I did everything the doctor told me to do and my back pain still keeps coming back. What am I doing wrong?

Why do some people get back pain over and over while others recover without a single recurrence? That's the question scientists from Australia posed in a recent study. They suspected that activity of the deep muscles in the back might be different in some people. This could be causing return bouts of back pain.

In fact, one-third of all adults with low back pain will develop pain again. And that's even after returning to normal function with apparent good recovery from the first episode. Other studies have shown that there is a problem with muscle relaxation. Messages from the nervous system may get mixed up so that the muscles lose the ability to fine tune motion of the vertebrae.

It looks like changes in motor control of the back muscles of people with low back pain may be why they get back pain again. Alteration in the timing of the short fibers on the side of the symptoms may be the key. Proper timing of deep muscle contraction in the spine is essential for normal spinal movement and spinal stability.

Without the normal firing sequence of muscles, motor planning is altered. As a result, the nervous system sets up a pain pattern. Just because back pain goes away doesn't mean the muscles have returned to normal.

For patients with recurrent back pain, in between episodes, their back muscles aren't firing normally. This puts them at risk for reinjury or another acute episode of pain. But what causes this change in motor planning? Is there some kind of damage to the muscle itself? Or is it because the person alters the way he or she moves to avoid pain and protect the spine?

And it's possible that our beliefs about pain and the desire to avoid pain may actually be able to influence motor control at the level of the muscles. If you haven't already, think about seeing a physical therapist. They are experts in movement. They can help you correct any protective postures and movement strategies you may be using unconsciously in an attempt to prevent future episodes of back pain.