Why Does Your Back Hurt?

If you have back pain that started after some acute trauma, then the pain is probably due to a local sprain/strain of the muscles and joints.

What about pain that is chronic and doesn’t seem to go away?

Chronic pain is often due to  musculo-skeletal imbalances. The site of pain may not be the source, but in many circumstances is the compensation. Addressing the compensation may provide short term relief, but the pain ultimately will return along with your frustration.

The compensatory site of pain is easy to identify because it hurts at a specific area. The source of pain can be identified by assessing movement patterns.

One type of movement screen is the overhead squat:

Stand facing a full-length mirror with your feet shoulder-width apart and pointed straight ahead and your arms raised overhead. Squat three times. Hold the pose at the lowest point in your third squat and take note of your body position at the checkpoints (Feet and ankles, Knees, lower back and hips, shoulder, neck and head)

Common movement distortions include:

1. Feet turn out or flatten

2. Heels rise

3. Knees moves in or out

4. Shoulders elevate and/or arms fall forward

5. Low back shifts to one side, arches, rounds or there is excessive forward lean of the torso

The overhead squat helps to identify potential areas where there is a problem. These areas can be further evaluated by assessing ranges of motion.

An effective treatment approach consists of:

  1. Lengthening tight muscles (e.g. trigger point therapy, stretching and self myofascial release with a foam roller and tennis balls)
  2. Strengthening weak muscles with specific exercises

An important point to note is that two people may may have pain in the exact same area, but for different reasons.  For example, someone may have low back pain due to restricted extension and another person may have pain due to restricted flexion. The treatment for the first patient might be focused on lengthening the psoas muscle whereas the treatment for the second patient may be to lengthen the hamstrings.

Dr. Lecovin is a chiropractor, naturopathic physician and acupuncturist. He graduated from Los Angeles College of Chiropractic in 1990, earned a Masters in Nutrition from the University of Bridgeport in 1992, and then went on to complete the naturopathic and acupuncture programs at Bastyr University in 1994. He holds additional certifications in exercise from the National Strength and Conditioning Association, National Academy of Sports Medicine and International Society of Sports Nutrition.

Dr. Lecovin specializes in treating musculoskeletal pain and sports injuries by integrating trigger point acupuncture, soft tissue release, joint manipulation, corrective exercise and nutrition. In addition, he combines exercise and nutrition for weight loss, weight gain and performance enhancement. His clinic, located in Bellevue, WA, offers naturopathic medicine, chiropractic, acupuncture, massage and infrared sauna therapy. He can be reached at Evergreen Integrative Medicine at (425) 646-4747 and his website address is

About the Author

Dr. Geoff LecovinNaturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/View all posts by Dr. Geoff Lecovin