Is it Back Pain … or Something More? Two Spine Surgeons Weigh In

April 2026

Ever felt that nagging ache in your lower back after a long day at the desk? Or maybe a sharp twinge when reaching for something on a high shelf? If so, you're definitely not alone. Back pain is a silent epidemic, affecting millions of people at some point in their lives. It can be frustrating, debilitating and often leaves individuals wondering, "Is this just a passing ache, or is something more serious going on?"

The Virginia Mason Franciscan Health (VMFH) spine team knows this cycle all too well and two experts weigh in on what patients should know and how everyone can be more proactive with spine health.

What if the secret to overcoming back pain was simpler than you thought? Two spine surgeons from VMFH share tips on how they help patients alleviate back pain, offering insights that might just change your perspective. Jerry Du, MD, and Philip Louie, MD, orthopedic spine surgeons at VMFH, help dispel common myths and offer tips for alleviating back pain, and provide advice on when individuals should seek help.

"The most common causes of back pain are actually mechanical or lifestyle-related, not dangerous structural problems," explained Dr. Louie. He often sees patients whose pain stems from everyday habits: prolonged sitting, poor posture, muscle strain and even a deconditioned "core" – those essential stabilizing muscles around the spine.

As people age, natural changes like disc degeneration, small disc bulges and facet joint arthritis also become common. Dr. Louie reassures that "These changes are extremely common and often part of normal aging rather than a sign of serious disease." So, that bulge on an MRI might be completely normal for a person's age.

Dr. Du added that "acute" episodes, like muscle spasms that hit when bending over to tie shoes, are also very common. These often improve quickly, he notes, with simple therapies he explains below.

Both Drs. Du and Louie agree: "the majority of back pain in both men and women is related to similar lifestyle factors like prolonged sitting, poor ergonomics, and reduced physical conditioning." So, regardless of gender, many of the solutions remain the same.

While lifestyle factors affect everyone, there can be some nuanced differences. Dr. Louie noted that women sometimes experience higher rates of chronic pain and conditions like osteoporosis. Hormonal changes during pregnancy and menopause can also play a role. Men, on the other hand, might more frequently encounter back pain due to physically demanding jobs or heavy lifting, although Louie notes this is a broad generalization.

A core principle they consistently share with their patients is that movement is medicine for your back. "One of the biggest mistakes people make is staying still for too long. Gentle movement is actually one of the best treatments," said Dr. Louie, a fundamental tenet he consistently advocates.

Instead of resting and staying mostly sedentary, try incorporating these simple, yet effective, strategies into a daily routine:

• Take frequent breaks: If a job involves a lot of sitting, stand up, stretch and move around every 30 to 60 minutes. Small adjustments can make a big difference.

• Embrace walking: "Walking, which is one of the best exercises for the spine," according to Dr. Louie, is a go-to recommendation for its simplicity and effectiveness.

• Stretch it out: Gentle stretching of hips, hamstrings and back muscles can relieve tension.

• Strengthen your core and glutes: These muscles are the spine's natural support system. Dr. Du even suggested "incorporating a back-focused exercise routine (such as McKenzie back exercises)" to maintain stability.

• Mind your posture: Pay attention to how you sit and stand. Good posture helps reduce strain.

• Consider pool therapy: Dr. Du highlighted the benefits of pool therapy, where "the decompression from the water allows them to participate more meaningfully in their therapy exercises."

While movement is key, some tools can offer additional support:

• Heat and ice: Heating pads can relax muscles, while ice can reduce inflammation.

• Self-massage tools: Foam rollers or lacrosse/tennis balls are great for working out tight knots, a common technique surgeons suggest.

• Lumbar support cushions: Excellent for prolonged sitting.

• Standing desks/adjustable workstations: Varying posture throughout the day is a game-changer.

• Resistance bands: Ideal for strengthening those supportive muscles.

• Lumbar corset brace: A helpful temporary support for activities like longer walks.

Remember Dr. Louie's words, echoing a core philosophy in spine care: "the most important “tool” is actually movement. Regular activity and strengthening are far more effective long term than passive treatments alone."

Ultimately, understanding your back pain and incorporating regular movement into your life isn't just about managing current symptoms – it's about prevention and building a resilient spine for years to come. By adopting these healthy habits and staying active, you can significantly reduce your risk of future episodes and maintain long-term spinal health.

While most back pain resolves on its own, it’s important to know when to seek professional medical care. Dr. Louie advised seeing a doctor if experiencing:

• Pain lasting more than four to six weeks.

• Severe or worsening pain.

• Pain with numbness, weakness or tingling in the legs.

• Difficulty walking or controlling bowel or bladder function (this is a red flag).

• Pain following a fall, accident or trauma.

• Fever, unexplained weight loss or a history of cancer.

Dr. Du reinforced these points, particularly highlighting "focal weakness, such as foot drop, new incontinence, and systemic symptoms, such as fevers, night sweats, unexplained weight loss," as reasons to seek evaluation.

The VMFH spine team offers a full spectrum of care, from conservative management to advanced surgical solutions, all tailored to individual needs. 

If your back pain is persistent, severe, or accompanied by any of the "red flag" symptoms, trust your instincts and connect with a physician today.