Is it possible for you to perhaps use more inside rail pressure and steering a little off the back foot (once planning) to help gain ground up-wind? I ask as I have lower back problems (slipped disk) and I find I don't have any pain when using this method. Twisting my top half more into the wind is more effective, but it hurts after 30 min or so. Pain =

Ps- I'm pretty average at sailing and this approach may not gain as much ground as twisting the shoulders around, but I do know it stops my back from grinding.