Stress is the number-one factor Sinett sees leading to patients’ back pain. (Here are 10 silent signals you’re too stressed out.) Countless studies have looked at the effect emotions have on pain, including a 2016 study in the journal of Brain Behavior that found mindfulness-based stress reduction could effectively improve back pain symptoms and frontal lobe regulation of emotional awareness.
How your digestive system functions impacts how your back functions. Diarrhea, constipation, gas, or an upset stomach can all trigger pain there. “An upset stomach or digestive system will create inflammation and gas,” explains Sinett. “Often the gas puts pressure on the abdominal cavity, including the lower back musculature, equaling 14 PSI’s (pounds per square inch), which is as much as the pressure of an inflatable football.”
With that much pressure, it’s no surprise your back hurts. Sinett sees patients whose diets consist of food with little nutritional value, such as candy, chips, pizza, and soda, all of which can lead to inflammation. But he also sees patients with back pain who are eating too much of a good thing: raw salads and green smoothies that create gas, and thus, pressure on their backs.
Fix it: A balanced diet can do wonders to improve your digestive woes and back pain. “An anti-inflammatory diet should help,” says Sinett. “You need to figure out the right diet for you; it’s very individual.” Highly processed foods, refined carbohydrates, sugar, and alcohol are a few of the common culprits of inflammation. Try swapping them for these 10 foods that fight inflammation.
Or, you’re not using a pillow at all. To prevent back pain, you want your head and neck to relax, says Sinett. The ideal pillow position is when your head is lower than your neck. A 2016 study found that pillow height elevation significantly increased pressure on the head and neck, and the extension (or curvature) of the spine, leading to pain and poor sleep.
Fix it: If you typically sleep on your back, place a pillow underneath your knees to help recreate the normal curvature of your back,” says Prakash Jayabalan, MD, PhD, a clinician-scientist at the Shirley Ryan AbilityLab. (This is the pain-relief pillow Amazon users swear by for better sleep.) He advises side sleepers draw their legs up toward their chest and place a pillow between the knees to level out the hips, and suggests you avoid sleeping on your stomach if possible—doing so increases the arch to your lower back and the strain on this region. (If you can’t help it, try one of these best pillows for stomach sleepers.)
If you needed any more reason to quit smoking, this is it. Smokers are three times more likely to develop chronic back pain than non-smokers, according to a 2014 study from Northwestern University. What’s most interesting about this study is that smoking didn’t simply affect the backs of the participants—it affected their brains. Lead author Bogdan Petre said in a press release, “We found that it affects the way the brain responds to back pain and seems to make individuals less resilient to an episode of pain.”
Fix it: The good news is the researchers also found quitting smoking can help prevent pain from becoming chronic. Your best bet for success is to try nicotine replacement therapy—like gum or a patch—or a medication like Champix, according to a 2014 systematic review. Talk to your doctor about what’s best for you.