Episode 55: 6 Simple tips to address your back pain

 Back pain is the one of the largest burdens on the healthcare system. It is complex, frustrating, and often misunderstood. But does fixing it require expensive surgery or endless adjustments? Often, the answer is no.

In this episode, we break down 6 Simple Ways to address back pain. We move beyond the traditional "structural" view and explore the Biopsychosocial Model—looking at how your movement, your social life, and even your self-talk influence your pain levels. From finding the "root cause" (hint: it’s usually not your back) to understanding why "Motion is Lotion," this episode provides a checklist to help you take control of your recovery.

In This Episode, We Cover:

• Motion is Lotion: Why being sedentary makes pain worse and how to find an "entry point" for movement that doesn't hurt (like breathing exercises or glute squeezes).
• The Biopsychosocial Model: Why you need to treat the "Psycho" (mental) and "Social" (connection) aspects of pain, not just the "Bio" (physical).
• Nutrition & Inflammation: Why it’s not just about "losing 20 lbs," but tracking how alcohol and sugar affect your inflammation levels.
• Finding the Root Cause: The 3 Big Buckets of back pain: Hip Asymmetry, Spinal Flexibility, and Core Stability.
• The "I'm Broken" Trap: How negative self-talk creates a fear-avoidance cycle that keeps you in pain.
• Education vs. Exercise: Why knowing why you are doing an exercise is just as important as the exercise itself.

Connect with Us: If you enjoyed this episode, please leave us a review on your listening platform or subscribe to our YouTube channel!

Disclaimer: Although we are healthcare providers, we are not YOUR healthcare provider. Content is for educational purposes only. Please consult your physician before making lifestyle changes.

