Does back pain return once it is FIXED?

Why does it always come back

What if all these things are done? What if everything is put in place to ensure that the back pain doesn’t come back? What if the core is the strongest it’s ever been? The disc pressure has come off and the pelvis is looking strong as well. However, there is still pain, not as much but sometimes there can be a niggle or something that is causing an issue whilst gardening or picking up the kids.

We have to go back to the causes of back pain, look at the structural, chemical and emotional components to how it develops. Most of the examples we have spoken about so far have focused on the structural side of care, this is really important. For 90% of cases it will cause resolution when we get to the root cause of the issue. For that last 10% we must look deeper.

Chemical stress

Chemical stress is what we are putting in our body and how it’s interacting with our health. The most common type of toxic stress is smoking and alcohol. Obviously, they cause a lot of reactions throughout the body and will change the composition of certain tissues. If these tissues are already inflamed it only exacerbates the problem and will delay healing.

So how does that even work? You’re telling me that when I drink alcohol it will make my back pain worse? There’s one main element with alcohol stress on the body, with that being the fact that it dehydrates the patient, causing the tissues to become a lot tighter. If you think about wet towels and you begin to suck the water out of it, it becomes dry and fluffy. A similar thing happens to the tissues surrounding the spine. They are supposed to be holding the spine in place and able to move and adapt to the demands the body is putting on it. When they are dry and brittle, the discs will take up more stress and can cause back issues.

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How does smoking work?

Smoking has an impact on the body. When you breathe in from the cigarette, it causes the chemicals in cigarettes to be absorbed into the bloodstream which then goes around the body. These chemicals cause a free radical reaction, essentially where they have a mind of their own and run around and bounce off different cells in the body.

When they go past an area that is damaged or inflamed it can exacerbate the issue. Picture this: a china shop with two damaged plates, and the lady who owns the shop is beginning to clean up the plates when two toddlers run into the store, hyped up on green smarties. They begin bumping into everything and causing more plates to smash and more damage. This is a similar way that free radicals from cigarettes work, they cause already damaged cells to become weaker and this then delays healing long-term. This is why when you break a bone, the doctor will recommend that you don’t smoke as they have shown that smoking affects bone healing.

Other types of chemical stress include prescription medications. They put enormous amounts of stress on the body. One of the most common medications that is used is Ibuprofen or Nurofen (trade name). This is an anti-inflammatory or NSAID and works on the body to reduce inflammation. Well, hold on a second, if this drug reduces inflammation then surely that’s a good thing? Yes, I see where you’re coming from, however, the knock-on effect of an NSAID is that it reduces the mucus lining in the stomach. The stomach has lots of acid to break down food so that it can be absorbed further down the digestive tract. When you lose the thick padded lining of the stomach, it leaves it susceptible to damage from the acid and this can cause hernias over the long-term, which is where there is a hole in the stomach. This can cause major problems and can often result in surgery, which is not where we want to be.

There is always a time and a place for medications. I have seen my clients walk into me on crutches bent over at ninety degrees and not able to function. To get in the car they had to take some sort of pain medication, otherwise it wasn’t possible. Pain medication such as Ibuprofen, Naproxen or Co-Codamol do provide short term relief, however, they shouldn’t be used long-term to manage pain as they can cause worse side effects and compensations in the rest of the body.

I would always recommend when taking any sort of pain medication to use it with food and with a lot of water to limit the knock-on effect it has on the digestive system and the rest of the body. It’s not my role to recommend when it is appropriate or not to be taking medication; this is a conversation to be had with a GP. With pain medications such as ibuprofen and naproxen, people do become over reliant on them and use them each day. The pain feels good when taking medication, and it’s difficult to come off that when there is still an issue there putting pressure and causing pain.

The NSAID category such as ibuprofen and naproxen are anti-inflammatory drugs, and these are the ones that can damage the stomach. Opioid medications such as co-codamol can block pain pathways with over-use of these for long periods of time, and the patient can risk becoming addicted much more commonly than taking NSAIDs. Non-opioid medication including paracetamol are one of the safer medications to take as they are less addictive and cause less issues with the stomach and digestive tract. It is still a stress for the body to process and can cause toxic stress on the liver.

Hope is not lost as there are some natural anti-inflammatories that can be administered and provide really good pain relief without having any side effects on the rest of the body.

Ginger, in its root and raw form, is one of the most powerful natural anti-inflammatories out there, and it can be taken in a juice or a smoothie or a tea. It’s also in a supplement form, which isn’t as effective and is not a natural source. The downside is that you have to have a lot of ginger to have the same effect as taking an ibuprofen.

Turmeric is also a great root vegetable that will provide a similar effect to ginger and can be taken in the same way either in a juice or a tea.

Omega 3 is a compound that is found in fats, more specifically oily fish and certain nuts like sunflower seeds and pine nuts. It works very similarly to an anti-inflammatory drug and has various other health benefits. What does oily fish mean? This is salmon, sardines, kippers and mackerel. There is absolutely no chance that I’m eating those and definitely not three times a week.

