What Causes Back Pain?


There are many causes of pain and these three are the ones that I get the most excited about and have given me the most benefit personally.  These could be helpful clues for you in your journey whether you have back pain or pain in general!


    1. Posture
    2. Movement patterns
    3. Adaptation
    1. Unrecognized Visceral (organ) Dysfunction or inflammation
    1. Physical and emotional pain are the same
    2. Mindset effects our pain
    3. What is your pain telling you?
    4. Trauma that is stored in our neurobiology



Physical Stress on the body has to do with structural balance of the bones, muscles, fascia (connective tissue) and joints. This has to do with posture, our movement patterns and adaptation.

Posture is how we hold our body. It determines the forces and loads on our body including the spine, joints, nerves, organs, lymphatic system and circulatory system. Everything needs space in order to function optimally. Compression is often the root of pain. Our posture can cause a lot of compression. Our posture is shaped by our movement patterns, our movement patterns shape how our body adapts. The ways our body adapts to our movement patterns forms our posture.

How you move determines whether what you do is breaking you down or building you up. The way we move creates patterns in the body and those patterns shape our posture. This is called adaptation. You can move in a way that creates balance; aligning the skeleton so that force is being translated in the most efficient and supportive way and there aren’t break points or you can move in ways that create imbalances and cause break points and junctures where the communication path breaks down.

Here are some examples of moving in ways that create imbalance:

  • Overusing one part of ourselves and underusing another part of ourselves.
  • Using isolated muscles instead of using integrated muscle chains
  • Repeating patterns that wear away at places that are already vulnerable
  • Using our body in a way that creates compression

For example, if I give a shiatsu treatment and use my upper trapezius muscle, and pecs primarily, that pattern pulls my head forward and causes me to slump. This causes pain and discomfort in my neck, chest, shoulders, abdomen, lower back and stagnancy everywhere. If I work all day like that I come out feeling very tired, stuck and, on extreme days, I might get nerve pain down my arms. However, if I put my focus on using my Latisimus muscles to press, pull, push, and move the body, it actually helps me stay aligned and I can work all day like that and come out feeling good.  AND having worked like that makes it easier to keep working like that the next day and the next… because I get stronger and more able to use my Lats. I am reinforcing and practicing that pattern.  The body loves efficiency and will actively adapt to whatever pattern we give it. Pretty soon, my body actually starts to physically look different because the structure is reflecting my movement patterns. Our posture reflects our patterns of movement and the ways that it has adapted to make those patterns available to us.

Our body is always adapting. Your body is going to adapt no matter what because it is a beautifully wired and perfect mechanism. It will improve at whatever you are asking it to do, even if what you are asking it to do is minimally metabolic and potentially bad for it. Your body will make itself better at doing that in an effort of efficiency.

ef·fi·cient  – /əˈfiSHənt/ – adjective: Achieving maximum productivity with minimum wasted effort or expense.

The body is always adapting from the input we give it or don’t give it. It is an efficient being that can learn what you’re doing and how do it better if you give it the right opportunity. If your muscles are working regularly to keep you upright and expansive and moving, your body will change over time and allow this to happen with less effort. This also means that if your muscles aren’t actively working to resist gravity, then your body will give that job to the skeletal system, compressing spaces between bones and wearing away at connective tissues. We are not given a choice around whether we adapt, but we can choose to actively adapt by building a pattern into our lives that helps us move toward balance.


Complacent Adaptation is a term used to describe us when we are passively sinking into gravity. When we are passively allowing our body to be taken into the downward pull of gravity we take smaller shallower breaths, we let our head drift forward, our shoulders roll forward, our rib cage gets smaller front to back which compresses the organs in the chest (heart and lungs) and slumps downward to press on the abdomen compressing the organs in the abdomen (kidneys, liver, gallbladder, stomach, spleen, pancreas, small intestine, large intestine, bladder & reproductive organs). With all this downward compressive force, the organs, nerves, lymph, and circulatory system cannot function properly, the joints collectively learn to rest on themselves and wear away connective tissue rather than utilizing their surrounding muscles which means the skeletal structure is not in a bio-mechanically advantageous position to function well and it causes focal points of pressure that create a cascading impact on the whole body. Our bodies start with the space and range of motion to function well. But life occurs and we change over time to meet the demands we place on our body. When we are no longer directing our body to be active against various forces, we rest into them.

