The 3 Real Causes of Low Back Pain No One Is Telling You About

Updated for 2026

By Dr. Tonya Westerbeke, DC — CEO & Founder, Back To Health Chiropractic · Zeeland | Portage | Muskegon, Michigan

Let’s Get One Thing Straight: Your Back Pain Is Not “Just Part of Getting Older”

I hear it every single week in our offices. Someone walks in — maybe it’s a 34-year-old mom from Zeeland who hasn’t been able to pick up her toddler without wincing. Maybe it’s a warehouse worker from Portage who figures the pain is just “the cost of doing business.” Maybe it’s a retiree on the Muskegon lakeshore who’s convinced their best days are behind them.

And almost every single one of them says some version of the same thing: “I guess this is just what happens.”

No. It’s not.

Low back pain is not a life sentence. It’s not a rite of passage. And it is most definitely not something you should “just push through” until you can’t push anymore. But here’s the problem — most people (and a lot of healthcare providers) are only looking at one piece of the puzzle. They’re chasing the symptom while ignoring the cause. And until you understand the cause, you’ll keep ending up in the same painful cycle, reaching for the same bottle of ibuprofen, canceling the same plans, and shrinking your life down to fit around your pain.

I’m not going to let that be your story.

In my 20-plus years of chiropractic practice — and after personally guiding thousands of patients across our three West Michigan clinics — I’ve come to understand that low back pain almost always comes down to three root causes. Not one. Not “it depends.” Three. And once you understand them, everything changes.

Here’s what you’ll learn in this post:

• The three root causes of low back pain (we call them the 3 T’s — and they might surprise you)
• Why the “just rest and take something” approach is making things worse, according to the latest 2025–2026 research
• What over 619 million people worldwide have in common — and how to make sure you don’t join their ranks
• The role your nervous system plays in everything (hint: it’s bigger than you think)
• Actionable steps you can take today to start addressing each cause

According to a landmark 2023 analysis published in The Lancet Rheumatology using Global Burden of Disease data, low back pain affected an estimated 619 million people globally in 2020 , and that number is projected to climb to 843 million by 2050. It has been the number one cause of years lived with disability on the planet since 1990. Not cancer. Not heart disease. Back pain. (Source: GBD 2021 Low Back Pain Collaborators, Lancet Rheumatology)

And here in the United States? Roughly 28% of adults report chronic low back pain, with recurrence rates as high as 80% within a single year. That’s not a healthcare system that’s winning. That’s a system that’s managing symptoms while the fire keeps burning underneath.

So let’s put the fire out. For real this time.

The 3 T’s: The Root Causes of Low Back Pain [Updated for 2026]

In chiropractic, we’ve long understood something that the rest of the healthcare world is only now starting to catch up to: your body is a beautifully connected system. Your spine isn’t just a stack of bones — it’s the protective highway for your nervous system, the master communication network that controls literally everything. When something interferes with that system, your body starts to break down. And low back pain? It’s one of the loudest alarms your body can sound.

The three root causes of that interference — and therefore the three root causes of most low back pain — are what we call the 3 T’s: Traumas, Toxins, and Thoughts.

Let me walk you through each one.

Cause #1: Traumas — The Physical Forces Working Against Your Spine

What We Mean by “Trauma” (It’s Not Just Car Accidents)

When most people hear the word trauma, they think of something dramatic — a bad fall, a car wreck, a sports injury. And yes, those are absolutely traumas that can cause devastating low back pain. But that’s only the tip of the iceberg.

The traumas I see most often in our Back To Health clinics are the quiet, repetitive, cumulative kind. They’re the ones that sneak up on you. And honestly? They’re the most dangerous because by the time you feel them, significant damage has already been done.

