Back Pain and Fatigue: “It Won’t Always Feel Like This”
- Dr Senadheera
- Jun 19
- 4 min read
Updated: Jul 2
“It won’t always feel like this.” — These were the words my GP offered me. At a time I was too overwhelmed to believe them. My body felt heavy, every task felt like a mountain, and my back pain was constant.
Those words did plant a seed. And now, with hindsight, I understand their truth.
As someone who has always been driven and proactive, I found it disorienting to feel so depleted. I was a young woman, unfamiliar with the true depth of the word fatigue. I thought I knew what it meant — but this was something else entirely.
This was a full-body shutdown. A thick, grinding exhaustion that seeped into my bones. The word tiredness didn’t come close.
Now, looking back, I realise how much chronic pain forces you to change — not just physically, but emotionally, socially, and mentally. It’s not just that pain hurts; pain drains. Especially when it’s in your back.
What Is Fatigue?
It’s a whole-body experience that affects your motivation, energy, and even your outlook on life. It can feel like:
Struggling to get out of bed despite a full night’s sleep
Losing interest in things you used to enjoy
Being overwhelmed by small tasks
Feeling mentally foggy or irritable
When daily back pain is poorly controlled — even when you’re doing your best with medications, stretches, or therapies — it can amplify the sense of fatigue.
A 2021 review highlights that fatigue is a common complaint among those with long term musculoskeletal pain, often arising from sustained (near constant) physical and emotional stress [1].
Why Does Back Pain Make You So Tired?
There are many physical and psychological links between back pain and fatigue. Here's how they interact:
1. Pain Is Physically Draining
Pain activates your nervous system. Your body stays on high alert, trying to manage or avoid discomfort. This long-term stress response can deplete your energy levels even if you’re not doing anything physically demanding.
2. Your Muscles Are Working Overtime
Pain often leads to compensatory movement patterns. For example, if you're favouring one side or sitting in a slouched posture to "relieve" pressure, you could be unknowingly straining other muscles. Over time, these muscle imbalances lead to fatigue.
3. Fatigue Becomes a Barrier to Movement
Ironically, movement is part of what helps relieve back pain. But when you're tired, you're less likely to exercise, stretch, or simply move your body. That inactivity contributes to deconditioning, further pain, and more fatigue.
4. Sedentary Lifestyle Worsens Circulation
Being still might seem like the only option when you're in pain. But low activity means your heart rate stays low, circulation slows, and muscles don't get the oxygen they need. The result? You feel sluggish and weak.
5. Medications Can Contribute
Some pain medications and anti-inflammatories have fatigue as a side effect. If you're relying heavily on medication but not addressing the root cause of your pain, you might be compounding the problem.
6. Sleep Disruption Is Common
Back pain often interferes with quality sleep. You might struggle to find a comfortable position, wake up frequently, or sleep lightly due to pain. Poor sleep leads to worsening fatigue.
6 Ways to Break the Cycle: From Fatigue to Function
Fatigue doesn't have to be your permanent state. Here are six practical steps to help restore energy and reduce the impact of chronic back pain:
✅ Keep Moving (Gently)
Try low-impact exercises like swimming, walking, or pilates
Avoid "all or nothing" thinking — even 10 minutes of movement counts
Celebrate small wins to stay motivated
✅ Stretch Daily
Loosen tight hip flexors, hamstrings, and lower back muscles
Stretch slowly and steadily — never force it
✅ Improve Your Posture
Build posture checks into your routine — use tools like the Pomodoro Technique as reminders
Review all your sitting spaces: home, work, and car
✅ Prioritise Restorative Sleep
Use pillows to support spinal alignment
Establish a calming bedtime routine — try gentle stretches, reading something light, or dimming the lights an hour before bed to help your body wind down
✅ Address Emotional Fatigue
Practice mindfulness, breathing exercises, or guided relaxation
Journal to reflect and release mental tension
Connect with others who understand your experience
✅ Speak to a Professional
If pain and fatigue are limiting your life, don’t wait
A GP, physiotherapist, or pain specialist can help you build a treatment plan that’s tailored to you
When to Seek Help
Fatigue deserves the same attention as pain.
See your GP if:
Fatigue is stopping you from working, caring for others, or enjoying life
You notice other symptoms like fever, weight loss, or numbness
Your pain isn’t responding to basic treatments
You feel hopeless or overwhelmed
Your GP can also undertake a “tired all the time” screen — a common set of blood tests designed to identify physical causes of fatigue, such as anaemia, thyroid issues, or vitamin deficiencies. This can help rule out or confirm underlying medical conditions contributing to your exhaustion.
Final Thoughts
When you’re living with chronic back pain, fatigue is not just in your head. It’s a physiological response to pain, poor sleep, inflammation, stress, and more.
You may not be able to change everything at once, but there are small shifts that can help you climb out of the fatigue spiral.
Start where you are.
Rest when you need to.
Move when you can.
And hold onto this: It won’t always feel like this.
Let's hear from you!
Which of these feels like your next best step toward breaking the fatigue cycle?
Commit to a daily stretch routine
Check and tweak my sitting posture
Focus on better sleep habits
Try something to ease emotional fatigue
References
Van Hooff ML, Spruit MA, Smeets RJ, et al. The relationship between fatigue and physical capacity in patients with chronic low back pain: a systematic review. Pain Res Manag. 2021;2021:5552823. doi:10.1155/2021/5552823
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