3 Ways Alcohol May Be Contributing to Your Back Pain

You may be familiar with a lot of the advice for preventing or lessening back pain. Strengthen your core. Practice good posture. Stretch more. But there’s a lesser-known tip to consider, too: Reduce your alcohol consumption.

Can drinking alcohol really cause back pain? Pain management expert Tara-Lin Hollins, MD, discusses the possible association between alcohol and back pain.

What’s the connection between alcohol and back pain?

Experts haven’t identified a direct connection between alcohol and back pain. Still, some believe there may be a slight association — mainly in people who already experience back pain and those with alcohol dependence. Up to 85% of people in the U.S. experience back pain in their lifetime. And 28% of people with chronic pain turn to alcohol for relief. So, it can be helpful to understand possible connections between the two.

Dr. Hollins says that if you follow guidelines for moderate drinking and don’t currently have back pain, there’s no reason to believe that alcohol will cause you to develop new pain. But if you experience some back pain or drink heavily and often, alcohol may lead to worsened back pain over time.

“There are many reasons you may experience back pain,” Dr. Hollins says, “and alcohol can be associated with or even cause many of those issues. So, while heavy drinking may not directly cause back pain, it may contribute to it.”

There are a few ways that drinking alcohol can worsen your existing back pain. Dr. Hollins explains the indirect connections between alcohol use and back pain.

1. It dehydrates you

Feel like you have to visit the bathroom more often whenever you’ve had a few drinks? There’s a reason for that: Alcohol blocks your body’s production of vasopressin, the hormone responsible for regulating water in your body. When vasopressin can’t do its job, you pee more than you should, which leads to dehydration.

Back pain associated with dehydration may include:

• Muscle spasms. You don’t just lose water when you pee. You also lose minerals that are critical for many important bodily functions, leading to an electrolyte imbalance that may cause painful spasms (involuntary contractions) in your back muscles.
• Spinal disk issues. Disks are shock absorbers for the spine, and they need water to maintain elasticity and provide cushioning. Dehydration can cause disks to rub together or press on nearby nerves — which, yes, is as painful as it sounds.

“Alcohol is a natural diuretic, and the dehydration that it causes can trigger muscle pain and lower back discomfort,” Dr. Hollins reiterates. “When someone comes in with spasms, one of the first things we do is check their electrolytes and hydration level.”

2. It aggravates nerves

Another connection between alcohol and the nervous system: People with alcohol dependence are at risk of developing alcohol-related neuropathy — nerve pain caused by the toxic effects of alcohol. The pain from alcohol-related neuropathy typically occurs in your legs (peripheral neuropathy), but this demonstrates the effects alcohol can have on nerves.

“If your existing back pain is associated with neuropathic pain or involves nerves at all, alcohol could potentially make it worse,” Dr. Hollins says.

She adds that many vitamins, including vitamin B and vitamin D, are involved in keeping nerves healthy and pain-free: “When you drink alcohol, you can strip your body of many of these vitamins and allow nerve pain to surface,” she notes.

3. It leads to weight gain

The empty calories in alcohol can contribute to contribute to weight gain, especially when paired with a calorie-heavy diet. Plus, heavy drinking and binge drinking have been shown to increase your risk of having obesity. And we know that weight can play a significant role in chronic lower back pain.

“Any added weight puts pressure on the spine,” Dr. Hollins explains. “Having stress and strain on the spine for a long period can add up, leading to arthritis and some level of chronic back pain.”

That may be especially true as you age. One study found that in people over the age of 50, the greater the amount of weight gain, the higher the association with an increased risk of chronic lower back pain.

Tips for drinking alcohol if you have back pain

If you do have existing back pain and plan to consume alcohol, follow these recommendations for drinking safely:

• Drink moderately. Moderate drinking is defined as having no more than one standard drink a day for people assigned female at birth (AFAB) or two drinks per day for people assigned male at birth (AMAB). But other factors, like age and body size, also play a role in how much alcohol you can safely consume. An example of a standard drink is 5 fluid ounces of wine (12% alcohol).
• No alcohol when you’re taking pain meds. Drinking when you’re taking certain medications — including common, over-the-counter pain relievers — can damage your organs. Acetaminophen can affect your liver, ibuprofen can harm your kidneys and aspirin can impact your stomach.
• Talk to your healthcare provider. Make sure they’re aware of your back pain, how much you drink and which medications you take. They can identify potential problems and help you create a treatment plan to ease your back pain.

“Making healthy lifestyle choices, including the decisions you make around alcohol use, is the best way to keep your back healthy,” Dr. Hollins emphasizes.