Back pain is destroying the quality of life for millions of people. Despite its prevalence, most treatment approaches and practices that I observe merely scratch the surface of symptomatic relief, doing very little to address the root causes of the pain. As a result, people are left in cycles of suffering, with little to no long-term and proper relief.

I'm going to articulate and explore five principles, which I believe are fundamentally necessary for us to realize and practice if we want to appreciate the root causes of our back pain and, in turn, understand the root solutions. I'll also provide a few tips or suggestions on how to engage with these principles and how to begin implementing them in the way you perceive and approach your back pain rehabilitation or prevention practice.

The first principle is cause and effect. We live in a causal universe. For any effect to come into being, the relevant and appropriate causes for that effect have to precede it. There is no exception to this. Anything we have observed in our universe, this is unfortunately the same reason. We can't do magic because the laws of physics, the laws that govern our reality, require that for a certain situation to come into being, the causes for that situation have to precede it. This might seem extremely obvious or simple, but I observe that many of us directly deny or ignore the presence of this principle. In fact, I see a lot of our medical community, the whole industry, as dominated by unconscious beliefs that there are magical cures, that there are shortcuts, that there are quick fixes.

When in fact, if we want to change anything about our health, our state of being, our development over time, we have to put the appropriate causes in place. We have to accumulate those causes, and we will begin to realize our desired effects.

This is just the way that things work. Yet most people who are experiencing undesired or unwanted effects, like back pain, believe that there is something they can do, some therapy they can quickly apply that will remove this effect. They can have some external intervention or some savior come and fix the unwanted effect they are experiencing, and then they can go back to their life as it was.

And continue fixed and whole without realizing that they have been setting the causes in motion through their movement habits, through their lifestyle, through everything that they do. They've been setting the causes in motion which have brought them to this effect. And if they return to their life and continue to set the same causes in motion, they will find themselves facing the same effect.

We have to change for things to change. This is where I think most of us have gaps in our acknowledgment and understanding of the principle of cause and effect. Things must change for things to change.

A really useful exercise is to analyze and start to connect the dots between what you do and how you feel. Start to understand your situation, your experience, and reflect on what causes or emotions brought me here. And when your situation changes, your health or lack thereof, look, analyze, understand what has changed about the causes that have led to the changes in the effects. This is how we can start to see the reality of cause and effect more continuously as a part of our experience. But it requires deliberate practice.

The question that takes us to the second principle is: What causes do we have control over? Which causes should we focus on? And out of all of the causes which shape our reality, all of the forces which shape our reality, which are in our control, because it's irrelevant what we can't control. Our only job with things we can't control is accepting them.

But as far as it comes to the matter of changing things for the better, the most influential force in our experience that is within our control is our own action. The choices and behavior which we engage in or approach our lives with. And this is the second principle: The importance of personal action, our actions, in shaping our experience.

There is nothing that comes close. Even when we compare things like genetics versus epigenetics, we have shown undoubtedly in research that it's our actions that shape us far more significantly than our genes. All the epigenetic forces, you can see this in many examples of how people go through personal transformations.

Fat, overweight, diseased, unhealthy, unhappy, depressed. And through changing their behaviors, their inputs, their choices, their habits, can essentially transform themselves into an entirely different being. Healthy, attractive, happy. The same person, same genes, but expressing very differently in response to different stimuli.

The same is true for every life situation. The same person. Or two different people who respond to the same situation differently will achieve completely different outcomes. The situation itself matters much less. We have seen people from poverty create massive wealth. We have seen people in wealth create massive poverty for themselves.

The situation they were in didn't dictate where they went. It was their actions, their choices, their habits, and behaviors.

So when it comes to focusing on the causes, the causal forces which shape our reality, bar none, our action is our priority.

And if we consider our personal action as the primary shaping force in our reality, then that means everything bad and everything good, everything wanted and unwanted, that we experience, we should start to look at as a consequence of our own action. Everything unwanted, we are to blame. Everything wanted, we are responsible.

And the other consequence of these principles, the cause and effect and the power of our personal action, is that if we are completely responsible for our reality, then we also have the power to change our entire reality. And this is such an amazing, interesting paradox. That only by taking full responsibility for our actions, our situation, and the consequences do we begin to access the power, the psychology, the belief, that we have the power to change our entire experience.