Physical traumas that cause low back pain include:

• Macro-traumas: Car accidents, falls, sports injuries, lifting injuries, slip-and-falls. These create immediate structural damage — herniated discs, sprained ligaments, fractured vertebrae, muscle tears.
• Micro-traumas (the silent killers): Sitting at a desk for 8+ hours a day. Scrolling on your phone with your neck craned forward. Sleeping on a worn-out mattress. Carrying a toddler on one hip. Standing on concrete floors in a factory or warehouse. Wearing the wrong shoes. Crossing your legs the same way every day for twenty years.
• Birth trauma: This one shocks people, but spinal misalignment can start at birth — especially with interventions like vacuum extraction, forceps, or C-sections. Many of the children we see at Back To Health have subluxation patterns that started in the delivery room.
• Repetitive motion injuries: These are huge in our West Michigan community. Whether you’re working a line in a manufacturing plant, lifting patients as a nurse, or training hard for your next round of golf or pickleball, repetitive forces on the spine create patterns of wear and dysfunction.

How Physical Trauma Creates Low Back Pain

Here’s where most people’s understanding stops: they think trauma hurts a muscle, and if you rest the muscle, you’re fine. But that misses the most important part.

Physical trauma — whether it’s a single big event or a thousand tiny ones — creates what chiropractors call a vertebral subluxation. A subluxation is a misalignment of the spinal bones that interferes with the function of your nervous system. It’s not just about a “bone being out of place.” It’s about the cascading effect that misalignment has on your nerves, your muscles, your discs, your inflammation levels, and ultimately, your ability to heal and function.

When a subluxation is present in your lower spine, it disrupts the nerve signals traveling between your brain and your low back, hips, pelvis, and legs. Your muscles compensate. Your posture shifts. Your discs bear uneven loads. Inflammation builds. And pain — that alarm system — starts blaring.

A 2025 systematic review published in the Journal of Orthopaedic & Sports Physical Therapy confirmed that spinal manipulative therapy — the primary tool we use in chiropractic care — effectively reduces both pain intensity and disability in patients with spinal pain. And it’s now recommended in evidence-based clinical practice guidelines as either a primary or adjunct therapy. (Source: JOSPT, 2025)

That’s not alternative medicine talking. That’s peer-reviewed, mainstream science.

What You Can Do About Physical Trauma Right Now

• Get checked. Not when it hurts — before it hurts. A chiropractic evaluation at Back To Health can identify subluxation patterns you don’t even know you have. Schedule online here.
• Move more, sit less. If you work a desk job, set a timer for every 30 minutes to stand and move. If you work a physical job, make sure you’re warming up and using proper body mechanics.
• Prioritize your sleep setup. Your mattress and pillow position matter enormously for spinal alignment. Ask us about our recommendations at your next visit.
• Strengthen your core. Not with crunches — with functional movements like planks, bird-dogs, and dead bugs that support your spine from every direction.

Cause #2: Toxins — The Chemical Stress You Can’t Always See

Your Body Runs on Chemistry — And Yours Might Be Working Against You [2026 Update]

This is the cause of low back pain that makes people tilt their head sideways and say, “Wait, what? Toxins cause back pain?”

Yes. And I’d argue this one is becoming more relevant every single year.

Here’s the connection: your body is a chemical environment. Every cell, every tissue, every organ depends on the right chemical balance to function properly — including the structures in your low back. When your body is overloaded with chemical stressors, it triggers systemic inflammation. And inflammation is one of the most well-documented drivers of chronic pain, including low back pain.

The Global Burden of Disease Study 2021 identified that 38.8% of all years lived with disability from low back pain were attributable to just three risk factors: occupational factors, smoking, and high BMI. Two of those three — smoking and high BMI — are directly related to the chemical environment inside your body. (Source: GBD 2021, Lancet Rheumatology)

Toxins and chemical stressors that contribute to low back pain include:

