Sooner or later, most Americans will suffer from back pain -- four out of five, according to the Mayo Clinic. One question leaps to mind: What's the secret of that fifth person? These folks may just be incredibly lucky. More likely, they simply don't fit the profile of a typical back pain sufferer. Nobody has any guarantees against back pain, but some people, for a host of reasons, are less vulnerable than others. Here's a look at some common risk factors for back pain. Some of them you can work to change; others, like your age, you can't. Either way, if you understand them, you may be able to form a game plan to keep your back as healthy and pain-free as possible.

Hard labor

If employers were truthful, many job descriptions would include the words "back pain." According to a 1997 report from the National Institute for Occupational Safety and Health, back pain often comes with any job that requires a lot of hard physical labor, heavy lifting, bending, twisting, or whole-body vibration. Jobs that require people to stay in the same position for hours at end can also be hard on the back.

Previous injuries from accidents or sports

Just as repetitive injuries from work can make you vulnerable to back pain, so can repetitive injuries from play. Years of playing or training for sports can lead to back pain, as can serious, regular dancing. In fact, even children who play sports or practice dance rigorously can get back pain, just like middle-aged adults.

The easy life

While some people work their backs too hard, others don't work them hard enough. People who rarely get exercise are prime targets for back pain. After years of neglect, the muscles that support the back can grow weak, stiff, and prone to injury. Weak back muscles put more pressure on the spine and increase the risk of compressing discs. Weak stomach muscles mean the back must bear a bigger load.

The way you move and sit

When you're lifting, twisting or bending your back instead of your legs can injure your back. In addition, holding or lifting objects too far away from your body can all hurt your back, tearing or straining a muscle, ligament, or tendon. Slouching in a chair makes it easier to injure your back, and tucking a phone between your ear and shoulder in order to talk while using the keyboard can result in excruciating neck pain.

A troubled mind

Some kinds of back pain may be tied to the emotions. Anxiety, anger, emotional stress, and depression all seem to make people more vulnerable to pain, according to a review of hundreds of studies in the May 1, 2000 issue of the journal, Spine. People suffering from emotional turmoil are more likely than others to develop back pain in the first place, and their pain is more likely to become chronic and disabling. The good news: treatment for depression, anxiety, and other mood problems might help many patients overcome pain. Some people may be able to avoid pain by finding effective ways to relax and clear their minds.

Smoking

Researchers have uncovered a surprising association between smoking and back pain. Several recent studies have found that smokers seem to be more likely than nonsmokers to suffer sore backs. Researchers speculate that nicotine might make the body more sensitive to pain. It's also possible that smoking damages the structures in the lower back by slowing down circulation. The apparent link between smoking and back pain raises many interesting questions about the root causes of pain. If you're a smoker, it gives you one more reason to quit.

Obesity

The link between obesity and back pain isn't as strong as many people think. While some studies have found that extra weight slightly increases the risk of pain, others have found no such trend. Back pain expert Richard Deyo, MD, sums up the situation this way: Extreme obesity might put extra strain on the back, but adding two or three extra pounds isn't likely to hurt. And people who are moderately overweight probably can't prevent back pain simply by slimming down, he says.

Age

Sometimes you just can't hide from the things that make you a target for back pain. Relatively few people suffer back pain before they reach 30, says Richard Deyo in the February 1, 2001 issue of The New England Journal of Medicine. But as the years go by, the muscles, ligaments, and disks in the back can show signs of wear. Eventually, activities that would have been harmless in your teens can leave you hunched over in pain.

Genetics

If you notice that your relatives have a predisposition for back pain, that may make you a likely candidate for the condition as well. Several small studies in Finland, including one reported in the April 11, 2001 Journal of the American Medical Association, show that patients with back pain share a certain gene. Certain diseases, such as ankylosing spondylitis, may be genetic and can cause back pain. There's not much you can do about your genes, but you can control other things that affect your back pain risk, such as your weight and the state of your stomach and back muscles.

Pregnancy

About half of pregnant women have bouts of back pain at some point in their pregnancies, usually when they're walking, standing, or bending. The answer is obvious: The weight of a growing baby tends to weaken abdominal muscles and alter a woman's posture, putting a strain on her back. Many women often experience sharp pains or weakness in their backs, legs, and buttocks, often caused by the baby's head pressing on pelvic bones that in turn press on sciatic nerves. The best treatment: rest. After the baby is born and the extra weight disappears, back problems usually do too.

If you've had back pain in the past, or just want to avoid it in the future, there are many ways to improve your chances of staying pain-free. If your job is literally breaking your back, it's time to find another line of work. If you don't get much exercise, there's no better time to start. If you developed your back pain as a result of exercising, it may be time to revise your routine -- doing stretches before exercising or checking our your technique with your doctor or with an exercise trainer. If you suffer from stress, depression, or anxiety, seek professional help. If you smoke, try and quit.

Remember, there's no surefire way to prevent back pain. But you can put the odds on your side.

-- Chris Woolston, MS, is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education.

References

First published March 26, 2003
Last updated January 10, 2007
Copyright © 2003 Consumer Health Interactive

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