Back pain is one of the most common health conditions – but did you know that your gut can play a bigger role than you might think? More and more recent studies are showing that the gut microbiome – the entirety of all microorganisms in our digestive tract – can influence not only our digestion but also our perception of pain and physical complaints like back pain. Sounds strange? Let's take a closer look.
The gut – our second brain
The gut is home to an estimated 100 trillion bacteria that not only digest our food but also communicate with the immune system and nervous system . Therefore, it seems understandable that the gut is often referred to as a "second brain." The so-called gut-brain axis is in constant communication with our central nervous system—and thus also with pain perception.
When the balance in the microbiome is disturbed —for example, due to an unbalanced diet, stress, medication, or infections —it's called dysbiosis. This can lead to inflammatory processes that are noticeable throughout the body. And this is precisely where things get interesting for anyone with chronic back pain.
Inflammation as a pain amplifier
An unbalanced microbiome can promote systemic inflammation—silent inflammation that often lies dormant in the body. This promotes the release of inflammatory messengers that spread throughout the body via the blood. This, in turn, can negatively impact the regeneration and resilience of muscles, joints, and connective tissue . Especially in the back area, this can lead to increased sensitivity to pain, tension , and impaired healing of existing complaints.
This makes it all the more important to specifically support the microbiome – and that starts on our plates. Because what we eat significantly influences which bacteria thrive in our gut and whether a healthy balance can develop.
Why a varied diet is so important
The diversity of gut bacteria determines how robust and balanced your microbiome is. And this diversity depends heavily on your diet.
Nutritional tips for a healthy gut
Fiber from fresh fruits and vegetables, whole grain products, and legumes feeds the good bacteria and promotes the production of short-chain fatty acids (e.g., butyrate), which have anti-inflammatory effects and stabilize the intestinal wall.
- Drink plenty of fluids and eliminate harmful substances: e.g. through water and unsweetened tea
- Variety counts: Eat “as colorful as possible” – at least 30 different plant-based foods per week
- Incorporate fermented foods: e.g. sauerkraut, yogurt, kimchi, kombucha
- Reduce sugar and processed foods
- Integrate healthy fats (e.g. found in olive oil) and omega-3 fatty acids: e.g. through linseed oil, walnuts, fatty fish
Beyond all these nutritional tips , exercise is key. Regular exercise stimulates your metabolism and bowel function . Even a daily walk is enough for this. Regularly practicing endurance sports such as jogging, cycling, or swimming is especially recommended.
What harms intestinal health
A one-sided diet , for example, with a lot of highly processed foods , sugar , and animal fats from heavily processed meat (e.g., sausages), promotes "bad" bacteria and reduces the good ones. In moderation, however, this is of course not dangerous. As with everything in life, it's all about balance.
Stress also plays a crucial role when it comes to gut health—and thus also back pain . As mentioned above, the gut and the brain are in constant communication via the so-called gut-brain axis .
Chronic stress can disrupt this delicate exchange. The result: The digestive tract reacts with discomfort, bloating, diarrhea, or constipation —all signals that the microbiome is also suffering. However, those who ensure regular rest and sufficient sleep can help their bodies recover better and cope with stress—which can also have a positive effect on their backs.
Think holistically – also in physiotherapy
If back pain recurs or becomes chronic in patients, it's worth looking beyond traditional muscle work. Physiotherapy treatment can be more effective in the long term through a holistic approach that also includes the gut. It may therefore be worthwhile to incorporate the following aspects into therapy:
- Collaboration with nutrition experts
- Accompanying relaxation techniques for stress reduction
- Patient education about nutrition and intestinal health
A brief summary to conclude: Back pain can be more than just a mechanical problem: In this article, we've shown that inflammation and the gut microbiome can often play a crucial role in other types of pain. With a healthy, varied diet, sufficient exercise, and reducing stress factors —in other words, looking at the bigger picture—you can not only do something good for your back, but also promote your overall health.
Note: Our articles do not replace medical advice. Please always discuss your individual situation with a medical professional.