• Poor nutrition and processed foods: The Standard American Diet (SAD — and yes, the acronym fits) is loaded with inflammatory ingredients: refined sugars, seed oils, artificial additives, and ultra-processed foods. These create a constant state of low-grade inflammation throughout your body, including the tissues of your spine.
• Smoking and nicotine: Smoking reduces blood flow to your spinal discs — the same discs that depend on nutrient-rich blood to stay hydrated, healthy, and shock-absorbent. Research consistently shows that smokers have higher rates of disc degeneration and chronic low back pain.
• Environmental toxins: Pesticides, heavy metals, endocrine-disrupting chemicals in plastics and household products, mold exposure — these all burden your body’s detoxification systems and contribute to systemic inflammation.
• Medications (especially long-term use): I want to tread carefully here because I’m not telling you to stop taking prescribed medications. But it’s worth knowing that certain drugs — including long-term NSAID use, steroids, and even some antibiotics — can affect gut health, nutrient absorption, and bone density, all of which impact spinal health.
• Alcohol and substance use: Chronic alcohol use contributes to inflammation, poor sleep quality, nutritional deficiencies, and dehydration — all of which worsen back pain.
• Dehydration: Your spinal discs are roughly 80% water. When you’re chronically under-hydrated, those discs lose height and cushioning capacity. It’s one of the simplest causes of back pain and one of the most overlooked.

The Gut-Spine Connection: What New Research Is Revealing

One of the most exciting areas of research emerging in 2025 and into 2026 is the connection between gut health and musculoskeletal pain. Your gut microbiome — the trillions of bacteria living in your digestive system — plays a direct role in regulating inflammation throughout your entire body. When your gut is imbalanced (a state called dysbiosis), it can amplify inflammatory signals that make back pain worse, longer-lasting, and more resistant to treatment.

This is why at Back To Health, we don’t just adjust your spine. We talk about what you’re putting into your body. We offer nutritional guidance and high-quality supplements because we know that a spine can only be as healthy as the body it lives in.

What You Can Do About Toxic Load Right Now

• Eat real food. If it comes in a box with a list of ingredients you can’t pronounce, put it back. Focus on whole foods — vegetables, fruits, quality proteins, healthy fats. Shop your local West Michigan farmers’ markets when possible.
• Hydrate intentionally. Aim for at least half your body weight in ounces of water daily. Your discs will thank you.
• Reduce or quit smoking. If there’s one thing you do after reading this article, let this be it. The research is clear, and your spine (and everything else) will respond.
• Support your gut. Talk to our team about probiotics, anti-inflammatory supplements, and nutritional strategies that reduce systemic inflammation.
• Clean up your environment. Swap out chemical-heavy cleaning products, invest in a water filter, choose glass over plastic when you can.

Cause #3: Thoughts — The Emotional and Mental Weight on Your Spine

Stress Is Not “All in Your Head” — It’s in Your Low Back Too [2026 Update]

If the toxin connection made you raise your eyebrows, this one might really challenge your thinking. Good. That means we’re getting somewhere.

The third cause of low back pain is emotional and psychological stress — what we call “Thoughts” in the 3 T’s framework. And before you dismiss this as woo-woo or “mind over matter” stuff, let me be clear: this is hard science. The research on the biopsychosocial model of pain is enormous and growing every year.

Here’s what happens in your body when you’re stressed, anxious, grieving, overwhelmed, or carrying emotional weight:

• Your brain triggers the release of cortisol and adrenaline — stress hormones that, in the short term, help you survive. But when they stay elevated chronically, they create muscle tension, inflammation, impaired healing, and increased pain sensitivity.
• Your muscles — especially in the low back, shoulders, and jaw — physically tighten and guard. This is your body’s protective response. It’s not imaginary. You can see it on EMG testing. You can feel it in the knots you carry around like boulders.
• Your nervous system shifts into sympathetic dominance — fight-or-flight mode. And when you’re stuck in fight-or-flight, your body deprioritizes healing, digestion, immune function, and tissue repair. Your low back, already under stress, simply cannot recover.
• Your pain perception changes. Chronic stress literally rewires your brain to be more sensitive to pain signals. This is called central sensitization, and it’s why people with chronic back pain often find that their pain persists even after structural issues are addressed.

A 2024 study from the Veterans Health Administration found that chiropractic care produced significant improvements not only in pain intensity but also in anxiety, depression, and fatigue — suggesting that the benefits of spinal adjustments extend far beyond the physical spine into the brain and nervous system itself. Researchers attributed these improvements to altered brain activity and neuroplastic changes. (Source: Brain Science, 2024)

Read that again: chiropractic adjustments change your brain activity. That’s not just pain management. That’s transformation.

