Back pain has a way of turning everyday life into a negotiation. Sitting at a desk, driving, standing up from the couch, lifting groceries, or picking something up from the floor can suddenly feel like a bigger deal than it should.

In this episode of The Lifestyle Medicine Show Powered By My Viva, Michael Dargie brings that everyday frustration to Dr. Prerana, My Viva’s Chief Medical Liaison, and Shara, My Viva Plan’s Director of Fitness. Together, they talk through what may be happening when a person says, “My back hurts,” and why the answer is often more layered than one single injury or one sore spot.

Dr. Prerana explains how clinicians think through back pain: taking a clear history, doing a physical and neurological exam, and ruling out serious red flags such as bowel or bladder changes, unexplained weight loss, fever, night sweats, or neurological symptoms. She also reminds listeners that pain can be complex. Imaging may have a role, but results need to be interpreted in the context of the person’s symptoms, history, and function.

Shara brings the movement perspective, drawing on her experience training people and working with clients who struggled with low back pain. She explains how sedentary routines, weak glutes, reduced core strength, tight hips, tight hamstrings, stress, sleep, and work demands can all contribute to how the back feels. One of her key points is that where the pain shows up is not always where the root issue begins.

The episode also gets practical. Dr. Prerana and Shara discuss why bed rest is not usually recommended as a long-term strategy, how to scale movement when pain is present, and why physiotherapy can help people understand their body mechanics. Shara also shares simple core stability exercises, including dead bugs, bird dogs, and side planks, along with the idea of “movement snacks” throughout the day.

The central message is not to ignore pain or push through blindly. It is to get assessed when needed, rule out serious concerns, and then rebuild movement, strength, mobility, and confidence in a way that fits real life.

Key Takeaways

• Back pain is multifactorial. It can involve the spine, nerves, muscles, movement patterns, stress, sleep, work demands, conditioning, and lifestyle habits.

• A clinical assessment matters. Dr. Prerana explains that healthcare providers look for red flags, take a history, and may do physical and neurological exams before deciding what comes next.

• Pain location does not always identify the root problem. Back pain may be connected to weakness, tightness, compensation patterns, or radiating pain from another area.

• Sitting for long periods can contribute to back discomfort by affecting hip mobility, glute strength, core strength, hamstrings, and pelvic positioning.

• Imaging can be useful in the right context, but it is not always the first or only answer. Results need to match the person’s symptoms and exam.

• Dr. Prerana highlights pain perception as an important part of the conversation and references a My Viva Plan knee pain study where participants reported a reduction in perceived pain after a 12-week lifestyle-focused program.

• Mobility and flexibility are not the same. Shara explains that flexibility relates more to muscles, while mobility relates to joints moving through ranges of motion.

• Core stability and hip mobility are practical starting points. Shara recommends dead bugs, bird dogs, side planks, walking, mobility breaks, and scaling movement to what feels manageable.

Key Moments / Timestamps

• [00:00] — Opening disclaimer: The episode begins with the show’s educational framing and reminder to consult qualified healthcare providers before making changes.

• [00:52] — Meet the guests: Michael introduces Dr. Prerana, My Viva’s Chief Medical Liaison, and Shara, My Viva Plan’s Director of Fitness.

• [01:11] — “A regular guy with a back”: Michael sets up the episode with the everyday reality of sitting, old injuries, and wondering what back pain really means.

• [02:00] — What clinicians look for first: Dr. Prerana explains history-taking, physical exams, neurological exams, and red flags.

• [03:44] — Pain is not always where the problem is: Dr. Prerana discusses radiating pain and why back pain can be difficult to locate cleanly.

• [04:37] — Why back pain is so common: Shara connects back pain to sedentary lifestyles, stress, lack of strength, sleep, work demands, and cumulative patterns.

• [05:24] — Sitting and the lower back: Shara explains how sitting can contribute to weak hips, glutes, and core muscles, along with tight hamstrings and glutes.

• [07:22] — What if the MRI is “fine”?: Dr. Prerana discusses imaging, structural findings, pain conversations, and why results need context.

• [09:23] — My Viva Plan pain-perception study: Dr. Prerana references a 12-week My Viva Plan study involving people with knee osteoarthritis and pain perception.

• [11:38] — Why bed rest is not the default: Dr. Prerana notes that avoiding bed rest has long been part of back pain guidance.

• [13:00] — How sitting makes the back “pay the bill”: Shara explains compensation patterns, pelvic position, core weakness, and tight hips.

• [14:30] — Flexibility versus mobility: Shara clarifies the difference and explains why both matter.

• [15:26] — Strength training as mobility work: Shara describes lifting through ranges of motion as one way to build mobility.

• [17:36] — What happens after red flags are ruled out: Dr. Prerana talks about education, physiotherapy, daily movement mechanics, return to work, and mental health.

• [20:31] — Movement snacks and core stability: Shara recommends dead bugs, bird dogs, and side planks as simple core stability exercises.

• [23:16] — Movement at work: The conversation turns to doing practical movement breaks in an office setting.

• [24:39] — Should back pain mean rest?: Dr. Prerana and Shara discuss why pain may call for adjustment, not complete shutdown.

• [28:37] — Mailbag: Do bad backs run in families?: Dr. Prerana and Shara discuss family history, bone health, and being proactive.

• [30:07] — Mailbag: Exercise before weight loss?: Shara and Dr. Prerana explain why movement and strength can still be useful before weight loss happens.

• [32:16] — Final takeaway: Dr. Prerana emphasizes pain perception, graded exercise, and appropriate rehab; Shara emphasizes core strength and hip mobility.

• [33:54] — Closing: Michael ties the conversation back to movement, strength, support, and My Viva Plan resources.

Links & Resources

• My Viva Plan: https://discover.myvivaplan.com