Why Your Back Pain Is NOT From A Bad Back

Back pain isn’t just a topic I frequently discuss because it’s one of the leading causes of disability worldwide—though that alone would be reason enough. It’s also because I’ve seen so many clients believe exercise wasn’t an option for them due to a history of low back pain, only to discover otherwise. Most importantly, I know from personal experience how back pain can not only interfere with workouts but also take over your life.

For years, addressing back pain has been my mission. After battling it for 35 years—including undergoing seven spinal surgeries—I finally understand the problem well enough to say I’m pain-free (though I still experience tightness). My goal is to help others achieve the same or, at the very least, significantly improve their back pain experience. While complete resolution isn’t always possible, everyone can get better.

No single solution works for everyone, as each person’s experience presents unique challenges. However, before exploring what can help, it’s important to dispel a major back pain myth: the idea of having a “bad back.”

I understand why people feel this way—trust me! I have screws and rods in my spine, yet I avoid saying I have a “bad back.” Why? Because for most people, chronic low back pain isn’t caused by a fundamentally defective spine. Even if you’ve been diagnosed with a bulging or herniated disc, that’s often not the true cause of long-term pain. Most bulging and herniated discs heal within 6-8 weeks with activity modifications and possibly some targeted exercises or physical therapy.

So, what if your pain has persisted for 5, 10, or even 20+ years? It’s always best to consult your doctor, but an important question to ask is whether the disc issue is truly the cause of your pain—or simply a normal part of aging. Research supports this:

“On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.” (PMID: 8208267)

In fact, medical guidelines discourage routine imaging for chronic low back pain unless red flags suggest a serious underlying condition:

“Don’t routinely image patients with low back pain regardless of the duration of symptoms unless: (a) there are clinical reasons to suspect serious underlying pathology (i.e., red flags), or (b) imaging is necessary for the planning and/or execution of a particular evidence-based therapeutic intervention on a specific spinal condition.” — Canadian Spine Society, Choosing Wisely Canada

“Do not undertake imaging for low back pain in patients without indications of a serious underlying condition.” — Australian Rheumatology Association, Choosing Wisely Australia

“Do not routinely offer imaging in a non-specialist setting for people with low back pain with or without sciatica. Consider imaging in specialist settings of care… only if the result is likely to change management.”— Royal College of Physicians, Choosing Wisely UK

Doctors are even taught that addressing patients’ fears and providing education about recovery is more effective than unnecessary imaging:

“Patients’ primary concerns of whether their pain is caused by something serious and what they should do to aid recovery can be addressed by sound education and reassurance, without the need for imaging.”

Many people who believe they have a “bad back” might be surprised by these statistics:

• Less than 5-10% of all low back pain cases stem from a serious spinal pathology.
• The remaining 90-95% are not due to a severe underlying cause and should be managed with conservative treatments such as exercise, physical therapy, chiropractic care, cognitive-behavioral therapy, or pain management. (PMID: 33579691)

So, what’s actually happening? That’s a big question—one I’ll continue to explore in future posts. But for now, let’s focus on a key factor: fear.

As one of my favorite chronic pain experts, Yoda, once said:

“Fear is the path to the dark side. Fear leads to anger. Anger leads to hate. Hate leads to suffering.”

You might think I’m just sneaking in a Star Wars reference, but science backs this up. Research shows that pain is influenced by psychological, cognitive, environmental, and neurophysiological factors. Increasingly, researchers are focusing on fear, because:

“…fear of pain and activity, driven by the anticipation of pain and increased injury—rather than the noxious sensory stimuli associated with pain itself—produces strong negative reinforcement for the persistence of avoidance behavior, resulting in putative functional disability in people with persistent pain.” (PMID: 20425197)

This raises the question: What should you do? The answer depends on what resonates with you. Some people find relief through psychological approaches, lifestyle changes, or exercise-based methods. The best starting point is whichever feels most accessible and effective for you.

Since many people turn to exercise, that’s what I’ll focus on here. For me, movement has always been therapeutic. But after transitioning from Strongman training to lying in a hospital bed, uncertain if I’d ever walk again, exercise felt impossible.

I won’t claim that a few magical exercises solved all my issues overnight. That’s unrealistic—and can make people feel discouraged when they don’t experience instant relief. The truth is, recovery took time, consistent effort, and a lot of trial and error. I faced setbacks but learned from each one. Avoiding frustration was tough, but I also learned to acknowledge it without letting it take control.

The good news? These strategies aren’t unique to me. Research supports methods like those used in Myofascial Integrated Movement (MIM) drills, which have been linked to reducing fear-related barriers to movement and exercise. (PMID: 27062950, PMID: 35686580)

Of course, MIM drills aren’t the only option. Chronic low back pain affects people differently, and a range of training approaches can be helpful. In future posts, I’ll explore other methods. But for now, I encourage you to try integrating MIM drills into your routine:

• They can serve as a 5-10 minute warm-up.
• They can be homework when discomfort arises.
• They can be a full workout for those who struggle to exercise without flare-ups.

The takeaway? Anyone can benefit from these training methods, and they may be a key step toward overcoming chronic low back pain. Stay tuned for more strategies in upcoming posts!