I'm fortunate that at 2X30 (soon, 2X32!) my back is pretty silent; I
attribute at least part of the reason to Grant's suggestion to me decades
ago to "get the bar up and back, and the saddle back and down."

I've been noticing the effect of "butt-back" recently on my Hon Solo,
which, because of the bar/"stem" design doesn't allow you to adjust the bar
for a perfectly comfortable fit. When I sit forward on the saddle, I notice
more weight on my shoulders/arms/hands. When I sit back, I notice that my
back and belly muscles tighten to bear more of the weight. On my Rivs (and
Matthews) with bars from 4 cm below saddle to even with saddle (but further
forward in the last case) my back is very comfortable with the butt-back
position, and this whether on ramps, hoods, or hooks. I find that my left
palm and my neck are what limit the amount of time I can spend in the hooks
(but even so, several miles are fine).

Accidents: I've been hit by car once (light tap at red light as car turned
right into me when light turned green, knocking me over) and fallen
multiple times without any outside help; most dramatic was age about 17,
taking long way into school, coming down hill along fast right hand curve
(riding on left, as this was British ex-colony) and letting front wheel get
into dirt on roadside. Mistakenly grabbed handful of front brake and did a
180* flip, bike coming down hard on top of rear wheel and leaving big "V"
dent. I was fine, not even bruised or scraped.

Funny, about 20 years ago I had a bout of flu that left my joints and bones
feeling sore; recall that this was one episode where I did have back pain;
but oddly, the back pain, noticeable while walking, disappeared when on the
bike, with bar at that time considerably lower; even the hooks were
comfortable.

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