This is something that I would recommend is supplemented, as some of our patients do find it difficult to get three portions of oily fish into their diets each week. You can get a good quality omega 3 supplement from for around £15, if you wanted to go to more of the Ferrari equivalent you can look at It is a better-quality supplement, but if you are just starting out then it depends what your goal is. You can always email me at, and I can provide some guidance.

There are plenty of other food items that can cause inflammatory effects on the body such as sugar and acidic foods. Foods that tend to be packaged or prepared will also have high numbers of artificial nutrition in them, which can cause the body to become inflamed and influence back pain.

So, you are telling me that if I’m eating chocolate and caffeine that will affect my back?

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This is a difficult concept to understand but I will try and make it as easy as possible. Firstly, with caffeine it is a dehydrant meaning it will draw water out of the body, which is why when you’ve had a lot of caffeine you feel very thirsty and your body is dehydrated. If you have a muscle spasm or a disc issue, then the water is sucked out the muscles causing them to be very hard and inflexible. The disc is 85% water, so there’s less water in the body and it’ll be reduced in size, causing more pressure in those areas.

Whether it’s artificial foods such as sugar and artificial flavourings, they will affect the acid/alkaline balance of the body. If I take you back to chemistry (which I must be honest wasn’t my favourite science), if you remember the pH scale and something that is a high pH is very alkaline and something that is a low pH is acidic.

The pH of the body is just over seven, and when this pH is maintained, most of its systems function in harmony. If the pH goes up to more of an alkaline balance, then a lot of research suggests that this is actually a good thing and is where a lot of nutritionists will try and get their clients. Many cancer patients will be on an alkaline diet as the theory suggests that the cancer cells cannot survive at a higher alkaline pH.

When we eat something acidic, bringing the pH lower, the blood will become more acidic and this is not good for cells and tissues in the body. Some foods that are very acidic like sugar, meat, processed foods and caffeine sustain a low pH for long periods of time can cause chemical disruption in the body and affect the ability of the body to heal.

The alkaline diet is very simple. The main concept is lots of raw, green leafy veg and a minimum amount of meat. Protein is sourced from nuts, seeds and eggs. There is very little processed food, and generally, if you’re making most things from scratch, then your body is going to be in a more alkaline state.

We also have another stress on the other side of the triangle called Emotional Stress. This is best described after a long week of work, when you come home and the house is a tip, kids are running around and the dinner is not on yet. You start to feel your shoulders tighten up and go into the neck, and you feel this sudden surge come around the head and develop into a tension headache. What happened?

This is a primary emotional stress causing the body to have a physiological response to either move away from the stress and do something different or to try and relax. A lot of people, particularly after a long day at work, will use alcohol to wind down the body and reduce emotional stress. This works as the alcohol has a relaxing effect, but it’s not a long-term coping method. You often find that people who start drinking on Friday after a long week but who do not drink on the Thursday after a long day, gradually creeps up the week until one glass of wine every night is not only having minimal effect on the emotional stress but also providing chemical stress to your body.

There are often more traumatic incidents as well such as relationship issues, bereavement, and accidents such as car crashes. These cause huge emotional stress on the body, and even though we cannot feel it or see it, it is still a huge amount of stress for the body to cope with. This must be managed by the body, and studies have shown that when we are stressed it causes a physiological response in the cells. Different hormones are released and the chemical composition of the blood and cells changes. If this is sustained long-term, it can cause adrenal stress and often burnout.

I talk to many people who work long hours and have busy lives, rushing here there and everywhere, myself included. It’s only when you stop and take a check that you think I can’t sustain this long term. It causes a huge drain on the body. I read an article the other day about partners at the ‘Big 4’ accountancy firms having a reduced life expectancy once retiring as the body is in constant fight and flight mode for forty years of working. Minimal sleep, poor diet, high stress and high stress from toxins. As things in the body start to break down, we seek medical advice and take pill after pill, all the while piling up this toxic and emotional stress on the body.

Where my clinic is positioned, we see a lot of our patients who work in the city with busy jobs and busy lives. Commuting each day is draining and also puts your body in a state of mind that can result in stress overload.

So how does emotional stress cause back issues? It’s not that a negative emotion will go to your back and say “I’ve had a rubbish day, you are going to hurt now.” It affects your body’s ability to deal with pain. So, very often, the body can block out or compensate for an issue in the spine by recruiting other muscles or walking differently. When there is emotional stress that is an emergency, it must deal with this first before trying to deal with the pain issue. And it brings it to the surface much more quickly and apparently (Yin, 2001).

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If you do know someone who wants more advice, please send them our details. You can send them this assessment as well to diagnose their back pain. It is a great tool to understand where your back pain is coming from, it is free and takes 60 seconds. Click here for assessment

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