When is Back Pain Serious?

10 Jan

Of all the injuries that I treat in the clinic, back pain is by far the most fear-inducing. It is not uncommon to hear of people calling an ambulance when unable to move from the floor due to feeling nauseous with immobilizing pain that can subside almost completely the following day.

From this fear, we have developed a narrative that lifting heavy weights or lifting with improper technique is bad for our backs and I hear concern from those who are suffering with back pain that they are doing more damage or that they should avoid lifting weights that impact the back.

In this blog, I explore some frequently asked questions about back pain, give you an idea of symptoms that should not be ignored and hopefully reduce some of your fear around back pain.

Is lifting weights bad for my back?

Weightlifting has a very low incidence of injury compared to other sports, and it is most certainly a myth that weightlifting is bad for your back. Quite the contrary. However, pushing our bodies beyond their current comfort zone can sometimes result in pain or an injury, and the back is no exception.

Sharp, tension, discomfort, aching, and tightness are all words I hear when describing back complaints. Deciding whether it is serious, something is damaged, whether to rest or even if it’s normal can be confusing.

Let’s explore some of these common questions.

Is back pain normal when lifting weights?

I will start this by saying no, pain is not normal and should not be ignored. You know your body. However, first, we need to be more specific when saying the word pain as this can help unpick the issue.

It can be useful to note the type of pain. Is it sharp, constant, or gripping, or would you describe it as uncomfortable, achy, full, tight or ‘working’? The latter are common descriptions of a tired back, perhaps fatigued or overloaded, (which may be your intention of the session - see ‘back pump’ in the next paragraph) or may be due to compensating for weaker surrounding tissue.

The ‘back pump’ is commonly talked about in weight training circles and deemed common if you have trained heavily through extension exercises like a deadlift or other form of similar lift. Particularly if this exercise is new to you. Often described as a fullness or tightness across the back it generally indicates the back has worked and should progressively improve over the next day. It may occur on similar training sessions until your back muscles are stronger but should ALWAYS progressively improve and over time, with repeated training, become less or the sensation no longer concerns you.

Another question I ask people is ‘If this feeling was present anywhere else in your body would you be concerned and would you describe it as pain?’. The lower back has won the top slot as the prime panic area for many people and thus our brains over-analyse sensations from this area.

When is my back pain a cause for concern?

Here are some further questions to ask yourself to help gain some perspective on your back pain.

Does the pain last longer than 48 hours post a lifting session?
Is the pain getting worse during the period after lifting?
Does the pain radiate into your buttock(s) or legs?
Is the pain or discomfort recurrent each time & unchanging?

If you answer yes to any of these questions, it doesn’t diagnose you as having a serious back problem, but the presence of these symptoms would suggest it is beneficial to have an assessment with a Sports Therapist or Physiotherapist.

These symptoms suggest that the issue is unlikely to resolve itself if you want to continue training and is likely to return even after some rest.

Have I damaged my back?

The human spine is more robust than you would think. Whether through nature or because of our learned beliefs about ‘slipped discs’ etc the muscles around the spine can be quick to spasm. Being in so much pain through muscle spasms and unable to move one day, only to be moving freely the following is not uncommon. Your worries or anxieties about your back can manifest into more protective spasms & pain. By expecting pain & worrying about pain, you manifest pain. Never underestimate the pain of deep back muscle spasms, they are breath-taking and frightening but often not reliable symptoms for injury severity & damage.