I’m a spine doctor — beware this surprising cause of back pain, and what you can do to improve it

It’s a real pain in the back.

An estimated 80% of Americans will experience back pain at some point in their lives — and for around 16 million of those adults, the issue is chronic and with no easy end in sight.

While incredibly common, back pain is notoriously difficult to treat because “it may be caused by multiple overlapping factors that cannot always be visualized on a scan,” Dr. Patricia Zheng, a physical medicine and rehabilitation specialist, told Medical Xpress.

Some common causes of back pain include muscle strain, herniated discs, sprains, arthritis, poor posture, obesity, lack of exercise and even stress.

But, according to Zheng, one of the most overlooked causes of chronic back pain isn’t physical at all — it’s psychological.

“In a 2024 study, we identified smoking, alcohol, obesity, sleep disturbance and depression as risk factors for chronic back pain,” she told the outlet.

“I think some patients are surprised that depression, which may be associated with sleep disturbances, is linked to back pain.”

Depression can often make pain feel more severe, which is why she recommends seeing a therapist or taking antidepressants to patients who consistently feel down.

“Studies show that the neurotransmitters that play a role in depression and anxiety are also involved in the way we process pain, so taking an antidepressant may dampen the nervous system’s overreaction to pain,” she said.

A recent study found only one out of every 10 treatments to be effective in relieving lower back pain, so the condition often needs to be tackled in a myriad of ways.

Firstly, Zheng recommends exercising — but not too strenuously, as research has shown that can actually make things worse.

“I can’t emphasize enough how important it is to stay active,” she said, adding that she personally rotates between Pilates, aerobics and light weightlifting five days a week.

“But I’m not perfect; when life gets busy, I slack off.”

When you’re in the office, she suggests maintaining good posture and getting up from your desk once every hour to move around “because prolonged sitting puts pressure on the spinal disks.”

As for those trendy standing desks? Some studies show they can help relieve back pain, but there’s more science behind simply going for a walk.

In fact, a recent Norwegian study showed that walking 100 minutes per day was associated with a 23% lower risk of chronic lower back pain.

If your back pain is due to an injury, Zheng emphasizes the importance of easing back into activity.

“The problem is, if you don’t move, you get deconditioned,” she told the outlet.

“That can make you more susceptible to future injuries.”

In some extreme cases, minimally invasive surgeries or steroid injections might be recommended.

Meanwhile, some people have successfully relieved back pain by following an anti-inflammatory diet, which means eliminating things like sugar, red meat and alcohol.

Although Zheng herself is no stranger to temptation.

“I try to eat a balanced diet, but for me personally, I love sweets,” she said.

“I’m not going to pass on the dessert!”