An acupuncturist from California has found populations that have zero back pain, and she thinks she knows their secret.
But first, some background.
A crick in your back. Backache. Back pain. It hurts, and it is debilitating. No buts about it.
You aren’t alone.
Back pain is THE biggest cause of disability worldwide (1). This is nothing to scoff at. In the US alone, 31 million people experience lower back pain at any given time (2). Whether muscular or skeletal, it is a condition that is incapacitating, and, according to the American Chiropractic Association (ACA), it is the second most common reason for visits to the doctor’s office as well as one of the most common reasons for missing work (3).
How is it that back pain is so common, yet, we still haven’t found an effective solution? Better yet, what is the root of the problem? Some new evidence has recently been presented, and it gives us insight on what might be the basis for most of the back pain we see today.
First, let’s take a look at what causes back pain.
Causes of back pain
Unfortunately, most back pain isn´t caused by anything in particular. Specialists call this “non-specific” back pain. Instead, most cases of back pain caused by a combination of physical and psychological factors that together cause distress con the bones and muscles.
There are two main categories of back pain:
- Acute back pain: in the few cases where there is a specific cause for back pain, it is caused acute back pain. It usually happens when you injure yourself after lifting a heavy load, sleeping in a strange position, or pulling a muscle trying out a new dance move. It can be solved by itself over time, or with some specific intervention like therapy or stretching.
- Chronic back pain: This is a lot more worrisome, because the causes often aren´t diagnosed. This has strong psychological causes. Stress, boredom, anxiety, overworking, dissatisfaction at work on in a relationship… all of these are potential causes.
When there is no cause found, specialists in city-settings will sometimes diagnose the patient with fibromyalgia. In reality, according to a recent study sponsored by the World Health Organization, a fibromyalgia diagnosis isn´t much different than other situations where patients feel widespread pain (4).
Who is more vulnerable to back pain?
While in most cases the exact cause of chronic back pain isn´t pinpointed, there are some “risk factors” or elements of lifestyle and genetics that may make you more vulnerable to back pain.
Some of these are:
- Age: The older you are, the more likely you are to have some sort of back pain. The first attack of low back pain usually happens between the ages of 30 and 40.
- Fitness level: When you don´t exercise regularly, you are more likely to experience back pain. Also, if you are normally sedentary and start exercising, you´ll probably feel back pain until you make it a habit.
- Diet: A diet high in calories can lead to weight gain, which puts stress on the back.
- Genetics: Some genetic illnesses, like arthritis, can negatively affect the bones and joints.
- Race: According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, “African American women are two to three times more likely than white women to develop spondylolisthesis, a condition in which the vertebra of the lower spine – also called the lumbar spine – slips out of place.
- Your job: Jobs that require you to lift heavy things, or, at the opposite end of the spectrum, a highly sedentary job, can lead to injury and back pain.
- Smoking: Smoking increases your risk of developing sciatica, which can then cause back pain
Are There Populations That Don´t Experience Back Pain?
This is where this gets really interesting.
Even though the study on back pain carried out by a researcher at the World Health Organization demonstrated that back pain occurs in similar proportions in all cultures (defined by nationality), some population-specific studies have suggested something different (6).
Esther Gokhale, an acupuncturist from California, had been experiencing intense back pain after she had her first child. She was diagnosed with a herniated disc. While she had surgery, it happened again, and she was determined to find a more permanent solution.
She set out to look for alternatives outside surgeries and drugs.
Gokhale decided to look for populations where back pain didn´t exist and study them, their lifestyle, their posture, and their bone anatomy. She visited indigenous cultures from West Africa to Ecuador, and found something extraordinary. Mostly of the indigenous cultures that were separated from Western ways of life didn´t experience back pain (7) .
What was their secret? “Primal Posture”.
Their J-shaped spine.
If you´ve heard anything about human anatomy, one of the first things had to have been how human spines are S-shaped. Take a look at the image below:
The image in the middle depicts two differently-shaped spines, though both claim to depict stereotypical human spines. The first is a modern depiction of an S-shaped spine, while the second is an image from a French anatomy textbook from over 100 years ago. The first shows a much more pronounced S-shape. The second one looks more like a dangling J than an S (11).
People in rural indigenous communities are often seen carrying heavy and baskets on their head, spending multiple hours a day bent over from the waist down working in fields, gathering wood. Nonetheless, they don´t have back pain.
Gokhale compared the shape of their spines with those of Americans, and the difference in shapes was clear. Children naturally have J-shaped spines, but, after hundreds of thousands of hours sitting at desks, tables, and in couches our spines turn more into an S-shape.
This, she theorizes, is the root of all back pain. She studied the work of anthropologist Noelle Perez-Christianens, as well as physical therapy methods like the Alexander Technique and the Feldenkrais method, and developed her own, 8 Steps to a Pain-Free Back. (8, 9, 10).
Want to be Pain Free?
There are a few methods you can put into practice to help achieve the J-shaped spine and help reduce chronic back pain forever.
Gokhale explains the method she developed in detail in her book, but there are also some things you can put into practice today to achieve better posture and less pain. Before trying any of these exercises, however, talk to your doctor about your particular issue and the best options for you.
- Roll your shoulders backwards: Hunched-over shoulders are the culprit for the top curve of the S in the “S-shape” spine. After years of sitting in a certain position, your muscles reconfigure so that slouching feels comfortable. When we get tense, this seemingly-natural position can start to hurt, and it can be difficult to relax.
A few times a day, roll your shoulders but lifting them up towards your ears and rolling them backwards, pinching your shoulder bones together. This helps to stretch out the muscles and, over time, reposition your shoulders above your hips, not in front of them.
- Many people with back pain have reported that Yoga helps to alleviate back pain. This is due to the ability for yoga to build strength and improve posture, as well as alleviate stress.
Certain poses, like Vajrasan (see image), helps to maximize blood flow, and stack your shoulders above your hips, while relaxing your back muscles (12).
- Upper-back support. This is one of my personal favorites. While it shouldn´t be the only solution, it has helped me to improve my posture, and be more conscious about how I position myself when I sit for long periods of time. One of my favorites is Str8-n-up, an all-fabric back support that helps to retrain your back muscles.
The back is a very complex part of the body, with dozens of bones, muscles, ligaments, that keep us up and moving, not to mention the spinal cord that contains essential nerved that run information from the brain to the rest of the body.
The back is beautiful, but also very fragile, which is why it is so important to take proper care of it. Eat right, exercise mindfully, improve your posture, and consult your doctor before trying any new methods, sports, or activities in order to make sure they are compatible with your particular issue.