Part 1: Why Active Adults Develop Chronic Low Back Pain: The Hidden Causes

Chronic low back pain has a way of making active people feel trapped: you want to train, work, travel, play with your kids, and stay independent, but one wrong move can bring everything to a stop. We get it, and we want you to have a clearer, calmer plan than simply “rest and hope.” Dr. Alexander Telfair and Julie Schwenzer break down what’s most often behind stubborn low back pain in active adults, using plain language and real-world examples.

We start with a big one: osteoarthritis in the lumbar spine, also known as spondylosis. We talk about how overuse, past injuries, body weight, and even uneven mechanics like scoliosis can speed up wear and tear, and why obesity is a bigger arthritis factor than many people realize. From there, we explain what conservative chiropractic care can look like, including soft tissue work, mobility-focused techniques like flexion distraction, and why rehab is the part that changes your long-term outcome. Our goal isn’t to keep you dependent on appointments, but to teach you how to maintain progress between visits.

Then we dig into disc herniations with an easy “jelly donut” analogy, how sciatica can show up, and why flare-ups can keep returning when tissue heals with less organized scar tissue. We also cover the common mechanism that triggers many herniations: bending forward, twisting, and adding load, whether that’s in the gym, picking up kids, or just doing chores. If you want to move better, build back confidence, and protect your spine without jumping to extreme procedures, hit play, subscribe, share this with a friend, and leave a quick review.

To learn more about Telfair Chiropractic visit:
https://www.TelfairChiropractic.com
Telfair Chiropractic  
630 S Orange Ave, Ste 300B, Sarasota, FL 34236  
941-685-2415 

Transcript

Welcome And Who This Is For

SPEAKER_00 0:00

Welcome to the Sarasota Pain Podcast with Telfair Chiropractic, hosted by Dr. Alexander Telfare. This is the show for active adults who want to move better, feel better, and stay in the game. Without jumping straight to extreme solutions, because let's face it, your body might have a few miles on it, but it's far from retired. Here we help you optimize your potential. One podcast at a time.

Why Back Pain Lingers

SPEAKER_01 0:27

Chronic low back pain can sneak up on even the most active adults, and often the real causes aren't what people expect. Today we're breaking down the underlying issues that keep pain lingering and what active adults should know about staying strong, mobile, and injury resistant. Welcome. I'm Julie Schwenzer, co-host and producer, here with the awesome Dr. Telefair, the chiropractic physician at Telefair Chiropractic. And we're really happy to talk to you because this is a topic so many active adults struggle with. So what causes some of the common chronic lower back pain in active adults, Doctor?

Arthritis And Obesity Explained

SPEAKER_02 1:02

Yeah, so some of the most common causes of chronic low back pain, I would say the leading cause is probably just osteoarthritis, our classic uh, some of my older patients call it, Arthur, goes wherever he wants to go. But uh yeah, so no, it's just arthritis, which is generally going to be due to things like overuse, obesity, traumas, uh aberrant biomechanics in the sense of, you know, uh, if you have like a scoliosis or if you have some sort of deformity about the spine, that can increase weight bearing in a non-symmetrical fashion and therefore cause early onset degeneration in those regions. So hopefully I'm not getting too fancy with those terms. Yeah, that's pretty much the main causes. I would say, you know, and something that people don't perhaps know is that obesity is one of the leading causes of arthritis, um, and including in but not limited to it, low back arthritis. So the proper term for low back arthritis is actually called spondylosis.

Soft Tissue Work And Rehab

SPEAKER_02 1:56

That is the medical term for it. And the way that we kind of go about treating that condition is, I mean, honestly, for almost all the causes, uh, there's gonna be some subtle differences, but generally it's gonna be we're gonna release the soft tissues that surround the spine, they're kind of tight and put pressure on it, and then we're going to increase mobility about the spine. Sometimes that could be something called flexion distraction. It's a chiropractic treatment where we just kind of increase range of motion, kind of like a gentle adjustment technique. Sometimes when indicated that we do chiropractic adjustments, but there's definitely quite a few patients that are not interested in that sort of thing. So I generally tend to stick with soft tissue. Um, so again, just releasing tight muscles and then rehabilitation is gonna be huge. That's really where the long-term outcomes are gonna be, especially because my model at Telford Chiropractic is more so to not only get you out of pain, because soft tissue will do that, the kind of you know manual therapy techniques I use, but the rehab is where it really gets you on a path to long-term success and try to educate those people how to kind of maintain that on their own and use me as they need me rather than being reliant on me, right? Because, you know, as a doctor, the Latin term for doctor is teacher, and I I guess I take that to heart. I definitely try to teach the people that I treat as best I can to ensure that they get the most out of it. So, yeah, arthritis is the number one cause, I would say. The next causes are gonna be things like disc herniations,