By taking responsibility, we become all-powerful. By definition, if we believe even 1% of the responsibility for our situation is outside of us, beyond our control. Then we lack that one percent of power to shape our reality. And this shift in perspective gives us endless opportunity to find the levers to pull, the opportunities to take to shape our reality.

I recommend that you really find a way to acknowledge what I've just described. That your actions are the primary shaping force of your experience. This can be meditated on. This can be journaled about. Coming to realize your responsibility, the role of your actions, is the doorway through which you must pass to access the power to change things.

When you navigate your reality and all the experiences you have, positive and negative, wanted and unwanted,

connect the dots between your actions as causes for this consequence. Understand what has changed about your actions that has changed what you are experiencing. Assess your current situation. Imagine how you would want to change it. And compare the causes required for what you want to experience.

Compare those causes with the causes that brought you to this current experience. What do you need to change about your action to take you to where you want to go? Connect the dots between what you do and where you find yourself.

The natural next destination we go is asking the question, where do I want to go? What are the effects or the consequences that I choose to bring into existence? What should be my priority that I should align my actions towards?

And I think we can agree upon the fact that we all want to experience positive consequences. We want to experience profound and significant consequences. We don't just want good, we want great. We know we don't want negative, we want positive. So how do we take ourselves towards the profoundly positive experiences?

And in this, the context of this conversation, how do we take ourselves towards significantly positive and desirable experiences of health, spine strength, back pain, resilience?

The question is also then how do we take, or how do we reach any significant experience when all we have to work with is the mere actions of our simple humanness. When all we can do is perform one action at a time, how do we best organize those actions so that the results are not just positive, but profound?

And this takes us into the domain and the principle of time preference and specifically low time preference. And what this principle describes is that for long-term accumulating and compounding results, often we have to take a short-term sacrifice or cost. And that most short-term or immediate gratifications come with a long-term cost.

And so we need to use a low time preference. If we want to achieve the much more profound, so I didn't make that very clear, but immediately gratifying pursuits, where we get something that feels positive right now has limitations because they are often coupled with long-term costs or long-term sacrifices.

The reason we're able to access much more profoundly or significantly massive or meaningful results by taking a short-term sacrifice and then building up towards a long-term gain is because, almost by definition, the long-term gain is sustainable. And if it's sustainable, we can continue to accumulate for longer and longer until these results start to compound and become something much more magnificent and significant.

Whereas we simply cannot achieve the same magnitude of results when we opt instead for the short-term and unsustainable immediately gratifying pursuits. So low time preference is a way that we access the sublime the profound by making that short-term sacrifice so that we can then rather accumulate sustainably.

Accumulate the positive outcomes so that over time they then compound and become something much more profound, much more significant.

And so in general, this is what we, what I believe we should be aiming for. How do we identify the consequences which are low time preference? They are not immediately gratifying, but instead they are sustainable and they can compound. And then eventually we reach something far greater than we could have ever reached with the short-term immediately gratifying choice.

So, one way to start applying this is first to self-reflect. Am I looking for quick fixes? Do I truly comprehend that real results take time? That massive achievements do not happen overnight? Am I looking for some miracle cure? Or am I willing to accumulate a lot of short-term sacrifices so that I can achieve massive long-term benefits?

I think with every positive thing that we indulge in or pursue, we can analyze it from this perspective. Is this a short-term, immediately gratifying pursuit? Or am I making a sacrifice here that's going to lead me towards a longer, more sustainable, more profound result? And of course, life is life.

We are here to live it. We are here to experience the pleasures. But if we fall out of balance, if we pursue the short-term pleasures excessively, and we are not implementing many long-term, low time preference practices, then we are going to pay the price for that. We are going to experience an imbalance. We are going to find ourselves in places we didn't choose to be because we chose the short-term gratifying experience and then ended up being forced to face the long-term consequences which we didn't choose or didn't realize we were choosing.

So before we move on to the fourth principle, let's just do a quick recap. We've started out with the fact that we live in a causal universe. The first principle is cause and effect. We acknowledge that in order to change effects, we need to change the causes. There are no shortcuts, magic pills, or quick fixes.

