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Smart self-inquiry is key for identifying why your back hurts. The following questions may serve to identify helpful behavior modifications and possible treatment options.

1. Does the pain change in intensity?

  • If you wake up in pain or it worsens throughout the day, that is a clue to the type of injury and can help narrow down appropriate treatments for your condition. Identifying times and types of sensations changes the mental dialog from “my back hurts all the time” to my back feels different ways at different times due to different activities.

2. If you roll over during the night, does your back “catch” painfully? Or at any other times during the day?

  • This may indicate spinal instability which can be addressed by strengthening and improving core stiffness through exercise. Avoid getting chiropractic adjustments, too much stretching or yoga, skip doing spinal mobility exercises and limit your end-range when flexing, extending or twisting

3. What worsens the pain?

  • If you can identify triggers, then you can also avoid replicating the injury mechanism for a period of time while you get stronger

4. Was there an initial traumatic event that you associate as the cause of your back pain?

  • Sometimes a traumatic event such as a fall or car accident will result in a clear mechanical injury. Identifying the conditions of the injury event can help us identify how to Rehab, Rebuild and Restrengthen over time. These are the three phases of programming in Retrain Back Pain.

5. Do you have osteoporosis?

  • Pre-existing bone loss determines if you should avoid certain activities and exercises that compress the spine. By taking osteoporosis in to consideration, we can limit inflammatory behaviors and decrease your discomfort

6. Is the discomfort worst first thing in the morning?

  • Adjusting sleep position, pillows and props may help. Adjusting activities to improve core and spinal stiffness may also help.

7. Does the pain worsen throughout the day?

  • This indicates gravitational positioning fatigue relating to spine hygiene. Improving postural positioning and adding rest intervals with progressive load activities may help improve endurance and postural strength.

8. Is the pain more in your middle back?

  • If the pain is located between shoulder blades or higher, this may relate to postural imbalances such as slouching and forward head position. A postural assessment, improving spine hygiene, self-massage and strategic strength and mobility practices can improve this

9. Does the pain ever radiate in to your bum, legs or feet?

  • This may indicate nerve entrapment due to disc pressure or facet joint inflammation. Postural assessment, anti-inflammatory protocols, lifestyle changes and an individualized exercise plan can improve this.

10. Does the pain increase or decrease with fast walking?

  • If fast walking feels better than slow walking, it’s possible that disc compression issues are at play. Self-decompression, self-massage, dynamic stretch and strengthening may help. If cumulative walking worsens symptoms spinal stenosis may be involved; for this postural assessment, anti-inflammatory protocols and lifestyle changes can improve this. If walking creates a sense of increased tightness it may be related to muscle spasm which can be addressed with dynamic stretching, self-massage, activity adjustments and strengthening.

Self-inquiry is part of the collaborative coaching model that is so effective at Retrain Back Pain®. This is just an initial starting point to get you thinking about stimuli and triggers.

One-to-one weekly coaching is an effective way to move this process forward in a consistent way so that you can get back to the life you love.

xo ~Dinneen

Note: These self-assessment questions are based on the questions included in Dr. Stuart McGill's book, "Back Mechanic: The Secrets to a Healthy Spine Your Doctor Isn't Telling You"