Postural imbalances come from our adaptations. It’s not because of shoes or because of sitting, it’s because our body is adapting to the shoes or to the positions we are in. The body is going to get really good at what you do on a daily basis. This adaptation process doesn’t change as we get older. The body is still able to adapt, but what does change, is the desire, the movent, the inertia, and the personal “want” to adapt get’s diminished. The body is adaptable while we are alive.

Anything that doesn’t address posture and movement patterns is a short term fix. Addressing our posture and our movement patterns is a huge way to take a more active role in our healing process.




A couple of years ago I tried my first 5 day fast. I chose to drink only water during that time. Around day 2 and 3 I started to notice that my body was changing. The pain in the right side of my pelvis that sometimes expressed as sacroiliac joint pain, sometimes sciatica, sometimes a painful right ovary during ovulation, sometimes a stuck ilio-sequal valve with a glob of something palpable there, and sometimes a really tight psoas muscle, were all disappearing. The shift in my pelvis was leveling out and my practice was disentangling my entire body in a dramatic and euphoric way.  For many years I had been thinking this pain was coming from a surgery I had on my right foot (I dislocated all the metatarsals in a fall during a rock climbing trip in Yosemite and had surgery to put the food back together, including several screws that I have never wanted to take out because disrupting that foot again feels scary). I had also broken my tailbone and torn the right hamstring attachment so… I just thought the pain in my right hip was coming entirely from these injuries and that I needed to work it out by focusing solely on my posture, movement patterns and doing self myo-fascial release work on the connective tissue (fascia) and muscles to heal the remnants from those injuries, but here I was, fasting and experiencing the entire thing disentangling itself… and my physical practice of foundation training was working for me and had been making me feel phenomenally better, but now when I was practicing, it was like I was capitalizing on something and the results were epic.

I knew certain foods didn’t make me feel well but this woke me up to the idea that although I was successfully avoiding those foods, I  hadn’t actually healed the issue in my guts entirely.

Then, a few months after that fasting experience I went to see one of the two osteopaths I love getting bodywork from and he first held a place in my lower spine that I felt a huge release going down my leg and even some movement in my abdomen happening and then he started doing some visceral (organ) manipulation around the area in my abdomen that I was feeling all that activity happening. He worked where the small intestine and large intestine meet and I felt not only my right leg and pelvis respond but all the other little patterns that are a part of that pattern responding, my right shoulder and my neck were also changing.

The sciatic nerve branches out from nerve roots all along the lumbar spine (lower back). Many of those nerves branches also swoop through the abdomen innervating the organs there and then the nerve branches swoop downward and unite into one big nerve through an opening in the pelvis called the Greater Sciatic Foramen, near the sacroiliac joint, then it travels down the leg all the way to the toes.

If you have compression between the vertebra along the lumbar spine it can affect the organ function in the lower abdomen as well as give you sciatica down the leg and pain around the sacroiliac joint as the nerve moves all through there. OR if you have inflammation or dysfunction in an organ there like in the digestive system, that chronic inflammation can affect the nerve roots causing the body to contract along the lumbar spine and compress there or simply affect the nerve causing sciatica down the leg. Inflammation affects everything around it. Imagine a bathtub full of water with a rubber ducky floating on top, if that water represents inflammation and the rubber ducky represents a body part and the water is rising, then the inflammation will affect the rubber ducky; the inflammation in the local body part will also rise up.

This led me to realizing why I love shiatsu and osteopathy so much! They both work on the visceral level with attention to the organs as well as on the systemic level looking at the body as a web of interconnected parts, not isolating one place and calling it bad and other places good. They seek to see how this web shifts, starts to break down and tighten, and how these compensations create imbalances and to understand where symptoms are coming from, their origin, and how the imbalance that creates those symptoms occurs.

