Why Does Lower Back Pain Keep Coming Back?
Low back pain returns for most people within a year. Dr. Sharma explains why, and what the research says actually lowers the risk.
If your lower back pain settles down and then comes right back, you're not unusual. In one study, more than two thirds of people had it return within a year of recovering [1]. That can feel discouraging, but it also means there's a pattern. Patterns can be changed.
This article explains how often back pain returns and why it keeps returning for so many Chicago desk workers. It also covers what the research says actually lowers the risk. Finally, it explains when recurring back pain needs a closer look, and how we help patients break the cycle. It's written for the people we see at our clinic at 371 W Ontario St in River North. Many work long hours at a desk in the Loop, Streeterville or the West Loop. For how we treat back pain in general, see our lower back pain treatment in Chicago page. It covers our full approach.
The short answer
Low back pain often comes back because the habits behind it are still there after the pain fades. The weak links in how you move are usually still there too. In one study, 69% of people had back pain return within a year [1]. Sitting over five hours a day, awkward postures and more than two past episodes made a return more likely [1]. The best-supported way to lower the risk is exercise, especially combined with education. In a large review, it cut the risk of another episode by about 45% [2]. Education alone, back belts and shoe insoles did not prevent it [2].
How common is it for lower back pain to come back?
Very common. One study followed people for a year after they recovered from an episode of low back pain [1]:
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69% had back pain come back.
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40% had a return that limited their daily activities.
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41% had a return bad enough to seek care.
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The typical return came about four and a half months after recovery.
So if your back pain keeps coming and going, it isn't a sign that something is badly wrong. It's a sign that the cause hasn't been fully dealt with yet.
Why lower back pain keeps coming back for Chicago desk workers
The same study found three things that made a return more likely [1]:
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Sitting more than five hours a day.
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Frequent awkward postures, such as bending and twisting.
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More than two past episodes of back pain.
Many of our patients work at desks in River North and the Loop. Long days of sitting, plus a commute, can add up to well over five hours. That doesn't mean sitting is "bad" for your back. It means long, still stretches of it are worth breaking up.
What actually lowers the chance of another episode
A large review of 21 trials, with more than 30,000 people, looked at what prevents low back pain [2]:
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Exercise combined with education cut the risk of another episode by about 45%.
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Exercise alone cut it by about 35%.
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Education alone didn't prevent it. Neither did back belts or shoe insoles.
That matches a later trial. A self-management education and exercise program did not prevent activity-limiting episodes [3]. The lesson is that knowing what to do isn't enough. Regular, specific exercise is what moves the needle.
For recent back pain, staying active also beats bed rest for pain and function [4].
How we break the cycle at our River North clinic
Care at True Precision Rehab has two parts:
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Hands-on care to calm the pain now. This can be gentle mobilization or an adjustment if you want one. It can also include dry needling, cupping or shockwave therapy. You never have to be adjusted, and some of our patients never are.
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Retraining so it stays better. We work on how you breathe, sit and move. Where it fits your back, we teach the "Big 3": the curl-up, side plank and bird dog.
Every plan has a re-check date. If you aren't measurably better by then, Dr. Sharma changes the plan or refers you. As you improve, visits space out and your home program takes over. The American College of Physicians lists exercise among its first choices for long-lasting low back pain [5].
When recurring back pain needs a closer look
Most recurring back pain is mechanical and not dangerous. But get it checked if the pattern changes. That includes pain that wakes you at night, spreads down a leg, or comes with numbness.
Go to the emergency room for numbness in your groin or inner thighs. The same goes for new bladder or bowel problems, or worsening leg weakness. See a medical doctor first with fever or unexplained weight loss. We screen every new patient for these signs and refer you the same day if we find one.
FAQs about recurring lower back pain in Chicago
Is it normal for lower back pain to come and go?
Yes. In one study, 69% of people had back pain return within a year of recovering [1]. Coming and going usually means the cause is still there. That might be long sitting or a weak link in how you move. It's a reason to work on prevention, not a sign of something serious.
How long is too long to have lower back pain?
If back pain isn't easing after a week or two, get it checked. The same goes if it keeps returning every few months or spreads down a leg. Most recent back pain improves over time [5]. Pain that lingers or keeps coming back usually needs a plan, not more waiting.
Do back belts or shoe insoles prevent back pain from coming back?
The research says no. A large review found back belts and shoe insoles did not lower the risk of another episode [2]. Education on its own didn't either. Exercise, especially combined with education, is what lowered the risk [2].
Do I need an MRI if my back pain keeps coming back?
Usually not. A large review found routine imaging for back pain without warning signs did not improve outcomes [6]. Imaging makes sense if the exam or your history points to something more. One example is nerve weakness that is getting worse. Dr. Sharma will tell you if you need it.
Does insurance cover chiropractic care for recurring back pain?
Many plans cover part of it. True Precision Rehab accepts Blue Cross Blue Shield (BCBS) and Aetna plans. We also offer cash-pay visits and 8- and 12-week care programs. We're open weekdays until 8 PM, so visits fit around a workday in the Loop.
Break the cycle in River North
Our clinic is at 371 W Ontario St in River North. It's an easy walk from Streeterville, the Loop and the West Loop. Same-day visits are often available. Book a visit or request a call back from Dr. Sharma.
Learn more on our lower back pain treatment in Chicago page.
Sources
[1] da Silva T, et al. Recurrence of low back pain is common: a prospective inception cohort study. J Physiother. 2019;65(3):159-165. PubMed
[2] Steffens D, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016;176(2):199-208. PubMed
[3] de Campos TF, et al. An individualised self-management exercise and education program did not prevent recurrence of low back pain but may reduce care seeking: a randomised trial. J Physiother. 2020;66(3):166-173. PubMed
[4] Dahm KT, et al. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database Syst Rev. 2010;(6):CD007612. PubMed
[5] Qaseem A, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. PubMed
[6] Chou R, et al. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet. 2009;373(9662):463-72. PubMed
Written by Dr. Parth S. Sharma, DC. Licensed chiropractic physician in Illinois (license no. 038.014266), trained at National University of Health Sciences. Dr. Sharma treats neck, back and nerve pain at True Precision Rehab in River North. About Dr. Sharma
