Cropped shot of a senior man in a green shirt holding his lower back suffering from back pain

Back pain is one of the most prevalent medical conditions worldwide, impacting millions of Americans and often restricting their daily activities. The Health Policy Institute reports that approximately 16 million U.S. adults experience chronic back pain, defined as pain persisting for more than three months.

Back pain, whether it appears suddenly or develops gradually, can greatly affect an adult's quality of life. It can limit mobility and physical function, strain emotional and mental health, create dependence on pain medications, and ultimately reduce overall well-being.

Spine expert Skulpan Asavasopon, PT, PhD, from Loma Linda University Health, emphasizes the importance of looking beyond the chronic label and understanding the underlying reasons for persistent back pain.

“The real question is why doesn’t the pain go away?” Asavasopon says. “We need to diagnose the root causes and mechanisms of pain to prevent it from recurring.”

Though back pain can happen to anyone, Asavasopon shares insights on the importance of good spine health and offers practical steps to help ease persistent back pain and keep it from returning. 

The importance of spine health

With so many adults experiencing back pain in their lifetime, Asavasopon highlights three key reasons why spine health is essential:

  • Economic Impact: Back pain leads to high healthcare costs, lost workdays, and disability, making it a significant financial burden on individuals and society.

  • Silent Suffering: Chronic low back pain is a leading cause of disability and workers' compensation claims, with many experiencing recurring, persistent pain. This causes suffering and impairs cognitive function, affecting overall clarity and performance.

  • Preventable Pain: Back pain doesn’t have to be a lifelong problem. Understanding and addressing the root causes can prevent it from becoming chronic. 

Defining a healthy spine

All spines naturally age, but what matters most is how well they function relative to that age. A healthy spine supports normal movements, adapts to daily activities without significant pain, and ages naturally without abnormal wear or deterioration. For example, X-rays of a 90-year-old’s spine may show degenerative changes, but it is still considered healthy if it functions appropriately for its age. Conversely, if a 20-year-old’s spine shows similar degeneration, it’s a clear sign of an unhealthy spine.

A healthy spine is not just about perfect structure; it’s also about mindset, explains Asavasopon. Accepting the natural aging process as a normal part of life can significantly reduce suffering. Asavasopon notes that a 90-year-old who accepts their spine’s normal aging experiences less pain than someone who perceives their spine’s aging as a problem.

This mindset shift is essential because it reframes the narrative around spine health, emphasizing that structural changes don’t necessarily equate to dysfunction. A positive outlook can greatly impact how spine health is perceived and managed, underscoring the importance of both physical and mental health in maintaining a healthy spine.

Reversing Chronic Back Pain

Surprisingly, most back pain doesn’t start with a clear cause. Asavasopon notes that many patients simply say, “It just started one day.” While injuries do occur, they are less common than many think.

The real culprit is often improper movement and posture. “How you move, sit, and function daily can put stress on your spine, leading to pain over time,” Asavasopon explains.

Below, Asavasopon outlines a three-step approach to reversing chronic back pain:

Diagnose the cause: The first step is identifying what’s contributing to the stress on the spine. “Understanding the biomechanics or movements that are putting stress on your spine helps identify the root cause of the pain,” Asavasopon says. Often, a person's pain is directly related to their posture — how they walk, sit, sleep, or move. Diagnosing the movement or posture contributing to the pain is key to achieving long-term relief, rather than relying on temporary fixes.

Educate: The second step is patient education and acceptance. “After diagnosing the cause of the pain, patients need to understand their diagnosis and what needs to happen going forward,” Asavasopon says.

When patients are less involved and lack a clear understanding of their condition, the approach tends to shift toward being physician-centered rather than patient-centered. When patients engage in their recovery process, it fosters a better understanding of recommended treatments and promotes a more collaborative approach to care.

Targeted intervention: To address the root causes of pain, patients must correct movements and postures contributing to their discomfort. This involves learning to sit, stand, walk, lift, and perform daily activities with proper mechanics that reduce stress on the body.

Maintaining a neutral spine — where the natural curves of the neck, mid-back, and lower back are in proper alignment — is essential for good posture, optimal movement, and minimizing the risk of injury or pain. While it’s normal not to maintain a neutral spine constantly, Asavasopon emphasizes the importance of being mindful of proper form. “Training both the body and mind to default to a neutral spine can significantly reduce back pain, including adjusting habits like walking or sitting when they contribute to discomfort.”

Chronic back pain can be eased by understanding its causes and making targeted changes to how you move and function. However, including your doctor or physical therapist in your recovery is important. Click here to schedule an in-person appointment, or visit lluh.org/videovisits for video appointments.