If we then move on from this principle and we look at what is the most influential or powerful causal force shaping our experience, that is undoubtedly our own action.

There is nothing more influential or significant in shaping our human experience than our own actions, choices, habits. And then we move on to the third principle, which is how do we access, or what are the most positively profound effects or consequences that we could possibly align our actions towards?

What are good goals to chase? And these are the low time preference compounding results, which can be far greater than any short-term pursuit.

And this takes us to the fourth principle,

which really is all about how we bring these principles into our personal reality. Are there general guidelines for causes which produce effects for all of us? And to some degree, there is, but this actually turns out not to be a useful way to approach the problem of which causes for which effects for me.

Because it turns out, because of the cause and effect reality, and because each of us has had an absolutely unique experience or life experience of causes, the effect that we are today is absolutely unique, just as we look so different on the outside, sound so different, speak so differently, behave so differently.

So on the inside, from our heart rate to our breathing rate, to our blood glucose, cholesterol, to the shapes of our organs, our bones, everything about us is completely unique. And because of that uniqueness, every cause we set in motion, every action we perform, we are not going to respond to it the same way.

Each of us would actually respond to the same action differently, however subtly. It would still be a unique reaction to an action. And so we cannot say that universally these are the right actions for you to reach that effect. If we take a universal effect. You and I both want to experience vibrant vitality.

We want to feel inspired and healthy. We want to have resilience. The path for you and I both to get there will be different. Perhaps you have a gluten intolerance. Maybe I don't. Maybe your metabolic system and muscular development are different from mine. And you have different needs. And so the way we respond to actions is going to be different.

And the path we need to take to get to that desirable outcome is going to be slightly different. And so how do we know if each and every single one of us is unique? How can we possibly know what each of us needs? And the only way we can do that is by paying close attention to our own personal reality.

That when you perform an action, you observe the consequence of that action. Feel in yourself, does this, after moving in this direction, after acting in this way, do I experience a sustainable form of increased health? Do I actually experience that benefit or am I living in the domain of, I read a textbook with solid research that says ketogenic diets are really good and there's a lot of evidence and then I keep forcing it down and you know I've lost some weight and I just keep persisting because I keep telling myself a story that this should be good for me instead of closely paying attention to how my unique reality is responding to causes and creating unique effects.

And the fourth principle is our unique individual reality. In functional medicine, the first pillar is described as biological individuality. But this goes beyond our biology. This goes into our personality, our life situation. And not only is each of us completely unique in any given moment, or should I say, completely unique relative to one another, but even relative to ourselves from moment to moment.

I am different from who I was and how I was a week ago. Maybe my schedule was different, maybe I was in a different life stage, maybe I was under different stresses. Maybe my physical activity was different and even my uniqueness is unique from moment to moment throughout our lives, through different seasons of our lives, seasons of the weather, different disease, and recovery stages.

And so there is no way to be absolutely certain that we are responding in the way we choose to respond to our actions unless we pay close attention to the consequences we are experiencing from our actions.

So it's really good to reflect on what you are using to guide your health choices. Do you religiously follow a diet? That by definition is based on research of a population of people, an average. Think about that. We base a lot of our research on the average of a group of people, when in fact, the truth is each of the people that contribute to that average are completely unique, and then you apply it to yourself as a unique individual pretending you are the average.

This is false. And so what are you using to guide your movement practice? How has it been customized to your personal needs, to what you are experiencing, your injuries, your pains, your weaknesses? And are you subjectively, through your own direct perception, are you experiencing improvements over time?

Because if you're not, there might be a mismatch between that program and your individual reality. Are you following a diet? Or are you listening to your body or are you using both? We need the diet, we need guidance, but then we need to apply and combine that intelligence, that intellectual framework with our direct experience.

and develop an intuition then. The diet's a starting point, but then we have to learn to listen to what is actually true for us, for ourselves.

This, of course, takes us to the fifth principle, and the way I've described this now is overlapping the fourth and the fifth. The fourth principle being our individual uniqueness. The fifth is the value or importance of our subjective experience. From what I've just described, and then you combine it with the idea that what most of us are pursuing in our lives, even though we experience it as objective pursuits, measurable pursuits, we can measure our health in some way, we can observe the money, we can feel it.

