Fixing Back Pain Permanently

Chronic back pain is incredibly limiting, and is more and more common—even with younger people. I've kept a short guide to solving back pain issues for a couple years, and a friend requested that I publish this publicly. Around 80% of people who have used this guide have told me that it fixed their issues permanently.

This is my maximalist approach to fixing back pain issues — I actually just point you to several resources that are exceedingly effective. This guide is unusual in that it's agnostic about what's actually causing your pain, and what the fixes may be. Specifically, the resources here all have very different models of back pain, and I have no idea which is correct. However, each of them has been the key for someone that has used this guide, so I keep them all here. You may need to try all before you know which will work best for you.

First, a pitch: if you have chronic back pain (not from a known injury), you absolutely should try to fix it. It will massively improve your quality of life, taking a huge weight off your mobility. If you look around online, you'll find many very different methods that people claim work. The secret seems to me that different methods work for different people, and you should try several before giving up. These method are all low-risk and safe, assuming you're otherwise healthy. However, if any are not comfortable with any, listen to yourself and talk to someone more qualified then me. That said, most back pain can be fixed with the approaches I list here without surgery or intense physical therapy.

Read the book, pain goes away

My single best recommendation is Healing Back Pain: The Mind-Body Connection, because it is the easiest — no stretching, surgery, or workouts. Read the book, and for many people, their pain is gone. In fact, I know someone who's back pain was fixed by reading the Amazon reviews. The proposed mechanism, in short, is that your pain could have started by an injury or similar, but is chronic as a somatic expression of emotional distress. This does not mean the pain is "in your head"; the pain is very real. But just like you can have an upset stomach when you're nervous, Healing Back Pain (which works on all sorts of pain, including RSI) models the most common back pain as a similar manifestation. Yes, it sounds far fetched, but this has been the most successful route, so I do recommend that you try it. Patterns of people who this has worked especially well for: people who often feel stress in their bodies, and people without an existing somatic-release practice (such as yoga, meditation).

Mobility training + posture re-wiring

Another popular mechanism of back pain is that we sit all day, so we have under-developed muscles, which get strained over time by needing to act in non-optimal ways. This approach is a non-targeted approach, in that it offers highly effective generalized back-strengthening exercises, coupled with posture techniques. This recommendation comes next because it's simple, and exceedingly effective.

The exercise is this video:

This is a re-make of an older version; they're similar. The workout is 12 minutes, and unless you're quite fit already, will be a challenge. It's fantastic at opening up your movement and mobility, even if you have no pain. If you need inspiration, read the YouTube comments. This workout works.

Additionally, with your stronger core and back, this approach benefits from re-wiring the movement patterns you're used to. Under this model, your weaker back promotes suboptimal ways of movement, which should also be corrected. There's a few options here. The first, to give you an idea of what I'm talking about, is this video:

The best approach I've found that directly addresses this is the Feldenkrais Method. This series is quite good:

(Part 2, Part 3, Part 4, Part 5, Part 6, Part 7, Part 8)

The core ideas:

1. Use your skeleton to support weight, not muscle
2. Move from the hips! Less back bending
3. Use gravity to your advantage
4. The core is about stability, transmitting force
5. Distribute weight/force evenly

Importantly, addressing these points involves changing how you move. It takes cognitive awareness and practice.

Another approach is unrelated to posture, per se, and more related to effortlessness. Your skeletal system can nearly effortlessly support your body, without needing to "strain" towards good posture. (This perspective is core to the Feldenkrais Method as well.) The Alexander Technique is an incredibly effective approach to re-wiring how your body sits and moves through space. It's usually taught with a teacher, but if none is available, Michael Ashcroft's course Expanding Awareness is very good.

A mechanistic, targeted stretching program

Your issue may be quite targeted in a way that a generic mobility exercise may not address. This route is the most work, but for people where the previous methods didn't help, may be the solution.

Treat Your Own Back is the best resource of this variety. It has a clear mechanism for chronic back pain, with prescribed stretches to address the underlying issues. 8 Steps to a Pain-Free Back is similar, and also quite good. You will learn movement patterns that a (good) physical therapist would teach.

The wildcard: fight pain with more pain

The title is a joke, but this approach has no clear model or mechanism, but has fixed my acute back pain twice in very short order. I also think it feels great (in a cold plunge sort of way), but not everyone agrees. It's a wildcard because this method has never fixed longer term back pain from anyone I know (though the Amazon reviews have plenty of people who it did help), and seems to work best for acute pain that isn't from an injury.

Lay on a acupressure mat. It seems to promote blood flow, so perhaps that's what it's doing? Either way, it's worked quite well for me (within 1-2 days, doing it twice a day for around 10-15 minutes). If you want more pain, this one is intense.

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Disclaimer: if you don't have chronic back pain (i.e., you just injured yourself), I doubt any of these will help. You probably just need to heal. And none of this is medical advice, of course. Please make good decisions about health issues.