa, Israel (2000). The study showed that smokers have twice the risk of suffering from back pain when compared to non-smokers.

After examining existing research, Finnish researchers concluded smoking is “modestly” associated with the risk of low back pain.

SOURCE: The American Journal of Medicine, January 2010.

It is thought that suggests that smoking leads to malnutrition of the disc which in turn renders it more vulnerable to mechanical stress.

British Society for Rheumatology 1993

#2 Prolonged Sitting

Dr. Eben Davis, a San Francisco chiropractor and repetitive injury specialist wrote a very insightful and poignant article entitled “What’s the best office chair for your back?”

Dr. Davis writes, “Sitting for long periods, especially in the office chairs that most of us use and consider ergonomically correct, can lead to a cascade of bad things, including back pain, neck pain, and even obesity.”  Dr. Alf Nachelson , in the Journal of Bone and Joint Surgery, reports In all cases, pressures were highest in the sitting position, about 30 per cent less in the standing position, and about 50 per cent less in the reclining than in the sitting position.

One back pain tip I teach my patients trying to prevent back pain is that the body doesn’t like ANY position for too long… even a good one!

What does this mean? Move.

Change positions. Motion is health. A river doesn’t get stagnant. Just like a stagnant pond, your muscles, joints and discs that don’t move can accumulate metabolic waste and become stagnant when you sit too long.

In my ergonomics class I actually teach 7 different standing positions. Most people never give it a second thought.

#3 Head Forward Posture

Used to be that the phrase “head forward posture” was a description. Now its actually a diagnosis!

Forward head posture is a clinical finding that has been identified in numerous studies (1-6) as a significant factor in not only back pain but a number of  musculoskeletal pain syndromes. I think more than any other factor regarding posture a forward head syndrome has the greatest capabilities of doing the most long term damage and causes back pain. The dangers of forward head posture is that it creates a “domino effect” by shifting the head forward. When the head shifts forward the center of gravity gets thrown off and in order to compensate, the upper body drifts backward to compensate for the upper body shift, making the hips and pelvis tilt forward.

The forward head position can be the cause of not only the head, neck and TMJ problems,but also mid back and low back problems.” (7)

Mom was right… “SIT UP STRAIGHT!”

  1. Mennell JM. The Musculoskeletal System: Differential Diagnosis from Symptoms and Physical Signs. Gaithersburg, Maryland: Aspen Publishers, Inc., 1992, pp. 126-33.
  2. Donatelli R, Wooden M. Orthopaedic Physical Therapy. New York: Churchill Livingstone Inc., 1989.
  3. Cailliet R. Soft Tissue Pain and Disability. Philadelphia: FA Davis Co., 1977.
  4. Haughie LJ, Fiebert IM, Roach KE. Relationship of forward head posture and cervical backward bending to neck pain. J Manual Manipulative Ther 1995;3:91-7.
  5. Greenfield B, Catlin PA, Coats PW, et al. Posture in patients with shoulder overuse injuries and healthy individuals. JOSPT 1995;21:287-95.
  6. Griegel-Morris P, Larson K, Mueller-Klaus K, Oatis CA. Incidence of common postural abnormalities in the cervical shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Phys Ther 1992;72:425-31
  7. “The danger of forward head posture, Jung Yun”

I think more than any other factor regarding posture a forward head syndrome has the greatest possibility of doing the most long term damage and it is most certain that it contributes and causes back pain.

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Ron Spallone
Dr. Ron Spallone, DC is the chiropractic clinic director. His passion is the driving force behind Denver Chiropractor dot com. He's been a Colorado chiropractor for over 15 years.


  1. 10 May 10, 12:32pm

    Great post,To many people sit all day in bad chairs without moving and they smoke! and wonder why their back hurts.
    Good stuff.
    Manhattan Chiropractor

    • Dr. Ron
      10 May 10, 3:16pm

      Hey Doc-
      RE: Back pain and golf.

      Also not uncommon for people to sit all day in their office chairs, then sit in their car to drive to the golf course. They’re in a hurry to try to play nine holes before the sun sets. After a few warm up swings they
      fire away. The discs and joints are prime to be injured with that combination.
      Dr. Ron

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