I still haven’t found the answer to my gut inflammation issue but I am changing what I eat, how I eat, the timing of eating etc..  and as I pay attention to what causes the pain there and what helps it feel good, I pick up clues and I am steadily feeling better.






I have seen a pattern in my practice that many people recognize their physical pain & have no problem asking for help with that but if they are experiencing emotional pain, there is a divide. Some come in really open to digging deep, having a big emotional release & feeling their physical pain diminish or transform to mirror that emotional shift & some come in w/ emotional pain & not only refuse help, they may resist even really feeling the pain.


“While Eastern medicine has tapped into the mind-body connection for thousands of years, only recently has Western medicine proven that the mind & body are not just connected – they are one in the same. Scientists at the University of Michigan did functional magnetic resonance imaging (fMRI) scans on the brains of 40 people & found that, whether people were burned by hot water or looked at photos of people who’d broken up with them, their brains showed an identical pattern: Two parts of the brain – the secondary somatosensory cortex & the dorsal posterior insula – registered physical pain. The exact same brain patterns occurred whether the test subjects felt a burn against their skin or felt emotional pain – the brain simply did not know the difference.” – Vicky Vlachonis: The Body Doesn’t Lie
I think this feels like relief & is supportive to those of us that are open to the connection between physical & emotional pain, but could feel scary, pushy or unsafe to those of us who haven’t felt the connection yet or who have been judged, shamed, or labeled as bad or wrong after revealing our emotions to someone. I like to talk about this stuff so that the door is open, but I don’t want to push anyone to do this work if they don’t want to, aren’t ready to yet, or feel that what they have going on is purely physical. It’s just a tool. Since emotional and physical pain are one and the same, we can stay with the physical and end up impacting the emotional without ever even talking about it!



Recently I read an article about people w/ multiple personalities—their different personalities reporting different levels of pain. It illustrates how our perception of pain has to do with what we are thinking & feeling about the pain.
In the “Tell Me About Your Pain” podcast I listened to last year on a road trip home after visiting my childhood home & having a re-awakening of sciatica & gut issues, I learned that if you look at your pain with a lens of fear, your mind amplifies the pain even though there isn’t greater damage to the tissue. I realized that every time I felt the pain in my gut & my hip, I was thinking about what I could have done “wrong,” criticizing my food choices, imagining my future going poorly because of what I had done, criticizing myself for not doing my practice right & afraid that I had been teaching my students something wrong if I was turning out like this…Self criticism, guilt, shame & fear were all layering around that pain & lacing the pain pathway w/ their messages. These emotions create stress hormones.
Stress hormones increase the level of cytokines (inflammatory messengers) in the body. That systemic inflammation causes more pain & can even make old injuries flare-up. Whatever we are imagining, our body experiences as a reality. If we get into a dark loop in which negative emotions lead to bio-chemical changes that interfere with our bodies natural healing mechanisms, which leads to less self-care, which creates physical pain, which leads to more dark emotions, which causes low self-esteem & sometimes leads to self-destruction…we’ve stumbled into a negative feedback loop, which amplifies the pain.
I realized I was in this & paused to really feel the pain… This is a switch from a fear lens to one of curiosity. I tried to feel it’s location, if was it moving? radiating? contracting? expanding? How big was it on a 1 – 10 scale? The more I looked for the pain, the more it disappeared. The more times I repeated this response, I witnessed the pain actually totally diminishing.
“When you give your full attention to your knee or your back or your head, whatever hurts, and drop the good/bad, right/wrong story line & simply experience the pain directly for even a short time, then your ideas about the pain, & often the pain itself, will disolve.” -Pema Chodron



Pain can be good, it is a messenger, and one of our most powerful teachers. Pain is an opportunity. Pain is potential. It is a signal, a warning from the body that something needs your attention, your evolution. You might think you got that kink in your neck from the car accident you were involved in last year, or the slow burn in your lower back from sitting all day in front of a computer, but if you look into that pain, truly see it, you will likely uncover something even bigger: the truth about your life, your relationships, your work, your state of mind.
All pain, every single kind, is both physical and emotional. All pain, when you learn how to feel it, listen to it, understand it, and let it go, can help you find the way forward.



