The three most significant lifestyle changes caused by back pain are:

Return to Technical Data Menu

• Posture change.  Posture is often changed so that less stress is put on the injured segment of the spine. Unfortunately, this new posture often increases the stress on other spinal segments.  For example, a common posture adopted in acute episodes of back pain is one where the pelvis is shifted to one side, the spine is somewhat rotated, and one hip is kept slightly flexed. This may provide relief in the short term, but can and often does easily lead to more long-term problems.
• Avoidance of Movement.  A natural reaction to pain is to avoid any movement that causes the painful area to work. In the case of back pain, even movements of the arms and legs can cause an increase in stress, so lack of movement is an initial response to back pain. This can help relieve pain in the short term, but lack of movement often continues for longer periods, which can have far more serious consequences long term. If a muscle is not used, it can very quickly lead to atrophy or wasting (as much as 5% of muscle bulk can be lost daily in some muscles), which in turn can lead to weakness.
  Muscle weakness often occurs to a greater extent on one side in the spinal area – which can cause a muscle imbalance that will predispose the spine to recurrent injury at low stress levels.
• Reflex Inhibition of Muscles.  Pain can cause a reflex inhibition of muscles. This means that if a muscle is injured or in spasm, nerve messages from the brain (that usually warn the stability muscles to prepare for movement and protect against injury) are interrupted or inhibited to prevent the pain. So the stability muscles become dysfunctional and cannot protect the spine from strain during movement, which can lead to more pain and inflammation. In this case, muscle impairments are not those of strength but rather problems in motor control.

It is apparent that changes caused by pain affect all three subsystems of stability.

Once the pain settles, however, there is no automatic change back to neutral posture, normal movement patterns, or to the brain re-activating inhibited muscles.

This seems to be one of the key reasons for the common pattern of recurrence of back pain.

It appears that the key to improving spinal pain and decreasing episodes of recurrence lies in changing the body mechanics back to its pre-injury state.
This would include

• correcting poor posture and movement patterns,
• strengthening weak muscles, and
• re-education of the neural control of stability muscles such as Transversus Abdominis and Multifidus