Chronic Back Pain: Causes, Myths, and Breakthrough Treatments

What actually causes back pain—and when does it require treatment? In this episode of Back to the Expert, spine surgeon Dr. Collin Haines breaks down the real reasons behind back pain, how to strengthen your spine, and the latest advancements in spine care.

Here, you'll get practical, no-nonsense guidance on building a healthier back through daily habits, functional core work, and smart movement. 

We also break down what chronic back pain can signal, how disc injuries present, and why modern spine treatments focus more than ever on preserving motion. 

Learn about:

• Good overall health as the foundation for spine health 
• A simple 10-minute daily maintenance routine for longevity 
• Functional core stability using planks, side planks, bridges, and bird dogs 
• Using yoga and Pilates to translate strength into real-life movement 
• Acute muscle strain versus chronic pain that suggests structural causes 
• How disc injuries feel versus disc herniation with sciatica symptoms 
• Treatment advances including less invasive fusion, regenerative medicine, and disc replacement 
• A real patient story using fusion plus disc replacement to protect nearby levels 
• When fusion is the better choice due to instability, scoliosis, or arthritis 

Dr. Haines also shares how just 10 minutes a day of targeted exercises can help prevent injury and support long-term spine health.

Whether you're dealing with back pain now—or want to avoid it in the future—this episode gives you clear, actionable guidance grounded in real medical expertise.

WATCH Episode 1 here: https://www.youtube.com/watch?v=xszpxn4nVLo

About the Series:
Back to the Expert is a podcast by the National Spine Health Foundation, bringing leading spine specialists directly to you—so you can make informed decisions and live your best life.

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Transcript

Welcome And Meet The Experts

SPEAKER_01 0:00

Back to the expert. I'm Dr. Tom Schuller. I'm a spine expert. And we're so glad you joined Back to the Expert. We're here today with Dr. Colin Haynes, a spine expert who's here to give you expert insight in how to live your best life. So, Colin, thanks for joining us. Nice to see you, Tom. It's great to have you here.

Daily Habits For Spine Health

SPEAKER_01 0:21

So, we're trying to help people understand how to live their best life. And being a spine surgeon and a spine expert, what are some thoughts people can take home about things they can be doing on a daily basis to get their spine healthy to live their best life?

SPEAKER_00 0:36

Yeah, Tom, I like to think that good overall health is good spine health. You know, something about myself, I actually sustained a disc herniation when I was younger or an injury to the disc. And I've been very fortunate my back doesn't bother me. I've never needed surgery, even a procedure on it. I'm very passionate that the reason that's the case is because I do routine maintenance exercises on my back. 10 minutes a day, in addition to my normal workouts, really has hit the sweet spot for me. So maintenance and longevity is critical.

SPEAKER_01 1:04

So let's talk about

Functional Core Over Crunches

SPEAKER_01 1:05

it. You're saying you're doing exercises. What kind of things are you doing?

SPEAKER_00 1:07

Yeah, you know, when I grew up, I thought it was all the sit-ups and crunches, all these things to try to get that six pack. Reality is it's functional core strength. So it's much more static stabilizers, planks, side planks, bridges, bird dogs, and different variations of those. They have them all over YouTube. I think they're wonderful. So isometric contractions.

SPEAKER_01 1:26

But now we don't live in a static life. We're very dynamic, especially when you're up moving and picking up kids and doing jobs and stuff. So how does that static exercise translate to the dynamics of life?

SPEAKER_00 1:38

Yeah, so uh the spine, the muscles of the core are basically the armor and protection for the spine. So the more strong and protected our core is, the more we kind of get away with in the structure of the spine. But just like you said, we need to be moving. I always think

Yoga Pilates And Aging Smart

SPEAKER_00 1:51

combination yoga and Pilates.

SPEAKER_01 1:53

That's that's great. And I think that's a great adage for people is if you don't know what to do, getting involved and understanding what yoga is, understanding Pilates is age appropriate. Uh, don't try to compete with a 20-year-old when you're a 60-year-old. But but age appropriate, I think that is something that can keep you functioning optimally. And so appreciate that insight.

Acute Strain Versus Chronic Pain

SPEAKER_01 2:14

So let's talk about people with back pain. When somebody comes to you and they're seeing you and they have significant back pain, what usually is the cause of the problem?

SPEAKER_00 2:23

So I think it very much depends on the type of the injury, but also the length of time that's been around. You know, one thing I always kind of heard when I was doing my emergency medicine rotations as a physician is everyone would have a back strain. And the reality is it's very uncommon. Typically, you know, we've all slut funny in our neck. You wake up, it hurts, a couple days later, it goes away. Usually if it's purely a muscular thing, it's a pretty quick onset, quick relieving sort of symptom.

SPEAKER_01 2:47

Yeah, you said you said back strain. So strain is an injury to a muscle, correct? Whereas sprain is an injury to a ligament. So go on.