The Stress Epidemic Hiding in Plain Sight

I see this every single day in practice, and I’d bet you see it in your own life too. The mom who’s managing the house, the kids’ schedules, her own career, her aging parents, and her marriage — and she hasn’t taken a full breath in months. The business owner in West Michigan who’s carrying the weight of payroll, growth, and uncertainty on shoulders that are permanently at his ears. The college student who’s anxious about the future and has had a “tight back” since sophomore year.

Stress doesn’t stay in your mind. It moves into your body. And your low back — the structural and neurological center of your body — is one of its favorite places to set up camp.

What You Can Do About Emotional Stress Right Now

• Get adjusted regularly. Chiropractic adjustments don’t just move bones — they stimulate your parasympathetic nervous system (the “rest, digest, and heal” side). Patients tell us all the time that they sleep better, feel calmer, and think more clearly after adjustments. That’s not a coincidence — it’s neuroscience.
• Breathe with intention. Five minutes of slow, diaphragmatic breathing (in through the nose for 4 counts, hold for 4, out for 6–8) can shift your nervous system out of fight-or-flight. Do it before bed. Do it in your car. Do it right now.
• Move your body to move your emotions. Exercise is one of the most effective treatments for both depression and back pain. A 30-minute walk along the Muskegon lakeshore, a round of pickleball at your local YMCA, or a yoga class can do more for your low back than you’d believe.
• Talk about it. Counseling, therapy, a strong faith community, meaningful friendships — these aren’t luxuries. They’re part of your health. Holding emotions inside creates physical holding patterns in your body. Let some of it out.
• Be honest about what’s heavy. Sometimes the most transformative thing we can do is simply name the weight we’re carrying. You’d be amazed how the body starts to let go when the mind does first.

Why This Matters: The Nervous System Is the Common Thread

If you’ve been paying attention, you’ll notice something — all three causes (Traumas, Toxins, and Thoughts) converge on the same system: your nervous system.

Physical trauma creates subluxations that interfere with nerve signaling. Chemical toxins trigger inflammation that assaults nerve tissue. Emotional stress hijacks the nervous system’s regulatory balance. And your low back — protected by and completely dependent on the lumbar spine and its surrounding nerves — bears the consequences of all three.

This is exactly why chiropractic care is so powerful for low back pain. We’re not putting a Band-Aid on the symptom. We’re not masking the alarm. We’re going to the source — the nervous system — and restoring its ability to function, adapt, and heal.

A comprehensive review of clinical practice guidelines spanning 2013–2024 found that 90% of guidelines favored spinal manipulative therapy for low back pain. That’s not a fringe recommendation. That’s near-consensus across the global medical community. (Source: Journal of Clinical Medicine, 2024)

And a 2025 systematic review confirmed that when manual therapy is combined with exercise, the results are superior to exercise alone for pain, function, and disability in low back pain patients. (Source: Journal of Bodywork and Movement Therapies, 2024)

At Back To Health, we’ve built our entire approach around this understanding. Every adjustment, every recommendation, every conversation we have with you is designed to address the interference — wherever it’s coming from — and give your nervous system the best possible chance to do what it was designed to do: keep you healthy, mobile, and fully alive.

Frequently Asked Questions About Low Back Pain [2026]

Q: Is low back pain really that common, or does it just seem like everyone has it?

It really is that common. Global Burden of Disease data shows that over 619 million people worldwide were living with low back pain in 2020, and that number is expected to reach 843 million by 2050. In the United States, approximately 28% of adults report chronic low back pain, and up to 84% of adults will experience at least one episode during their lifetime. Low back pain has been the single leading cause of disability worldwide since 1990 — making it one of the biggest health challenges of our time.

Q: Can chiropractic care actually help with low back pain, or is it just temporary relief?

Chiropractic care does far more than provide temporary relief. By addressing subluxations — misalignments in the spine that interfere with nervous system function — chiropractic adjustments work at the root cause level. Research published in 2025 in the Journal of Orthopaedic & Sports Physical Therapy confirms that spinal manipulative therapy is effective for both pain reduction and disability improvement. When combined with exercise, the outcomes are even better than exercise alone. Additionally, 90% of clinical practice guidelines reviewed between 2013 and 2024 recommended spinal manipulation for low back pain.