Transcript

Speaker: 0:01

Welcome to the podcast, the podcast healthcare professionals providing insight to navigate your health so that you can go fix yourself. The podcast hosted by Mike Bruno, chiropractor and athletic trainer. And me, Michael Stanton, athletic trainer, certified strength conditioning specialist. Although we are healthcare Your healthcare provider will discuss general health interventions in this podcast, but you should not take that as health advice that works in every situation. Before doing anything on your changes, please consult with This podcast and views from this podcast are separate from our full time jobs and our own opinions. If you're enjoying the podcast, please leave us a review on your listening platform and or like subscribe to our podcast at YouTube. Links to our show can be found in the show notes on any platform that you're listening to. So today's episode topic, we're approximate six simple ways to Very it's a very loose six. Oh I dude this is This is the I mean, you're you're the I always kind of call Is that is that bad? Should I not say that? Should you not say chiropractors I mean, the the people. Like, I'm not a like the doctor So when people most people just which is preferred. Um, I had one one of my clients She was like, I don't know what And I said, whatever you want. She said, Doctor Bruno sounds Doctor Mike sounds like weirdly Um, I don't play football with Um, whatever. Whatever, whatever. Yeah. It's like, call me Jerry. Um. But, yeah. No, at least because actually get something done on uh, what are you going to. Neurologists? Well, it depends on what you there's a lot of specialists Physiatry. I don't know if this is, is this No. No, this isn't I, I just kind of thought about it as we started. Very I would say if you say spine doctor, there's the surgical route and there's the non-surgical route. So if you were to say that's, uh, like dos Yeah, but but even then, yeah, I They have to specialize into that because like, a D.O. is like they get a lot of they actually learn. The only difference between like up doing a bunch of like, have to learn. Right? Right. So there's, uh, it's funny, who's a physical therapist, and asking me to teach him how to do to be, like, proficient at it. But he learned it one time in a semester when I was talking to Courtney about this, when I was going through chiropractic school. This is a story that I it's She goes, yeah, we don't really and manipulation and stuff. One slide in one class, one time was said chiropractors cause strokes, don't do neck adjustments. Moving on. And that was it. Talk about that. Black and white. Oh, yeah. Yeah, yeah. That's how parts come at you. Sorry. Everyone's got their turf. I guess it would all be better Um, I mean, yeah, pets and If you are a very high quality comes and see you, they your degree is technically, I have people all the time who by the end of it their questions Like, what do you do? Yeah, my license, chiropractor But the goal is to, you know, doesn't really matter. Yeah. There's a lot of crossover And like everyone has like all three of the we really went off topic here but um, the all three. Yeah. All three I have like their And it like, you know, physical with, all right, we got movement get things better. Athletic trainers honestly it's But the biggest thing that separates athletic trainers is actually the emergency action planning, the emergency care, things like that, probably from like the general health perspective. And then just having the it's the very beginning. Uh, in the schooling, um, which helped me in chiropractic school so much. Oh yeah, I'm sure I have friends who came in with psychology degrees or business degrees and they really like, uh, cadaver lab was a rude awakening for them. And I was been there, done that, simple rehab principles, like, I It didn't learn. We didn't we? I mean, we did have rehab class, years ahead and had practice and and stuff prior, we would go minimums and that was it. So some people were that's like, you know, that's their starting point. And I'm looking at it like this. Half of this stuff doesn't even Yeah, because because I've been Yeah. It was a, it was more of a this your boards type thing. So me and my rehab professor did percent, truthfully, ninety education that I've sought out Yeah, I would honestly say a It's the same for me. Yeah. One of my, uh, buddies, dad's, time, and he always said, just Go get the degree. Um, and then figure out how you're going to practice afterwards, which is kind of sad, but. Yeah, but, I mean, that's in a sense. Yeah. There's too much to go over to School itself. And what I've seen get people You know, we're really tangent. But what I've seen, uh, people most of the time isn't the No. So it's hard to it's hard to Let me try the traditional stuff first, because that's more of a shotgun approach. It's hey, this is what usually you were had zero experience, like your best shot at feeling Um, and usually it's oh okay. Like maybe I did notice I always tell people if it's not a hard yes or a, it's if it's not a hard yes, it's a hard no. So we do something exercise or intervention. Hey like did you notice a change And they say ah well like if Yeah I, I always have to tell someone it's like all right like Did you see a change and and like they're like, hesitate to answer. I was like, you can say, no, you're not going to hurt my feelings. Like, yeah, like like you always Like, I always have to give that Like, you know, I saw something I thought would work, but for some reason, it doesn't work for you. Fine. We go back to the drawing board Right. And that's the whole part. Because something that could they could have a terrible work for them on Tuesday. Yeah. So being able to be fluid in what the goal is, you can make to still get you to the end. End goal. Yeah. Okay, now let's start the. Stop that. Yeah. All right. How how we're going to address So I made a list of six things add do whatever the hell