Excerpt from Vicky Vlachonis in her book: The Body Doesn’t Lie
“Your emotions are born in your nervous system–the system that physically runs up and down your spine and branches to every organ and limb and digit of your body. These emotions trigger neurochemical changes in your brain, hormonal releases in your endocrine system, blood flow changes in your circulatory system, and airflow changes in your respiratory system. This is actually your bodies adaptive response. Your body meets a challenge (stress) and, through adaptation, learns how to function better to meet that challenge. This adaptive system works the same whether you encounter physical or emotional pain. It’s primary objective is to teach your body to be more resilient, to handle stress better, and to continue to expand your capacity for life. Your adaptive response helps you become stronger for having endured a challenge, it is evolution on an individual level…
Problems don’t start because of emotions themselves. The trouble comes when you don’t express them or release them. layers of buried emotions build up in our scar tissue, causing adhesions in the fascia the layers of connective tissue that stretch all around your organs and muscles. These festering, unprocessed emotions clog up your circulation and generally create disharmony within your body. Once you really see and feel those buried emotions, and can pinpoint where the pain is actually coming from, you can consciously increase the flow of your bodies natural painkillers and anti-inflammatory chemicals to help you release the pain and heal…
Research at the Mayo Clinic found that over 95% of the acupuncture points, (that are used in acupuncture and Shiatsu) which Chinese Medicine has described for two thousand years, correspond to common myofascial trigger points.  In a treatment, the practitioner does some diagnostic work to find where to work on the body and can stimulate these points with a needle or with finger pressure until the tissue gives and the blood flow increases but also an emotional and physical shift happens…
We experience all our feelings, thoughts, actions and reactions through these connections between our nervous system and our musculoskeletal and fascial system. Every emotion we experience leaves a trace throughout the brain and body. Those exact emotions can be re-triggered by anything we experience, whether it is in the real world (through our senses) or purely in our minds, that seems similar to those memories that are written into our cells…
Emotional pain is the same as physical pain–not just metaphorically, but literally. The body and brain process both types of pain in absolutely the same way. So while it may make perfect sense to you that your body still holds on to an old tennis injury or the whiplash that you got in college, it should also seem reasonable that the pain of a break-up or big loss might still be locked in your tissues in the same way…
Caroline Stone, in her book, Science in the Art of Osteopathy: Osteopathic Principles and Practice, compares the spinal column to a keyboard that ‘one could play — releasing various keys (joints) and improving the function of the tissues/organs related to those keys — or as a mirror, each articulation acting as a reflection of the state of whatever organ/tissue sends signals to that segment.’ Osteopaths use the spine as a ‘decoder ring’ to diagnose illness–they see and feel the body’s reactions to those releases and we can tell how the organs are functioning even before any illness shows up in other symptoms or tests. Stone calls the spine a ‘window on the internal environment of the body.’
These reactions are related not only to the internal organs and their dysfunctions but also to how our tissues interact with those organs. if you have a knot in your tissues, or the blood flow to a specific area has been blocked, all the healthy communication between different parts of the body will be disrupted. This communication breakdown can make normal movement and function (and emotional processing and changing states in the nervous system) difficult, if not impossible–which is when the system starts to shut down. That’s the point at which people tend to sprain their ankle, or break their arm, or get those nagging pains in the lower back…”


Emotions are just a vibration moving though the body. It comes and it goes. Sometimes they are really strong, sometimes they are medium level and sometimes they are barely there.  Everyone has them. Sometimes we want to deal with them and sometimes we don’t. All emotions are normal. They are neither good nor bad; they simply are. There is no such thing as a new stressful emotion. Taking a deep look and listen to our emotions is a big piece of that puzzle of healing. In my experience, healing comes through looking at our entire orientation to life.