In dreams, most pain is simulated. That is, it only hurts because you expect it to hurt. "That knife going through my back should probably hurt. Oh wait, yeah, sure enough it does!" That's one of my favorite things about lucids: once you know it's a dream and can expect things to not hurt, you feel invincible.
As for you back hurting you in real life, maybe you had a cramp or some other strain in real life, and your subconscious conveyed the pain into your dream. Often our dreams can be influenced by external stimuli. For example, you can hear a garbage truck outside while you're sleeping, and the dream can convey it as a racecar driving by. So I imagine the pain in real life caused the pain in the dream, not the other way around.
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