Summit interventional spine expert Seth Bires, DO, discusses the common reasons for a stiff or achy back and shares how both stretching and strengthening could help.
Common Reasons for a Stiff Back
There are a lot of reasons why your back could feel stiff or achy, but one important factor to consider is that muscular symptoms in the back are often not the primary source of the problem. Instead, they are a response to irritation from deeper underlying spinal structures due to lack of muscular support:
- Intervertebral discs: These are the cushions between the bones of the spine (vertebrae). The discs can develop wear, small tears, or height loss and bulging overtime. They can also experience herniation of the inner disc material. This often presents as deep ache that can be exacerbated with sitting or bending forward.
- Facet joints: These are small joints in the back of the spine that connect each vertebra to each other one. These joints can be irritated with repeated back extension. Repetitive stress on these joints can also cause them to become arthritic over time. This often causes pain to one or both sides of the spine, sometimes referring into the hip, buttock, or upper thigh, and is frequently worse with standing or leaning backward.
- General spine arthritis: Degenerative changes to the spine can lead to narrowing of spaces around spinal nerves as well as shift the distribution of forces throughout the spine, which can cause stress and irritation to other spinal structures.
Factors That Contribute to Increased Stress on the Spine
- A sedentary lifestyle can lead to supporting muscle weakness and decreased hydration of the joints
- Tight or weak core and leg muscles can change how your back moves, placing unbalanced stress on the spine
- Prolonged sitting or sustained postures can lead to excessive asymmetric stress in the spine
- Poor mattresses or pillow support can also place sustained stress on the spine. It is important to remember that there isn’t one specific mattress or pillow type that works for everyone.
Stretch or Strengthen? Which One Do You Need?
“Any of the sources of pain mentioned above can lead to a stiff back, since the body’s natural response is to try to protect the underlying irritated structures. This response can in turn cause more pain and tightness in the overlying muscles,” Dr. Bires said. “Therefore, it is important to utilize a combination of both stretching and strengthening to improve mobility and stabilization of the spine.”
How Stretching Can Help
Stretching can improve blood flow and ease muscle tension that builds up around an irritated spine. Remember to start with a short dynamic warm-up — a gentle version of the activity you’ll be doing — and save your stretching for after activity, when your muscles are adequately warmed up.
Stretch gently, to make sure you don’t strain your back or the specific muscles you are targeting. And don’t forget your hips and legs too, since tightness in these areas can cause a stiff and achy back as noted above. Over time, you’ll gain flexibility, leading to greater trunk mobility. Keep in mind that stretching alone often won’t resolve pain that is coming from a disc or joint so it works best as one part of a broader plan.
How Strengthening Can Help
“Strengthening is one of the more consistently helpful approaches for the lower back, in part because stronger, better-coordinated support muscles help protect and unload the discs and joints of the spine,” Dr. Bires said.
Core and trunk stabilization exercises, along with leg strengthening, help balance the load across your body so your back isn’t forced to do more than its share. A stronger, better-supported spine also makes it easier to maintain good posture through the day rather than slumping forward. It is important to not overdo strengthening exercises with excessive weights or overall cumulative load. General soreness is okay, but if your back pain and stiffness are worse the following day, this may be a sign that you are overdoing it.
When to Get It Checked
See your healthcare provider if your back pain is severe, persistent, keeps coming back, or is accompanied by pain, numbness, tingling, or weakness in the legs. These can be signs that your back and exercise routine may need better guidance from a physical therapist or physician. “And as always, it is always helpful to check with your provider before starting a new stretching or strengthening routine so the plan fits with the underlying source of your pain,” Dr. Bires noted.
