I used to have serious back problems, bad enough that surgery was advised by some doctors. I've been through multiple courses of steroid therapy, physical therapy, and epidural steroid injections. The latter combined with finally figuring out the right exercises for me finally did the trick. I have since been able to ride, run, and trail run without back pain.
WRT to riding without back pain I find that for me the following works:
- Avoid a sit up and beg posture favored by many tourists. Riding in a relaxed fashion with most of your weight carried by your legs, and with bars well below the saddle. Elbows should be well bent and not much weight should be on the hands. The arms shoulders and even hands should be loose and relaxed.
- That will require that you maintain good core fitness and work toward a form that is fluid and relaxed.
- For me this means bars 4-5" below the saddle.
- I do whatever it takes to sleep well and comfortably. Waking up all stiff and sore in a bad start for the day. That means carrying a decent sleeping pad and changing position at intervals during the night.
- At the slightest hint of back pain during the day I do my stretches.
I am convinced that sitting bolt upright on the bike is absolutely the worst thing, at least for me. The jolts and bumps go right up the spine. I find that mimicking the form of racers rather than the form of most tourists to be far more comfortable once it is mastered. If you decide to try that approach... Ease into it, as it takes come conditioning and practice to master.