SPEAKER_00 2:55

Yeah. So when we think about more long-term injuries, kind of what we call chronic three months, six months, or longer, I always step back and try to figure out the why behind that. Typically it's something in the structure of the back, whether it's a disc that's a very common issue that we see, a different joint. There's some certain joints called the facet joints or the SI joints, or a ligament that you're alluding to. I usually think of something in the structure of the spine when it's been there for a longer period of time.

SPEAKER_01 3:19

Yeah. So the discs are ligaments and they're what attach each vertebra together to allow our spine to move. So how does how does that disc injury, that injury of the disc ligament, how does that present to as a patient coming to see you?

Disc Pain And Sciatica Signs

SPEAKER_00 3:34

There are a couple different types. When someone really injures the disc themselves, usually it's deep down achy back pain. It's hard for them to put their finger on it. Oftentimes sitting for long periods of time, bending forward can be painful. Another thing that could happen is that there's a herniation. So that's when the disc, which is a shock absorber, has this sort of jelly on the inside. And if that jelly ruptures out and presses on a nerve, that can cause shooting pain, weakness, numbness going down the leg.

SPEAKER_01 3:59

If it's pinching a nerve, correct. Yeah. So people come in and you do your therapy, they don't get better, they're coming to you with one, two years of chronic back pain.

SPEAKER_00 4:11

What do you what do you have available in today's tricks to solve the problem?

Modern Options Beyond Traditional Fusion

SPEAKER_00 4:15

Fortunately, tons of advancement has occurred in this field. Once upon a time, the only option was an old school muscle cutting procedure called a fusion. And fusions can work well. Essentially, what a fusion is, it's sticking the two bones together. But there are less invasive ones, ones where you actually come in through the front by spreading muscle rather than cutting it, that can take that painful disc out and put a wedge that holds a spine in the proper position. So that's one advanced version of kind of a traditional treatment. But where we really, really advanced a lot is in the field of both regenerative medicine and motion preservation.

SPEAKER_01 4:50

What is motion preservation?

SPEAKER_00 4:52

It's a one common example, we think of it as disc replacement. So disc replacement means taking out that damaged disc and putting a movable one in its place. You know, we think about if you have hip arthritis, while fusing the hip that fixes the pain. We don't want a peg leg. By doing a disc replacement, we can regain motion and fix the pain.

SPEAKER_01 5:12

Yeah. So so keeping things moving is good. And you take a look at the spine. We have 23 discs in the spine, and you don't want to start taking them out and taking away that motion if you can avoid that. Absolutely.

A Customized Plan For Two Bad Discs

SPEAKER_01 5:23

So so let's come to a practical uh case. So talk to me about patient you've treated and what you've done, whether it's a fusion or a disc replacement or regenerative medicine, and how that's helped the patient.

SPEAKER_00 5:33

Well, the nice thing is we can use a combination of it. We can actually nowadays can do a more customized approach. So I had a patient recently, really lovely woman in her 30s, mother of three, dog mom of two, working as a nurse, miserable back pain and leg pain. What happened with her, unfortunately, is she was living with this chronic baseline pain that was really stopping her from doing what she wanted to do, but then she developed that disc carniation we were talking about, terrible nerve pressure, causing severe sciatic or shooting pain down the leg. Once upon a time, the only option would have been to either fuse every level on her back that was degenerative or just take that discarniation away. Now, when we got her images, though, we found two discs that were problematic. I didn't want to have to treat both levels with a fusion. So what we did for her was you did a fusion at the bottom level because her body required it at that spot, but then did a disc replacement at that level above. The goal to maintain motion as well as longevity for the rest of her life.

SPEAKER_01 6:31

So that topping off a fusion, doing doing a motion preservation above the fusion, that's a good thing?

SPEAKER_00 6:38

It is. A big downside of a fusion in general is that the levels nearby, above and below a fusion, have a higher chance of breaking down. Now, it doesn't mean the fusion's a bad option. It's just something that's a risk we accept. So if we can do a disc replacement safely at the spot above a fusion, then that higher disc is protected to hopefully really put a bookend on the degenerative cascade our body's feeling.

SPEAKER_01 7:00

So why would you have to do a fusion versus doing a disc replacement at every

When Fusion Beats Disc Replacement

SPEAKER_01 7:05

level?

SPEAKER_00 7:05

One of the common things we think about is disc replacements are not as ideal if abnormal motion is a problem. So there are some medical terms, one called spondylolisthesis, which means the spine's moving too much. Um slippage of the spine. Exactly. Translating forward and backwards when you broke shouldn't be. Someone has a scoliosis or a big curvature in their back. Or sometimes if someone has this, um there's a joint called the facet joint. If these joints are really painful and arthritic, a disreplacement may amplify motion there, thereby actually causing some more pain in those joints.

SPEAKER_01 7:37

That's

Final Takeaways And Thanks

SPEAKER_01 7:38

great. Well, Colin, thanks for joining us today. I mean, the great news is we have wonderful technology. Today's spine surgery is not the spine surgery of old. And thank you for the insights and the success story. So thank you for joining us for another session of Back to the Expert. Back to the Expert.