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Other Back Pain Factors

Exercise, good posture, safe lifting techniques and weight control are important to prevent recurring back pain. But there are also other factors that can affect back pain other than those listed in Preventing Back Pain. Back pain can be augmented by lack of sleep, by depression and anxiety, stress, and even by smoking. Aging is also a significant factor.


The incidence of back pain increases between the ages of 20 to 65. There are multiple factors involved, but one of the main factors a gradual loss of muscle mass.

Strength exercises are THE best way, if not only way, to counteract the loss of muscle mass that goes with aging and prevent back pain. It's never too late to begin exercising and reap the rewards.

* The incidence of back pain actually goes down after the age of 65. This is because the majority of back pain is caused by muscle or ligament strain and people of working age are more likely to suffer from overuse injuries or acute injuries from lifting something too heavy, etc. However, the incidence of back pain caused by conditions such as osteoarthritis of the spine and spinal stenosis increases in people over 65.

Besides relieving back pain, strengthening the core muscles also improves balance, which helps prevent falls. Strengthening exercises increase bone mass and well as muscle mass, an added bonus. Stretching exercises maintain mobility and prevent injuries that cause back pain. Back Exercises Counteract effects of Aging. Back Exercises Page.

The discs in the spine also gradually deteriorate with age. Low-impact aerobic exercises increase the exchange of fluids in the discs, improving the health of the intervertebral discs and their ability to absorb shock.

Lack of Sleep

If you are suffering from back pain, lack of sleep will aggravate it for several reasons. It is while we are sleeping that much tissue repair takes place. Also, lack of sleep causes brain chemistry to become imbalanced and lowers the pain threshold. People who don't get enough sleep suffer more from chronic pain, including back pain.

Of course back pain itself can cause sleep difficulties, as can any type of pain or discomfort.

Fatigued back muscles can't adequately support the spine and poor posture may result. When the spine is not in proper alignment, more stress is placed on the muscles, discs, and spinal joints. Fatigued back muscles are more easily strained.

An uncomfortable mattress may cause sleep difficulties.A medium-firm mattress that is both supportive and comfortable may improve both sleep and back pain.

If you suffer chronic back pain and/or are having trouble sleeping, your doctor may prescribe a low dose antidepressant that raises levels of serotonin. Low levels of serotonin are linked to sleep problems and a lowered pain threshold. Aerobic exercise can also increase levels of serotonin and improve the quality of sleep. Don't do aerobic exercise too close to your bedtime as your metabolism is raised after aerobics and can keep you awake.

Because a tolerance can build up to sleep medications, they are not suitable for long-term use. A tolerance to pain medications containing codeine can also develop if they are used regularly, rendering them ineffective. If you have chronic back pain, pain medications containing codeine should be saved for days where your pain is at its worst.

Sleep difficulties are also commonly caused by depression, anxiety or stress.

Depression and Anxiety

Chronic lower back pain is sometimes linked to depression and anxiety. The exact cause for this is not known but there are many theories. Low serotonin levels are common in both chronic pain and depression.

It may be that fatigue is a symptom of depression and when fatigued, the muscles in the back don't support the spine properly. Mental stress and anxiety can also cause the muscles to tense up (contract), especially in the muscles of the neck and back, and tense muscles are more easily injured.

Of course the back pain itself may be contributing to the depression. Chronic pain can lead to feelings of helplessness, and a lack of control over anything in one's life can lead to depression.

Low doses of antidepressants are often helpful in treating chronic back pain. If the depression is the main problem, a regular dose of antidepressants may be required. Aerobic exercise also increases levels of serotonin and endorphins - natural substances released by your body that are similar to opiates - and relieves back pain and depression.


Stress causes the muscles can to tighten up, which reduces blood supply to the tissues, causing lack of oxygen and an accumulation of waste products (such as lactic acid) in the muscles. This leads to fatigue and also can cause or intensify pain. Muscles can actually go into painful spasms. The muscles of the back and neck are commonly affected by stress. See Stress and Back Pain for more information.


Smokers have an increased rate of back pain, especially lower back pain, possibly because lowered oxygen levels in the tissues of smokers delays healing. Smokers also experience increased degeneration of the discs.


High Heels: Wearing high heels throws your spine out of alignment and can cause lower back pain. Wearing high heels causes the pelvis to arch forward, causing sway back and extra stress on the lower spine. Try to reduce the amount of time wearing heels over 1 or 2 inches high to prevent back pain.

Cushioning: Adequate cushioning in the soles helps absorb shock, which is transmitted up the legs to the lower back, created when the feet hit the ground when walking or running.

Support: Support features built into the shoe help correct gait problems that can place extra stress on the entire lower body.

*The amount of cushioning and support and even the shape of the shoe that is best depend upon the foot type and gait style of an individual. See Footwear and Back Pain for more information.

There are many factors that contribute to back pain. Improvements in one area often lead to improvements in other areas. For example, exercises to increase strength and flexibility of the back not only reduce the risk of back strain, they help reduce stress, anxiety and depression and improve sleep, which also help reduce the perception of pain.