Back Pain Is Not Just a Middle-Age Problem
Back Pain Is Not Just a Middle-Age ProblemMost people assume back pain is something that ambushes you in your forties or fifties, a consequence of too many hours hunched over a laptop or spent weeding the garden. But a landmark 26-year study published in 2025 suggests the story begins far earlier, and the implications for how we look after our spines are significant.
Understanding where persistent low back pain may have originated could change how you approach your recovery and long-term spinal health.
What the Research Actually Found
Researchers followed a group of healthy volunteers from childhood into their mid-thirties, using MRI scans to track changes in their spinal discs over 26 years. The findings were striking.
Disc degeneration (the gradual breakdown of the cushioning pads between your vertebrae) did not creep in quietly during middle age. Instead, it accelerated markedly during adolescence, particularly at the lower lumbar levels L4–L5 and L5–S1. These are precisely the disc levels most commonly associated with low back pain in adults. Together, these two discs are the workhorses of your lower back. They are the pivot point for almost every movement you make during the day, from bending to pick something up to simply sitting down. Because of this, they are also the most common site for disc degeneration, nerve irritation and the kind of deep, persistent low back pain that can radiate into the buttock or down the leg.
Perhaps most telling of all: people who reported back pain at any point in their lifetime showed more disc changes at age 19 than those who had never experienced pain. Those who had noticeable disc degeneration by their mid-thirties had already been on a steeper decline as teenagers.
The conclusion? Adolescence is a critical window for spinal health — not midlife.
How Common Is Low Back Pain in Brighton
In Brighton and Hove, more than 42,000 people are living with back pain. Of these, 10,000 back sufferers are under 35 years old (Arthritis Research UK). It is more common in women. If you are living with back pain you know how disabling it can be. It can stop you working, decrease an active life and lead to obesity.
In the UK alone, back pain costs the NHS and economy billions of pounds each year in treatment, lost productivity and long-term incapacity. It is one of the most common reasons people visit a chiropractor in Brighton and across the country.
What Causes Discs to Degenerate?
The intervertebral discs are remarkable structures. They act as shock absorbers between each vertebra, allowing you to bend, twist and carry load. But they are also vulnerable, particularly as they receive nutrients through diffusion rather than a direct blood supply.
Disc degeneration is now understood to be caused by a combination of genetic, mechanical and lifestyle factors:
- Genetics accounts for 30–54% of lumbar disc degeneration, according to twins studies (Battié et al., 2009)
- Excessive mechanical loading, particularly in jobs involving bending, heavy lifting or prolonged sitting, which accelerates wear
- Poor nutrient supply to disc cells is now considered a central driver of degeneration (Urban & Roberts, 2003)
- Lifestyle factors including smoking, obesity and physical inactivity all contribute
- Age increases both prevalence and severity, but as this study shows, the process starts young
Some individuals also appear to carry a genetic predisposition to early degeneration, meaning structural changes can begin in childhood regardless of lifestyle.
Adolescence as a Critical Window: What Parents and Young People Should Know
The research suggests that the foundations of adult back pain may be laid during the teenage years. This has practical implications that go beyond the clinic.
Adolescence is a period of rapid skeletal growth, increased sedentary behaviour (studying, screen time) and often reduced structured physical activity. It is also when posture habits, whether good or bad, tend to become entrenched.
Practical steps to protect spinal health in younger people include:
- Encouraging regular varied physical activity, including swimming, yoga or team sports
- Reducing prolonged sitting with regular movement breaks
- Ensuring school bags are worn correctly and are not excessively heavy
- Addressing poor posture proactively rather than waiting for symptoms to develop
- Seeking an assessment from one of our chiropractors or physiotherapists if a teenager reports persistent back or neck discomfort
Lifestyle modifications like learning to sit and move in ways that put less strain on the spine may need to begin earlier than previously assumed. Early intervention, rather than early resignation, is the message.
Is Chiropractic Care Safe for Children and Teenagers?
One question we hear regularly in our clinics is whether chiropractic treatment is appropriate for younger patients. The short answer is yes. Chiropractic care is safe and suitable for all age groups, from school-age children through to older adults, and is practised by registered chiropractors across the UK every day. In fact, the General Chiropractic Council, which regulates the profession in the UK, requires all chiropractors to be trained in the assessment and treatment across all age groups. The treatment simply looks a little different depending on the patient sitting in front of us.
For adults, spinal manipulation typically involves a short, precise movement applied to a specific joint. For children and teenagers, chiropractors use considerably lighter, gentler techniques that are adapted to the size, weight and skeletal development of the young patient. Practitioners use soft, sustained pressure and mobilisation techniques that feel more like a firm massage than anything else. Many young patients find the experience entirely unremarkable.
If your child or teenager has been complaining of back discomfort, stiffness or postural issues, it is worth seeking an assessment sooner rather than later. As the research highlighted in this article suggests, the foundations of spinal health are laid earlier than most of us realise, and early, gentle intervention is far preferable to waiting until symptoms become harder to manage.
What Is Spinal Manipulation and How Does It Help?