But what we are actually pursuing is one step up from all of that. I don't just want health so that my blood markers come out positively the next time I go see my doctor. I want to feel good. I want to feel free for as long as I can in this life. And one useful metric that I could use to increase my chances of experiencing that sense of vitality is to use my blood markers and to be aware of changes in them, but they are not the goal in and of themselves. They are one useful tool to help move me in the direction of health and health is actually meaningless if I don't feel it, if I don't perceive it, if I don't have the experience of being more alive, of being more inspired, of being more energized. Health is empty without feeling it, without experiencing it.

So in essence, what we're actually pursuing, or should be pursuing, is the subjective, the directly perceptible experience of health. And all the measures, all the metrics, all the frameworks, all the ideas, these should be just little tools, useful things that can assist us to move us towards the direct, subjective experience of health.

But what we can also use at the same time, and following on from the fourth principle where I made it overlap a little bit, what we should perhaps be using as our primary goal and guide, more importantly, is our subjective experience of health.

Does what I have done, do the actions I'm performing, have they increased in a low time preference and sustainable fashion? Have they increased my sense of aliveness, my sense of energy, my experience of inspiration? And that is a more accurate and relevant marker than any lab test could possibly be. They are important and valuable because they have the chance of moving us towards a greater sense of aliveness and health, but they're not the goal and nothing can confirm it as truth other than the fact that you experience more. And this absolute importance of our subjective goals, or should I say the subjectivity,

being the most important element of all of our goals runs into everything we do. Whether we believe we want to make more money, there's actually a subjective experience behind that, that we seek even more than the money, to which the money is a useful means to reach the end. The end might be a sense of safety, an experience of psychological freedom.

It might be the opportunity to have a better chance of experiencing relationships, which would leave us with a sense of feeling seen or connected, not alone. These are the kinds of subjective experiences that lie behind everything we pursue. And it's important to remember that everything we think is a physical pursuit is actually just a means to a subjective end.

This is especially true with health. Nothing can tell you more accurately whether your lower back pain rehabilitation or prevention program is working than your direct experience of whether you have more pain or not. Your individual and unique reality.

These five principles, I believe, need to be fundamentally realized if people want to experience radical revolutions within their health and within their life.

If we do not acknowledge these principles, I don't see how we can reach radical improvements.

So, I hope that these have made sense to you and that you have some first tools or ideas on how you can start to apply them in your thinking. It doesn't just happen overnight. You can't just say, "Oh, I agree with you. I agree with what you've said. Wonderful." No, there's a very different process to now install and rewire the way we perceive our reality.

It takes deliberate and intentional practice to rewire the way we perceive our reality because it is a lot more constructive and produces much more beneficial outcomes if we perceive our reality through the lens of the five principles I have just articulated.

Journal about them, listen to this again and again, read the essay. And then turn it into action; I've given some suggestions for practical implementations of these ideas. Record those practices, write them down, and then repeat them. Implement and practice repetitively until you start to form a new way of thinking about your reality.

Sometimes these principles just click. You realize, "Wow, that completely nullifies the way I used to see things. And it's impossible for me to look at it the same anymore." Those are beautiful moments, but they shouldn't be expected. Instead, we will need to set some new causes in motion so that we can experience new effects, even if those new effects are different thoughts.

So, by acknowledging that we live in a causal universe governed by cause and effect, that effects require the relevant causes to come into being, and then looking at what is the most profound or powerful causal force shaping our reality, we must acknowledge that our own actions, which are also completely controllable, are that primary force shaping our reality.

If we ask the question, how do we access the most profound effects or consequences, we will discover the consequence of low time preference, a means by which we can access consequences that are much more profound than any immediately gratifying pursuit. Following this further, we reach the fourth principle. If we then ask, how do we know whether the causes we are putting in motion are moving us towards the effects we desire, we acknowledge our individual unique reality and the need for us to directly observe the effects of the causes we put in motion, the consequences of our actions. We have to directly observe them. And then, taking this fourth principle a bit further to the fifth, we come to acknowledge that what we seek is a shift in our directly perceivable reality. What we seek, the effect we pursue, is a transformation in our subjective internal reality. We want to feel better. We want to feel more alive. We want to feel more energized. And we want that experience for as long as possible.

I hope this helps. Thanks for listening.