Disc Herniation Basics

SPEAKER_02 3:18

and I'll talk about that in a second here. Spinal stenosis, again, I'll talk about that a little bit more, and then sprains and strains. So that's gonna be like your ligaments being pulled or you know, hopefully not ruptured, and then strains are gonna be your muscles or tendons, right? Those could also have issues. So a little bit about those conditions. So a discarniation. I I'll go over that because it's probably one of the most common uh things that people deal with, especially when they seek further treatment, right? Let me ask you this. We'll we'll make this fun. What what do you know about discarniations? What do you know about that?

SPEAKER_01 3:52

Well, I don't know like too much in terms like medically, but I do know that a lot of people, peers, people you know, older than me too, like relatives, they found out later that they had it, but didn't know. And they just kind of, especially older generations, they just kind of deal with the pain longer. And then finally at some point, maybe somebody forced them to seek help, like a relative or or a friend or something. But it's something that seems to occur for a long time before somebody really figures out what the cause was because they see somebody like you finally.

SPEAKER_02 4:24

Yeah. Well, and it just depends because like the initial onset is generally gonna be pretty intense, right? It's gonna feel like you threw your back out and you're kind of like a little crippled, honestly, depending on the extent of your herniation. Obviously, there's multiple, you know, severities to it. If they're subtle, you could go about functioning might feel like you pulled something there, but you kind of worked through it all the way up to you can't move, you know, you're you're stuck on the ground, you're not paralyzed by any means. Like you still have function, it's just you're in so much pain, you just you can't do it. You're like weak because of pain.

The Jelly Donut Analogy

SPEAKER_02 4:57

So discarniation is essentially the best way I can put it is think of like your jelly donut, right? Essentially your spine, so you got vertebrae, right? We've all seen like a spine before. Um, you have a vertebrae and then a disc and then vertebrae. And the disc is just like a cushion, a force absorber between the vertebrae, right? So to speak, and also plays a huge you know part in like uh stability and stuff of that nature. So again, jelly donut equals disc. So the jelly donut analogy is there because inside the disc is something called uh the nucleus pulposis. Don't need to remember that, but that is literally just like kind of a jelly texture, and the outer dough part of the disc is a bunch of concentric ligaments, right? Just like layered ligaments surrounding that jelly. And a disc herniation occurs when those ligaments or the dough gets ruptured, and that jelly can kind of leak through now the doughnut, and what's on the other side of those of the disc is that's where we got spinal cord and nerves coming out from there, and that's why people might get sciatica, rock pain, or hamstring pain associated with that sort of thing. And so that's kind of what a disc herniation is, and it's a bummer because when those ligaments, and this kind of goes for just about any ligamentous injury, except obviously there's things outside the standard deviations of normal, but generally they're gonna heal with uh with scar tissue formation. That's gonna be the primary mode of healing. And the thing about scar tissue is instead of the ligaments healing like they once were, they're very organized, right? And that allows for them to be very stable. They kind of heal like that, very unorganized. A good analogy I I thought of when I was putting together my notes for this is like when you run over a nail in your car, right? Your car tire, and you have to put that, you know, you got a pack it, you gotta put that tire patch on, right? That tire patch is gonna be inherently weaker than the integrity that was there prior to that initial insult or that original rubber that was there. And so that's kind of literally a great analogy for uh what goes on with the disc. So I guess what I'm getting at is you're going to remain susceptible to re-injury at that level, unfortunately. And that's why rehab is so important, a proper diagnosis is so important because I see a lot of patients that have dealt with these pains for years, and it's been on and off. Yeah, it's been on and off, and they kind of, you know, that's uh it wax and wanes, and um it's no fun, you know, and it's no fun kind of living life questioning your pain. And it kind of limits like your activities, and you're like, oh, I don't know if I want to go do this because it might cause pain, or I don't know how hard I want to push with this because it might cause pain. Half the time they don't even know the triggers for it, you know. They don't know if it's like riding their bike versus using uh you know, doing a core workout or whatever it may be, doing dishes, cooking, being on their feet all day, whatever. So, yeah, it's very important to figure out triggers. And again, so that's the disc herniation.

