Your Back Pain Probably Isn't a Back Problem

When someone comes to me with back pain, the first thing I tell them is this: it's very rarely actually about the back.

Most of the time, the real problem is somewhere close by. The back extensors, the muscles running along your spine, end up overworking because something else isn't doing its job properly. That something is usually the inner unit, the deep core.

The inner unit is made up of the pelvic floor, the transversus abdominis, the multifidus muscles, and the diaphragm. Together, they're supposed to create the internal pressure and stability that supports your spine from the inside out. Not the six pack everyone associates with "core strength", something much deeper.

When part of that inner unit is weak, or sometimes too tight, it creates an imbalance. Your back extensors sense the instability and step in to compensate, working harder than they're built for, day after day. Eventually, that overwork shows up as pain.

This is why so many people can stretch, strengthen and rest their back and still not get anywhere. They're treating the part making the noise, not the part causing the problem.

Once we find where that inner unit imbalance actually is, and start rebuilding it properly, the back usually stops needing to compensate. That's when the pain starts to ease, not because we hammered the back harder, but because we finally gave it help.