Back pain is so common that if you have never experienced it, it is probably just a matter of time. Most back pain is low back pain. It often radiates into one’s behind or down a leg. Why is low back pain so common? Well the real reason is that you were supposed to die in your thirties, and you didn’t. Your parts were not designed to last 60 or 70 years. It’s kind of like expecting your 1969 Ford Valiant to drive you into the 21st century without an overhaul. Ironically I know someone with a 1969 Ford Valiant who doesn’t have back pain. Maybe it’s the seats. I don’t know. The other reason for the commonality of back pain is the fact that your back is basically a stack of jelly donuts and electrical wires.

Visualize a jelly donut. Do no eat the jelly donut. Just visualize it and what might happen if you put a heavy weight on one side of the donut. Of course the jelly would squirt out the other side. Well that’s you. You are the jelly donut. During a lifetime of bending forward at the waist, your jelly has gradually squirted out your back side. The jelly then runs straight into the electrical wires that, in this analogy, are the nerve roots traveling from your spinal cord to your leg. When the jelly hits the wire, the wire sends a pain signal down your leg and you experience “sciatica”. It turns out that the donuts most often affected are lumbar donut number five and sacral donut number one. The wires from these donuts travel down the side of your leg and foot, or straight down the back of your leg. You may not experience only pain, but weakness as well because the wires carry nerves for both sensation and muscle control. Typically a person might find it difficult to rise up on their toes; bummer if you’re a ballerina.

But donut disease is not the only way backs can go wrong. Your back has many other parts. Any one of which can break and cause pain. The disks between each vertebra can wear out and allow the vertebra rub against each other, ouch. The disks can also develop a tear. There are “facet” joints in your back that are also subject to wear, lose cartilage, develop arthritis, and become painful. Any of the many muscles, ligaments, and tendons may be strained and hurt.

The good news is that most back pain is self limiting, which is to say that given some time, the injury usually heals itself, or given lots and lots of time you die and then the pain goes away. Sometimes it doesn’t and that’s where things like physical therapy, massage, chiropractic, and medicines can help. It is uncommon for people to need surgery for back pain. At this point you are probably wondering “Why do they let him write these articles?” or maybe you are wondering “How do I know when to get help with my back pain problem?” Obviously if the pain is severe, we can help. Beyond that there are some symptoms that need help sooner than later. Loss of touch or sensation in a hand or foot can be a problem, but if it is minor, does not constitute an emergency. However loss of strength is a bigger deal and any kind of incontinence caused by the back pain is considered a surgical emergency. Other scary signs are fever or weight loss with back pain. Seek medical help for your donut. Do not seek donuts for your weight loss.