Spinal manipulation is one of the core treatments delivered by a chiropractor. It involves applying a controlled, targeted force to a specific spinal joint, sometimes producing the familiar “pop” sound caused by movement of gas within the joint capsule. If you don’t like the idea of that, we have a gentle mobilisation technique using an instrument, the Impulse iQ.
But what is actually happening physiologically?
Research published in the Journal of Manipulative and Physiological Therapeutics shows that spinal manipulation works through several interconnected mechanisms:
- Neurological modulation. Chiropractic adjustments stimulate tiny sensory receptors in your spinal joints, which effectively turns down the volume on pain signals before they reach your brain.
- Restoration of joint mobility. Restricted or “fixated” segments regain movement, reducing compensatory stress on adjacent discs and muscles
- Reduction in muscle tension. Manipulation decreases abnormal muscle tension around the affected joint, improving function and reducing spasm
- Enhances your body’s own natural painkilling response. It has been shown to trigger the release of endorphins and other natural pain-relieving compounds
The Cochrane Database of Systematic Reviews confirms that spinal manipulative therapy is effective for acute and chronic low back pain, producing clinically meaningful reductions in pain and disability.
Why Chiropractic and Physiotherapy Work Well Together
Chiropractic care and physiotherapy are often seen as separate disciplines, but in practice they complement each other exceptionally well, particularly for patients with disc-related back pain. Here at Sundial Clinics, our practitioners work closely together as a team.
Chiropractic manipulation addresses the joint itself: restoring movement, reducing nerve irritation and interrupting the pain cycle. Physiotherapy, meanwhile, focuses on strengthening the surrounding musculature, correcting movement patterns and improving postural control.
Think of it this way: manipulation opens the window; physiotherapy keeps it open.
A combined approach is supported by evidence.
When Should You See a Chiropractor?
You do not need to be in severe pain to benefit from chiropractic care. Many patients come for assessment after noticing stiffness, reduced mobility or a dull ache that has been quietly building for months or years.
Signs it may be worth booking an appointment include:
- Low back pain that persists beyond a few weeks
- Pain that radiates into the buttock or leg (possible nerve involvement)
- Stiffness first thing in the morning that takes time to ease
- Back pain that recurs repeatedly despite rest
- A teenager or young adult in your family reporting persistent back discomfort
Your chiropractor will carry out a thorough assessment, including a full history and physical examination, and refer for imaging where appropriate. Treatment is tailored to the individual; there is no one-size-fits-all approach.
Frequently Asked Questions About Back Pain and Chiropractic Care
Q: At what age can someone see a chiropractor?
A: Chiropractors can assess and treat patients of all ages, including children and teenagers. Techniques are adapted to suit the patient’s age, size and condition.
Q: Can disc degeneration be reversed?
A: Current evidence does not support full reversal of disc degeneration. However, research suggests that lifestyle interventions, exercise and manual therapy can slow progression, reduce symptoms and significantly improve function (Belavý et al., 2017).
A: When performed by a qualified and registered chiropractor, spin
Q: Is spinal manipulation safe?
al manipulation is considered safe and well-tolerated. Serious adverse events are rare. Minor side effects such as temporary soreness are common and typically resolve within 24–48 hours (Rubinstein et al., 2019).
Q: How does chiropractic care differ from physiotherapy?
A: Chiropractic care primarily focuses on spinal joint function, manipulation and neurological pain modulation. Physiotherapy emphasises rehabilitation, exercise prescription and movement retraining. Both are evidence-based and many patients benefit from both disciplines working together.
Q: Can back pain that started in my teens be treated now?
A: Absolutely. While the research suggests early degeneration begins in adolescence, effective treatment is available at any age. A chiropractor in Brighton can assess your specific presentation and develop a personalised treatment plan.
Q: How many sessions will I need?
A: This varies depending on the nature and duration of your symptoms. Some patients notice significant improvement within three to six sessions; others with chronic or complex presentations benefit from ongoing management. Your chiropractor will discuss realistic expectations at your initial consultation.
Q: Does the NHS cover chiropractic treatment?
A: NHS provision for chiropractic is limited and varies by area. Most patients access chiropractic care privately. Many health insurance policies do cover chiropractic treatment so it is worth checking your policy.
Q: What is the best exercise for a degenerated disc?
A: Low-impact exercise such as swimming, walking and Pilates is generally well-tolerated and beneficial. Core stabilisation programmes have strong evidence for reducing pain and improving function in patients with lumbar disc degeneration (Hides et al., 2001). Your chiropractor or physiotherapist can advise on the most appropriate programme for your specific condition.
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.
Sources & Further Reading
Lund T, Aavikko A, Ristolainen L: Progression of lumbar disc degeneration: a 26-year follow-up study of healthy individuals from childhood to adulthood
Samanta, M. et al. (2023). Genetic predisposition to early lumbar disc degeneration: a systematic review.’ European Spine Journal, 32(4)
Todd, A.J. et al. (2015). The chiropractic care of children: a systematic review of the literature.’ Journal of Manipulative and Physiological Therapeutics, 38(9)