he already does anyway. Yeah. Um, so number one, my my first like, the general population, I like, athletes, like legitimate But so number one is just be Be more physically active. Because a lot of times that will for your sedentary population. Yes. One of the common isms that And you. Yeah, it's not the prettiest There's some value to it because something is better. The the caveat to that is when someone says, okay, but everything hurts. What do I do? Where do I start? So if you're blindly giving that okay, well walking hurts, but So I'm going to go walk anyway. And it exacerbates symptoms that Um, but for the large part of better off doing general stuff. More? Yeah. It doesn't have. Yeah. Sorry. Back pain specific is. Yeah. At that level is not a thing. It's do something. Yeah. And even then, like the people because for whatever reason, it Also we're saying walking it can It could be an arm bike. Like like it could be, um It could be, it could be biking. Like, it could be something. It's like whatever kind of gets Yeah. The point is, you have to find Yeah. So especially when I work with people, the goal is to find something that they can tolerate on day one, even if it's a super acute problem where everything hurts. Sometimes the answer is a Yep. And holding a position. And that is enough to get the And then you stack from there. Yeah. Even like I go back to, like, Like even you get that person post-surgical that can't do anything. It's like I do tell people just Like it's something like just start doing a little bit of something kind of like breathing exercise where like you're not making movement, but hey, you're in a position and focusing on breathing. That's enough. Mm. Absolutely. Absolutely sweet. All right. I don't think we have to belabor I think kind of goes with one is maybe that kind of, you know, make ties or communicate with something that's a like I love going out for coffee. Me, a lot of my friends, I'll grab some coffee. And that's like a very social Uh, even running, running clubs, there tomorrow, actually, where just, uh, we jog. I don't really go very fast. I talk the other person. It's very chill. Um, it's actually coffee More coffee. So that's my. For me, it's really just have That's funny. The the social aspect, the big fancy term I'll use is biopsychosocial. Yep. So that's a model in for people who don't know that's a model in pain. So there's bio the physical part of it, psycho the mental part of it and social is what Mikey just alluded to. So having most pain has is not It's a combination of all three So if you hammer the physical social, the likelihood of you resolution is much lower. Yeah. And like even kind of going off Right. If you break down, let's say. All right. You had the bio Someone has an Okay, so you just hammer that away and you give a blanket statement of you can't do anything physically. Like, there's no there's no Hey, you can't do anything until the ankle sprain has fully healed. You can't go for walks. You can't do this. You can't do that. So that's when, like us, we have to take into account like, okay, well, what is that going to do them from a psychological standpoint, you're probably taking away from their favorite activity. And then from a social activity how they socialize and And that's what you have to kind And that's also why I really model, because there is a built to it, where we're always conversation prior to getting is really helpful for me to so I can give them the Because if you miss that part and you come in and you treat everyone's back pain the same like it's car on an assembly line, right? Maybe that works for one out of either don't notice any change It's the percentages are not So the whole goal is to be able to address the full person, which is not just the physical injury. Like, hey, my back hurts. Yeah. And like even so like we we've before and whatnot. You know, we use that as like kind of get someone over a hump. I honestly use it as a great conversation with someone. Like as I'm doing treatment, I'd be like, hey, how are you feeling? What's going on with your life? How's this? How's that? Like in the college setting, it was very easy to make those connections. Like. Right, because you're working with people for sometimes five years. Um, so, so, like, a lot of times and see what's going on. You kind of pick up, you know, Oh, you know, I just broke up. Broke up with so and so and it's well be leading into your back this past week. Um, so definitely a big part to I feel like one of the, one of talk about was the injury Yeah. Yeah. So people are more stressed out because of school, especially student athletes, and they get hurt during that time a lot more frequently. It's interesting. Yeah. You know, it's it's all the different things going on. And it's like it also just like middle of the season, like it'd be like out of season. And it's like maybe it'll always The strength, conditioning coaches, their sport, the actual coaches. Like maybe we de-load them that finals or whatever it is. So I kind of I'd be curious if I mean, I know sports science would think that with the amount coming in, there's some team Yeah, you would think so. Um, all right, I'm gonna move to number three, kind of number three. Number three, uh, nutrition and Um, and so obviously I'm gonna Um, we're not you know, we're not the dietitians at all, but we do have our general background on. Okay, can it be that is it Is it what you're eating? Do you recognize that, uh, when day, I'm in worse pain. Is it? I had a bunch of alcohol. I didn't sleep well. I wake up the next day and I I feel like a lot of people struggle to actually make those connections. And it. It could just be because they don't track what they do, like, right? Like how many people are the day before, what they drank looking at like, oh, what is my or even looking at their sleep? This is a perfect platform because this is something that you really have to say with caution. Usually when I'm talking