If it seems like everyone you know has back pain, you actually might be close to the truth.

“If you go on the street and pick a random group of people, 20% will say they have back pain right now, 40% will have had it in the past year, and 80% have had back pain over the course of their lives.”
–Patrick Roth, M.D.,

“If you go on the street and pick a random group of people, 20% will say they have back pain right now, 40% will have had it in the past year, and 80% have had back pain over the course of their lives,” says Patrick Roth, M.D., author of The End of Back Pain. That’s a lot of back pain. 

The cause of all the discomfort? For many people, back pain often comes from spinal stenosis, or arthritic wear and tear. “As we age, the joints become enlarged and generate pain,” says Dr. Roth. But that’s not always the case. In many instances, the cause of back pain isn’t as clear. 

There are certain things, like improperly lifting a heavy object, that can throw your back off and create pain. Here are seven other things that you might not know cause pain.

1. Smoking

Smoking can affect back pain in two ways. “Smoking has been shown to decrease blood supply to the discs in the back, causing premature aging of discs,” says Vijay Vad, M.D., an assistant attending physiatrist at the Hospital for Special Surgery in New York City. That premature aging of the discs can cause pain in the lower back, according to the study, which was conducted at Johns Hopkins University.

Another study from the Northwestern University School of Medicine found a different smoking-back pain connection. According to that study, smoking affects the way the brain responds to back pain and makes people less resilient to it.

2. Sitting

“There’s no question that sitting puts pressure on the discs in your back,” says Dr Roth. “The pressure decreases blood supply to the discs and increases the risk of disc injury,” agrees Dr. Vad. If you’re someone who sits at a desk all day, consider using a standing desk to alleviate the pressure on your back, or take breaks every 30 minutes or so to stretch and walk around. Walking can flush toxins and “brings nutrition to the discs,” says Dr. Vad.

3. Your cell phone

Talking on your cell phone, especially if you use your shoulder to balance it at your ear, can create uneven pressure, causing neck pain. And that neck pain can extend to your back. Also be mindful if you text a lot — you’re potentially straining your neck by looking down repeatedly. Opt for earphones when you talk on your cell, and try to hold your phone in front of you when texting to reduce the strain on your neck.

4. Your mattress

If you’re constantly waking up with back pain, it might be that your mattress is too soft. “A medium-firm mattress is ideal for your back,” says Dr. Vad. With a soft mattress, the weight on your back can be uneven and cause you pain. 

5. Diet

It stands to reason that being overweight can put more pressure on your back and make you more susceptible to back pain. One study from Stanford University found that people who are extremely overweight are at four times greater risk of having lower back pain. The study also found that doing just 20 minutes of exercise a day can reduce the risk of back pain by 32%. 

Another part of your diet to pay attention to, according to Dr. Vad? Sugar. “Processed sugars can spike inflammation in the body and cause back pain,” says Dr. Vad. So consider cutting back on big sugar offenders like cookies, doughnuts, cake, and other sweets.

6. Flying

The next time you fly, consider checking your heavy luggage instead of storing it overhead. “The pressurized air in the cabin can irritate a disc and make it vulnerable to bulging,” says Dr. Vad. “So be careful lifting heavy luggage or heavy weights or doing vigorous sports right after a long flight.” He suggests stretching and walking right after a flight to help minimize the risk of disc bulge.

7. Stress

“The lower back is the ultimate example of the mind-body connection,” says Dr. Vad. Stress can tighten your muscles and cause discs to bulge, creating pain. It can also lower your threshold for pain. “It literally stiffens you,” says Dr. Roth. Manage your stress with exercise, meditation, and deep breathing.

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If you do have back pain…

Though doctors used to recommend bed rest to help back pain, the thinking has changed. “There’s no doubt that returning to activity as best you can is the best thing for back pain,” says Dr. Roth. “Movement actually makes pain better.” He also recommends doing exercise as well as you can, then when the pain has passed, strengthening your core and abdominal muscles, which help keep your back strong.

As for the best way to lift heavy objects? “You want to do a hip hinge rather than bend from the back,” says Dr. Roth. Keep your knees slightly bent and your back locked. “Olympic weightlifters are the least likely to have back problems because they are so meticulous about their form,” he says.

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