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Back Pain and Chronic Dehydration

By Dr. James J. Lehman

Updated May 20, 2014

Cropped view of man massaging sore back
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This article describes some observations about a possible connection between not drinking enough water and suffering from back pain. The guest author is James Lehman, DC, who is a professor of orthopedics and neurology at the University of Bridgeport College of Chiropractic.

Years ago, during a very hot spell in Albuquerque, New Mexico, I discovered that my patients who had back pain were negatively affected by not drinking enough water every day. It became obvious to me that certain patients were more sensitive to palpation of their spinal muscles than I expected during their initial examinations. In addition, they were more uncomfortable after their first chiropractic treatments than I would have expected. Normally, people have a tendency to experience some temporary muscle soreness and myofascial pain after their initial chiropractic spinal manipulation.

This muscle soreness is caused by the change in posture that occurs after an initial chiropractic spinal manipulation because the chiropractic treatment affects the length of the involved muscles. During this hot spell, several patients exhibited this muscle soreness not only after their initial chiropractic treatments, but after their follow-up chiropractic treatments as well. This response to chiropractic care concerned me because it was so unusual. Normally, patients with back pain respond quickly to chiropractic care. Consequently, my inquisitiveness stimulated me to research hydration (water intake) data.

It soon became obvious to me that there was a dearth of information regarding the proper hydration levels for the average adult. There were volumes of articles about runners, institutionalized seniors, and military personnel, which detailed required daily water intake needs indicated in these specialized situations. Unfortunately, my research did not reveal many articles that discussed the required daily water intake needs for the average adult. Although the AMA web site mentioned the value of proper hydration and suggested eight to ten glasses of water per day, I could not substantiate their recommendations with a scientific reference.

Currently, there are many more research articles available regarding proper water intake. I am most impressed with a monograph titled Hydration: Fluids for Life. As stated in the foreword of the monograph:

This monograph provides readers with an overview of current knowledge related to the functions of water, methods of determining hydration status, sources of water in the diet, and specific considerations for infants, children, physically active individuals and the elderly.

This 39-page publication by the North American Branch of the International life Sciences Institutes should be mandatory reading by anyone interested in proper hydration.

In my practice, I take into account more than just the biomechanical causes of back pain. A patient's medical history relative to the cause of their back pain is essential, but I also normally delve into their health status. This health status involves their psychological state and their lifestyle activities. Obviously, smokers, alcoholics, and couch potatoes are more prone to back pain than active, healthy individuals. It also seems that everyone is more prone to episodes of low back pain when they are dehydrated and/or under extreme amounts of stress. After an initial history and examination, I set out to determine a comprehensive chiropractic treatment regime, one that would best benefit my patients suffering with back pain. This regimen includes proper hydration levels by recommending increased water intake.

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