What causes low back pain?

Lots of people ask me what’s causing their lower back pain. I think it’s very important that they know too.

Low back pain can be caused by many things but I like to split it up into a few simple categories.

Let’s first consider whether your low back pain is caused by:

  • Overuse – repetitive bending, lifting, sport, sustained standing/extension postures

  • Under-use – often related to sustained sitting including desk work or lack of physical activity

This is a very important point, because almost all my patients expect that their back pain is related to overuse, which creates some of the most chronic cases of low back pain. These people tend to really protect their back and reduce physical activity in fear of hurting their back… when this is really exactly what it needs!

So does posture matter? I’m going to have you think about this differently today.

I’ll get you to think about:

  • Extension based postures (standing, serving in tennis, swimming, reaching overhead)

  • And flexion based postures (bending forwards, lifting, sitting)

In talking about sitting, let’s consider that when we are sitting, the lower back is in a position of relative flexion (bending). The hips need to flex to allow us to sit, creating a bending force on the lower levels of our back, no matter what posture we sit in.

This is exactly why you may be sore bending if you sit in an office all day. Have you noticed that you feel stiff getting out of your chair (no matter how comfortable you were when sitting in it), then have pain picking things up off the floor later on? If that’s the case, is it the way you lifted? Or could it have more to do with the fact that your body was in a flexion-based position all day?


In the next blog post we will discuss what you can do if you have realised that your back pain may actually be an underuse issue, possibly due to sustained sitting.