to their back pain and they throw like, yeah, this is bothering And I could probably stand to that would help me lose my bat And I, I want to what I want to do is sit there and, like, turn my head and ask them, do you think every fat person has back pain? Yeah, it's a because the answer There there are people who are less back pain. So could it be a contributing Sure. I'm not going to take that away, an or as an excuse because the hey, I need to lose this weight And that's just not true. Yeah, I feel like that's that So like when you're just looking your weight isn't going down, start thinking, oh, my back pain You probably never want to make Um, I'm thinking, because it's weighing myself regularly more curious to see what I see what would happen. But I'll be honest, I usually like, hey, we're going to do. I don't want people to shoot go When it comes to weight. I just want people to go for It's kind of what you do. I want you to feel better off as a result. Great. Awesome. But really, you're just going going for the how do you feel after it? And it doesn't like right. We do like general lifestyle changes and those will probably help people and, you know, like for you when we talk about earlier. Hey, how about you just start walking a little bit like we'll start with one mile a day in the morning. That's all you gotta do. And that might be a huge Yeah. We always have to put a target And does the question always refers back to does this get us closer to the target, or does this get us further away from the target? Whether it's walking a specific your sleep habits, all of those And we have to move the big perfect exercises in the world pain if you are a severe Yeah, so we have to know which And the important thing, it's important to consider all of those things and know about them, which comes back to having conversations with your clinician. Because if you're leaving? I've had a professor tell me You'll be amazed at the things So phone consultation. We're going through injury Okay. Nothing too crazy to talk about. And then I meet them in person Oh, wait, by the way, I forgot replaced last year. I forgot what you forgot. I mean, it must be a good Damn. Yeah. I don't even know how to come Um. Oh, you lost my train of That's fine. Right. It's gonna. Oh, coming back to it, it's like And we've talked about it It's not an information problem. Like, people generally know what they need to do from a diet standpoint, like. Right. Everyone kind of knows, okay, I I gotta eat the healthy foods. But. Right. The struggle is the It's like, how do you create the Information is free. Implementation is key. Yep. Perfect. Boom! Let's go. All right, number four. Number four. Figure out your root cause. And I think for back pain. Right. Because it's and we've talked It almost has never because of It's if it's if you're thinking of that bio standpoint, it's most likely something in the hip. Heck, it could even be you have of motion that's leading to your go all the way down. Maybe it's something going on with your shoulder that's causing you to compensate your back. When you go into a back squat or Yeah. Um. Go ahead. Rich and I mentioned I just use cause all the time, and now see everybody saying saying, oh, Yeah, yeah, you should, you You were you were early maybe. And the the frustrating part is when you say root cause, the perception is root cause means one thing. So hey, my back pain is not Okay? It's being caused by something What is that? One other thing? Yeah. Still missing the mark. Yep. So back to what we were talking about before with the biopsychosocial. We have to understand all three physical is the most obvious. And then it's our job as psycho and the social. Maybe not indirectly. More indirectly. Um, asking the right questions at the right times to get a better understanding. Because I know from my doctor's office at my yearly my intake paperwork. The assistant asked, are you a And I said, no. Um, she goes, okay, you don't smoke anything ever. And I said, oh, I mean, I have a cigar at a wedding every like maybe three times a year or whatever. Um, then the doctor comes in, have you been a smoker? Like, whoa, whoa, whoa. Yeah, there's a difference. Yeah. So being able to have a conversation with somebody to really understand where you're coming from because it's so easy to get stuff lost in the shuffle. Yeah. So back to root cause. Right. With from a physical standpoint, specifically with back pain, I look at it in three buckets where we could have a, a hip, uh, we call it asymmetry problem. So does one hip move a lot more We look at spinal flexibility because most people are focused on stiff core and braced core, where a lot of problems actually come from the core being too stiff. So we have to look at their And then um, a so a lot more spinal flexibility with a, um, the other option being a core, uh, stability problem, hip asymmetry, core stability, spinal flexibility. Those are the three big buckets I look at from a physical perspective when it comes to back pain. Yeah, yeah, yeah. I think once again, I think it's doesn't mean it's just one other lot of times like you'll have I'm pretty sure it's because I Yeah. Um, and like, I'll speak about I had right some right foot pain for honestly a few weeks, four weeks. And a lot of it was one I just said, yep, that's because I ran like an asshole for the past for like the past three weeks prior to it happened, I ran a marathon, I got pissed, I didn't do well. So then I ran twenty miles two Then I ran a half marathon the Yeah, like I spiked my workload. That's probably it. But I probably also didn't Um, I was an impending father, So it's just like I had a lot of did not match the recovery from So one hundred percent. Yeah. And even with that, uh, we do those three buckets to see which Mhm. Usually people have signs in two So you do all those tests and if you don't have someone working alongside you it's confusing because you have positives show up in in all three