Potential Causes: About Low Back Pain

The junctions where the curves of the spine change direction allow the most movement: C7 – T1, T12 – L1, and L5 – S1. For this reason, these points of transition are the most vulnerable to injury. The juncture between the sacrum and lumbar is known to be particularly injury-prone. (Doug Keller)

  • Arthritis
  • Collapsed Arches
  • Excessive Joint Flexibility (including pain from an exaggerated low back curve due to weakness of lower abs or pregnancy, for example)
  • Injury
  • Ligament Strain
  • Muscle Spasm
  • Muscle Tightness, Muscle Weakness, Lower Crossed Syndrome
  • Non-Specific Chronic Low Back Pain*
  • Posture, Movement Habits / Compensation, Repetitive Misalignment in Forward Bending
  • Sciatica
  • Scoliosis
  • Stress, Mental Tension

*Non-Specific Chronic Low Back Pain

While a small number of chronic low back patients can point to an originating cause such as herniated disc, the majority are classified as having “non-specific chronic low back pain,” meaning no detectable cause. This is consistent with chronic pain in general and we highly recommend you study our Chronic Pain section to learn more.

Repetitive Mis-Alignment in Forward Bending

A normal lumbar spine has a mild curve forward, and in this position, weight is evenly distributed throughout each disc. During toe-touching, the lower back flexes, losing its normal curve, and more weight is put on the front of the discs. The gel-like centers get pushed backward, into the now stretching support ligaments. While this can happen during forward bending even if a person tends to have excessive lumbar curve (“swayback”), it is especially problematic if the spine has lost the normal curve and become flattened. With repetition, or if great force is applied as in heavy lifting, the ligaments weaken and may “bulge” like a bubble in the wall of a tire. Or the ligaments may tear, allowing the gel-like inner disc to leak out, resulting in a herniated disc. The bulging or herniated disc may cause lower back pain or, if it is pressing on an adjacent nerve, pain can be referred into the hip & leg. – Julie Gudmestad

Muscle Spasms, Stress Response

Whatever the underlying cause, the result may be muscle spasms in a variety of locations that can be more painful than the original problem…When the body’s stress-response system is activated, tension in muscles increases, which by itself can cause pain… Physician John Sarno, the author of Healing Back Pan: The Mind-Body Connection, argues the cause is usually entirely psychological. Dr. Sarno believes that back muscles go into spasm and cause pain because of mental tension, and that if you can get to the root cause of the tension the pain will disappear. – Timothy McCall, MD

Over- or Under-Used QL

Overuse or under use of the QL (quadratus lumborum) is often considered to be a common source of recurring lower back, buttock and hip pain. This muscle usually gets called in to do the job of the erector spinae if they are weak or prohibited. The modern seated lifestyle puts QL into constant contraction where it becomes short/tight and can eventually land in spasm. It can also be strained if you have a habit of sitting crossed legged with the same leg on top all of the time. In this scenario, a higher percentage of body weight lands into the bottom leg, and the top leg QL muscle works unnecessarily for as long as the position is held. – Kristen Butera