Q: I sit at a desk all day. Is that really causing my back pain?

Prolonged sitting is one of the most common micro-traumas we see at Back To Health. When you sit for extended periods — especially with poor posture or an unsupportive chair — you place sustained compressive forces on your lumbar discs, shorten your hip flexor muscles, weaken your core and gluteal muscles, and create patterns of spinal misalignment. Over time, these micro-traumas accumulate and result in the same kind of dysfunction and pain as a single large injury. The good news? It’s highly correctable with regular chiropractic care, targeted movement, and workstation adjustments.

Q: Can stress really cause physical back pain, or is it just “in my head”?

Stress-related back pain is absolutely real and well-documented by research. When you’re under chronic emotional or psychological stress, your body releases stress hormones like cortisol that increase muscle tension, trigger inflammation, and shift your nervous system into a state of heightened pain sensitivity called central sensitization. Your brain literally amplifies pain signals. This is why addressing the emotional and mental component of low back pain — through chiropractic care, stress management, exercise, and support — is essential, not optional.

Q: How do I know if my low back pain is serious enough to see a chiropractor?

Here’s the honest truth: you don’t have to wait until it’s “serious enough.” In fact, the best time to see a chiropractor is before pain becomes chronic or debilitating. Just like you see a dentist for prevention and not just when a tooth is falling out, chiropractic care works best as a proactive strategy for spinal health and nervous system function. That said, if you’re experiencing persistent pain lasting more than a few days, pain that radiates into your legs, numbness or tingling, difficulty standing or walking, or pain that’s interfering with your daily life — please don’t wait. Schedule an appointment with us today.

The Bottom Line: You Were Not Designed to Live in Pain

Let’s bring it all together.

Low back pain — the kind that steals your energy, limits your life, and makes you feel decades older than you are — almost always comes down to three root causes:

• Traumas — the physical forces (big and small) that create spinal misalignment and nervous system interference
• Toxins — the chemical stressors that fuel inflammation and rob your body of its ability to heal
• Thoughts — the emotional and psychological weight that rewires your nervous system and locks your body in a pain pattern

These three causes don’t exist in isolation. They layer on top of each other, compound over time, and create the complex, frustrating, life-limiting back pain that affects hundreds of millions of people worldwide.

But here’s the part I need you to hear, the part that drives everything we do at Back To Health Chiropractic: all three of these causes are addressable. Not just manageable. Not just “livable.” Addressable.

When you restore proper alignment to the spine, clear interference from the nervous system, reduce the chemical burden on your body, and give yourself the emotional and mental space to heal — your body responds. I’ve watched it happen thousands of times. In patients who were told they’d need surgery. In moms who thought they’d never run with their kids again. In athletes who were ready to quit. In grandparents who thought their best years were over.

Your body is designed to heal. We just have to remove what’s in the way.

Ready to Find Out What’s Really Causing YOUR Low Back Pain?

Our team at Back To Health Chiropractic is here to help you identify which of the 3 T’s is driving your pain — and create a personalized plan to address it at the root.

➡ SCHEDULE ONLINE: bthclinics.com/locations

Prefer to call?

Zeeland: 616.546.3500

Portage: 269.345.2273

Muskegon: 231.830.1111

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Sources & References

GBD 2021 Low Back Pain Collaborators. “Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050.” Lancet Rheumatology, 2023.

Cheng, M. et al. “Global, Regional, and National Burden of Low Back Pain: Findings From the GBD Study 2021 and Projections to 2050.” Spine, April 2025.

Gevers-Montoro, C. et al. “Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain.” Frontiers in Pain Research, 2022.

Trager, R.J. et al. “Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations.” Journal of Clinical Medicine, 2024.

De Zoete, A. et al. “The Effectiveness of Spinal Manipulative Therapy in Treating Spinal Pain.” JOSPT, 2025.

International Association for the Study of Pain. “The Global Burden of Low Back Pain.” Fact Sheet, 2025.

This blog post is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider regarding your specific health condition. © 2026 Back To Health Chiropractic. All rights reserved.

Dr. Tonya Westerbeke

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