depending on where you're at with your back pain. Yeah. What I would say too, it's like And you have the acute like and And let's say you do have the I lifted out with my back like you maybe actually strained a muscle and whatnot. You're probably going to start And if you don't treat it right, you start bleeding over into like the psychosocial aspect of it. Um, and that's probably what Um, because yeah, it's like me It's you just don't actually take care of an injury the way you should. You go, ah, you go to a doctor two weeks and you'll be fine. So you go, all right, I'm going weeks, and then you try to just started, and it's just Yeah. A lot of what we do is rebuild As an example, I had a client come in years of back pain, uh, but was a competitive horseback rider. Was a black belt in jiu jitsu. Badass. Yeah. And the way that she talked to Oh, I'm broken every day. I was like, there's so much Yeah. So. Again, more indirectly, the point where we finish the And she said the most valuable sessions was that she no longer Yeah. Which is huge. Yeah, that's the goal. I mean, I think outside of any catastrophic injury, like when you just have like on back pain or any pain that just kind of gradually comes on, it's probably correctable. Like, you can probably do something to get yourself in a better spot. And it's funny how much the mental side of it actually affects it. Mhm. It's huge because if you have back pain and you stop doing the things that you love and you go down that rabbit hole, then you start telling yourself, I can't go back to doing said thing because I'm going to hurt my back again. And then you start avoiding stuff and then you become sedentary. And then when you're sedentary, bad things goes way up. Quick, quick tidbit for you know, back pain actually costs our medical system the most out of anything else except for maybe cancer. Um, yeah. Back pain is the biggest burden Yeah. Sorry. Side note I was just reading Um, number five, by the way, on my list was address your mental health. So I feel like we essentially That's covered. And number six is finding or your back pain. So there's actually there's more And we may have talked about this in an episode or two ago, but when it comes to a lot of injuries like what you act, what your actual like exercise rehab plan is that you implement doesn't matter. Like they did a couple So it was like one group had education, only one group had And essentially both the education group improved. Like their pain, the exercise So what they kind of took out of understanding back pain. And or really it's it was a couple different areas of the body. But educating like this is what This is how we're going to This is what you should feel know, here are your exercises. They're going to get you better. I agree with that. The the thought process of it's a car and saying, fix it it up is what most people assume Yeah. The ability to understand what is again, getting you either taking away from your goals. Because I've had conversations me, oh, I'm doing the X, Y, and YouTube to fix my back pain. Um, and then they show me those and those things are actually their goal because they think themselves, but they're actually not doing it on purpose. It's lack. It's a lack of education where they they trusted a source without context or being able to go back and forth, and it got them stuck. And I also say too, when it comes to write, the reason why the exercise only group probably didn't work. So you're trying what they what people do in general. In traditional PT, they tried to say, all right, we got these group of twenty five people with that got diagnosed with Si joint dysfunction. So they're going to do these And we'll compare it to the Well right. If you're not personalizing your plan of care for why are they having that Si joint dysfunction. You're going to get a large a So probably why that research also didn't really work too well for the exercise only group one hundred percent. And that's why the general recommendations, you call it cookie cutter, you can call it generic when it's just a general thing. The goal is not to help The goal is to help one out of percent to ten percent of those want out of that thing. So I would rather go more, much more narrow and deep and help a But those individuals help them Yeah. I'll give a quick example. From that standpoint. It was actually my mom was She was having back pain. She she works at a farm and sheets and stuff, and like that. Sorry. Back pain. So I honestly did the quickest eval you could ever imagine because she like mentioned it on my way out, but it was straight up like she had no like she couldn't like do any type of hip abduction. Like she could not be in a single leg stance or anything like that. So I legitimately gave her, all right, you're gonna do these three exercises, do it sets reps, whatever. And she's like, yeah, I was good It's like, okay, cool. Like, right. Because guess what? I just kind of focused on the I honestly didn't even tell her you honestly, a lot of people mobility on her. I straight up just did hip abduction and you got a quicker result. Mhm. Yeah. You have to know. You have to know your starting You have to know what the goal Because if you don't know those wasting a lot of time doing Yeah. So for you you knew exactly what You knew exactly what her goal So giving one or two exercises solution than sitting down and and trying to teach her all of It's not helpful. No. Yeah. There's a lot of people that don't want the dissertation, although I used to really enjoy the. All right. I'm going to give a dissertation on rehab of whatever with my baseball athletes. You realize a lot a lot of Some people like nerding out, I'm all for it. When they start asking But for people who are like, I I trust you. Do what you think is best. I'm going to have conversations people who are asking, why and not that? Yeah, exactly. So. All right. Those are six points. There it is. Jesus. All right, go fix yourself. You.