Acute and Chronic Back Pain. Here are 2 Causes Why

Sherwin Nicholson | May 5, 2020

lower back pain and your muscles

Know the differences to help treat yourself

When the pain is Acute

Any back pain that you experience suddenly and without any predictable warning signs is considered to be acute.  Acute does not means that the symptoms are less severe.  In fact it can be very painful at times and immobilizing, requiring urgent care and rest.

These instances can occur in times when you have a minor cramp or spasm or ‘freeze’ up, restricting your movement and demanding immediate care.  In time, your spasm or cramp clears up.   These episodes are rare with little pattern.

If your pain is acute, bed rest and medication are usually all you need and you can resume your daily activities upon recovery.  This recovery can occur within days to a few weeks.

Some episodes may seem like they are only that, acute.  But you have to watch out when the same type of episodes begin to repeat themselves.

Look out for the signs of why your pain may return

When the pain becomes Chronic

Although you may feel the discomfort is only short and temporary, it happens because the underlying back problem itself is becoming chronic.  The repeated issues are difficult to assess but are usually a result of poor posture, lumbar support, weak abdominal muscles, or tight hip and leg muscles.

Of course there are far more serious reasons for chronic pain such as an injury, illness or disease.

For most cases, it usually begins with your muscles

When muscle groups that support these areas of the spine are not well conditioned, then less stable muscles must compensate and suffer to adjust.

Because they are not equipped to maintain support, they fatigue and lose their ability to keep the discs balanced. This triggers neighboring deeper and outer muscles to guard and spasm.  This is the acute discomfort that is felt.

An all too common trigger

Sometimes acute pain can be triggered when we turn or lean to reach and pick up or move a seemingly harmless and straightforward object causing a crippling spasm.  It is not this movement that is the root cause, but from an earlier underlying issue that the body has not yet recovered from.

This simple new task triggers an area of the back to aggressively protect another area from further injury by locking up.

the deeper muscles of the back

Other acute triggers are: sitting poorly, reaching in an unbalanced or awkward position for an object (reaching for something behind you in the car), lifting items that one is unaccustomed to (lifting an active child or pet).

Other examples include performing tasks that are out of your natural daily activity and that require over extension of muscle groups (weekend gardening, moving), and performing dynamic or strenuous exercise or activity that is out of your regular fitness routine (weekend warrior in sports or heavy snow shoveling).

Together, these movements call specific muscles groups to either flex, contract, extend, stretch or twist for sustained duration and intensity.  When that muscle is not prepared or conditioned for this type of movement, it can hurt.

Although one may feel that their muscles are sufficiently conditioned for the task, it is usually deeper or weaker muscles that are not able to keep up with or match the stronger ones and therefore start to hurt.

Any movement that involves a twisting action on the spine is very likely to trigger acute back pain and can become a serious long term problem.

It’s important to rest but be careful how much you do

After proper medical treatment and examination for any serious, physical, underlying problems, a period of rest and recovery should be followed.  However, too much rest can also hurt as recovery encourages too much muscle inactivity.

When you take the time to rest, you are unknowingly allowing the muscles to become tight again. Your joints will also lose mobility and hurt as a consequence.

To prevent this, you must begin mobility exercises as soon as medically advisable as muscles require movement to heal and function properly from injury.

Questions to ask while recovering from acute back pain:

    • Is the underlying cause one that requires immediate medical attention from a doctor?

    • Are the activities that you are performing a risk to trigger more discomfort?

    • Are you relying on medication and rest as the first step of your treatment plan?

    • Can these activities therefore be avoided or adjusted to prevent injury?

    • Is your work posture affecting you?

    • Are your muscles (specifically hip and leg) adequately stretched?

    • Are you performing an adequate exercise and stretching program that is designed to protect your spine?

These questions should be answered before resuming your activities and routines.  Otherwise, the chronic underlying problems will not be resolved, and you will be faced with the same issues again.

Sometimes acute back pain can be triggered when we turn or lean to reach and pick up or move a seemingly harmless and simple object thereby causing a crippling spasm.

If you are in need of help because it hurts when you sit at work, follow these 5 important tips now.

Chronic Back Pain

It is not only one of the most common complaints at the doctor’s office, but it is also one of the most difficult to diagnose and treat.

More people stay home from work for extended periods of time due to this common condition.  The burden to the health care industry is significant and shows little sign of change.

Chronic sufferers can become easily frustrated, exhausted and discouraged from the lack of available and effective help to treat their own particular cause.

It not only involves the lumbar vertebrae and the discs in between, but the various muscle groups,  imbalances, hips, legs, joints, ligaments and nervous tissues that are present.  Compounded with this are the sufferer’s lifestyle, the level of activity and general conditioning.

The two leading causes of chronic back pain are: muscular and skeletal.


Muscular causes are similar to the ones mentioned in the acute situation, that is, poor conditioning of the muscles (inactivity),  poor posture,  imbalances in the muscles groups involved (stretching and strengthening), hip flexor and abdominal issues.

Inactivity, causes your muscles to lose their ability to provide sustained support for the spinal column.  Prolonged tension severely limits proper muscular function.

Poor posture can cause the spine to be out of alignment for extended periods of time. The muscles that align the spine can alter in their strength and flexibility causing compression in between the discs and the nerves.

Uncorrected muscles imbalances can keep you in pain

Muscle imbalances can cause one side operating the joint to become dominant while the other side weakens.  When your joint goes off balance, joint pain can happen. Over time, the more active muscle dominates the imbalance causing progressive weakness and possible injury.

Although the causes are similar, the degree to which the injury to the spine affected is greater and more damaged at the skeletal level.   The lumbar vertebrae become subjected to sustained pressure both balanced and imbalanced leading to disc injury.

A serious chronic condition known as adaptive shortening syndrome is very common if your back hurts often.  It is responsible for this muscular imbalance and is very easy to become prone to.  Most of us suffer from it, but it is very treatable since it typically requires exercise conditioning.


Skeletal causes are from the wear and tear of the bones and joints.  This aging process leads to degenerative conditions of the vertebrae and the discs in between.  Sometimes it is not from aging but an excessive amount of pressure on the joint during an activity such as heavy lifting or falling.

Aging and injury to the edges of the vertebrae from excessive contact from bending may lead to osteophyte formation. This is a protective measure by the immune system and is also known as ‘bone spurs’.

Disc shrinkage from aging and injury cause the vertebrae to come closer together accelerating osteophyte formation and facet joint wear and discomfort.

The facet joints are a significant source of chronic discomfort as they wear.  These joints help to protect the spine through their lubricated and gliding support as one joint moves above the other.

Facet joint pain is as severe as disc pain and can make it even harder to treat and overcome.

To address and manage these causes, medical consultation must be the first priority.  With appropriate consultation, one can determine if a program is an advisable and safe one to use.

Most programs do not provide initial relief as quickly as the sufferer would like to achieve, but with patience, perseverance and time, the benefits of the exercise program can be achieved as progress is made.

The Low Back Pain Program eBook provides specific exercises designed to target the lower back muscles, hips and legs.  These exercises help to relieve both forms in a careful step by step way for someone who is already suffering.


Read about how your hip flexors and hamstrings are hurting you.


  1. Acute pain-Diagnosis and treatment of LBP.Casazza BA1.-
  2. Management of chronic LBP.Bogduk N1.-
  3. Solving Back Problems – Dr. J. Sutcliffe. Timelife Custom Publishing. Health Fact File.  1999. RD768S82
  4. Predictors of response to exercise therapy for chronic LBP: result of a prospective study with one year follow-up.-