SPEAKER_01 7:46

If you don't mind, if you could

How Discs Get Hurt

SPEAKER_01 7:47

please expand on the causes of herniation, like what is a movement? What uh what are some examples of your patients that have it? What do they do to even get it?

SPEAKER_02 7:55

That's a great question. So it's generally like the easiest way to go about herniating a disc is gonna be it's gonna be basically flexion, so leaning forward and then rotation. And with that, you have some sort of load. So whether that's you're picking up a weight from that angle, like you twist, I mean, even stuff, you know, depending on how sensitive or prone, susceptible somebody is to injury, especially if they had a pre-existing, that could just simply be you're at you're doing dishes and you bend and turn to put something in there, and boom, your back goes out, you know. Mine happened a few weeks ago, and I threw my back out, and luckily I know how to fix that, right? Uh thank god.

SPEAKER_01 8:34

But did you fix yourself or did you see another provider? Nice.

SPEAKER_02 8:40

I can I have a fancy table that does automated traction, so I just hop on that, and then I did a bunch of rehab. Um, tons of rehab.

SPEAKER_01 8:47

See you practice what you preach, perfect.

SPEAKER_02 8:49

Oh, a hundred percent, yeah, a hundred percent. That's a big thing. Um, but yeah, so that's gonna be your primary mode. Um, and then you know, car accidents, high velocity um things that can occur or definitely that make you know very common for uh discarniations, and then again, just flexion, uh weighted, you know, where we bend over and we're picking up a big weight. So think of doing you know, straining really hard during a squat or a deadlift, and those movements are great, but proper form and technique is essential to uh preventing injury, you know.

SPEAKER_01 9:20

I get nervous too, like thinking of the grandparents picking up the kids, you know, off the ground.

SPEAKER_02 9:25

Yeah.

SPEAKER_01 9:26

Or even the parents.

SPEAKER_02 9:27

Yeah, 100%. Um, and again, just depends on pre-existing uh susceptibility. You know, it's like how prone are they? Because essentially, you know, once you hurt or injure a disc like that, um, you're gonna be more prone pretty much the rest of your life for re-injuring that same disc. You're more likely to injure that one than any other, generally speaking. Crazier things have happened. Maybe some people stack up tons of scar tissue and they might be less prone, it just depends. But generally speaking, that's the way it goes.

Spinal Stenosis And Wrap Up

SPEAKER_02 9:54

Um, so that's disc herniation, um, spinal stenosis. So that's another very common cause. Um, and that's going to be where there's some torp, some type of like either it's arthritic, it's generally going to be arthritic. So it's going to be from like, you know, uh the spine getting more compressed vertically, or you know, resulting. I I could get into the weeds on this one, but I want to make sure it's digestible. So I'll just keep it simple.

SPEAKER_01 10:19

Thank you for breaking this down and like the different types of common causes of back pain because that's very helpful, and you've probably given people hope, you know, that they can feel better if they've been dealing with this for a while, and that's what we need.

SPEAKER_02 10:34

Absolutely. I hope so. Yeah.

SPEAKER_01 10:35

Well, yeah, thanks again for breaking that down so clearly. Chronic low back pain is something so many people deal with. So this has been very helpful. Thank you, Doctor.

SPEAKER_02 10:43

Of course. Thank you, Julie.

How To Book And Final Message

SPEAKER_00 10:45

Thanks for listening to the Sarasota Pain Podcast with Telfair Chiropractic. If pain is slowing you down, Dr. Alexander Telfair at Telfair Chiropractic specializes in conservative, comprehensive care designed to keep you active, mobile, and doing what you love without unnecessary procedures or downtime. Because the goal isn't just to feel better, it's to move better, live stronger, and truly optimize your quality of life. For more information or to schedule your visit, go to Telfairchiropractic.com or call 941 685 2415. Until next time, keep moving, keep improving, and remember a well maintained body performs better than a brand new excuse.