You might often ask yourself, why does my back hurt? Or, why do I keep hurting my back?
Well, a huge 34% of who have episodes of low back pain will get it again and again. This causes a huge flow on effect with time off work, doctor and physio visits, as well as loss of quality of life during that time. If we can better understand why acute low back pain recurs then we can better manage it.
First of all, this first part of this blog is easy to explain – why do things hurt. Here is a short video from one of the best at explaining pain:

Things hurt due to a combination of our peripheral receptors signaling our brain that they have felt something and importantly how our brain interprets this signal. For more information on pain and the different types, check out this post.
So, with that covered, but we come back to the question of why does my back hurt; do we really know why acute low back pain recurs in over one-third of people?
There is most likely a number of factors and we don’t know them all, that’s for sure. But what we do know is that following an episode of low back pain, activity of your deep back muscles is decreased on the injured side – even once the pain is gone.
It’s been shown that the multifidus muscle which runs down the side of your spine, supporting, moving and stabilising your vertebrae has different activation to that of a normal back. This shows that even with good management when you have low back pain – the muscles don’t always get back to your normal by themselves, possibly leaving you more prone to another episode of low back pain.(2)
The good thing to remember is that in 90% of cases of low back pain they are pain free and better within 6 weeks and that 85% are classed as non-specific low back pain where there isn’t a diagnosis (you don’t need a label on it saying you have injured your joint, muscle, ligament or disc).
But even with that huge amount improving within 6 weeks – many of those recur again so it is important to ensure your muscles are fully rehabilitated, just like you would if you were returning to sport following a hamstring injury for example. Because if you can get that Multifidis firing better again that is one less thing to worry about and a much better chance of your back pain not coming back.
So if you keep asking yourself “why does my back hurt again!” go see a local physio for some advice and rehab exercises – they do work and the effects do last (1)