Back pain: understanding it to manage it properly

By Dr. Giovanni Santarelli, physiotherapist at San Rossore Sport Village.

Back pain is one of the most common conditions among adults and athletes. A 2015 study indicates that more than 80% of people experience at least one episode of low back pain during their lifetime. Research published in 2021 in The Lancet Rheumatology also shows that low back pain is now the leading cause of years lived with disability worldwide, with a significant impact on quality of life.

It affects people of all ages, with a higher incidence between 40 and 65. It is often considered a single problem, while in reality there are different types of back pain linked to different causes, such as herniated discs, postural changes, osteoarthritis, spinal canal stenosis, functional overload, or muscle contractures. Identifying the origin is the first step toward effective treatment and prevention of recurrence.

Management can be divided into three phases. In the acute phase, characterized by intense pain and functional limitation, the goal is to reduce symptoms through pharmacological and physical therapies. This is followed by the subacute phase, when pain decreases and a re-education program can begin with manual therapy and controlled exercises aimed at improving mobility, posture, and muscle relaxation. The stable phase is when pain is almost absent, but it remains essential to prevent chronicity.

Numerous scientific studies confirm the importance of physical activity: a 2024 study published in the Journal of Orthopaedic & Sports Physical Therapy showed that regular exercise reduces the risk of developing low back pain compared with a sedentary lifestyle, especially when performed at moderate intensity.