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We get this question A LOT. While there are many many things that can cause lower back pain, there are 4 things we see over 90% of the time.

- Hips and ribs are too stiff making the low back compensate with movement.

- Actively trying to stand up straight which compresses the back more.

- Trying to squeeze the abdominal muscles all the time which actually increases pressure on the back if done incorrectly.

- Fear that their spine will fall out of alignment or their disc will suddenly herniate.

Your posture isn’t ever the sole reason for your back pain.

I think about it this way…

Lets say you’re riding in the back of a car for a couple of hours, and your knees are getting sore from staying in the same position. 

It doesn’t take much to feel better. You get out of the car, move around for a few minutes, then you’re fine. 

But what if you never got out of the car? That would be a big problem for your knees. 

Posture is kind of like that. If you physically are unable to change the shape of your back even if you're standing, sitting, or lying down, your back is going to feel uncomfortable. 

The problem isn’t your posture, the problem is that your lack of mobility in your hips and rib cage won’t let you change your posture.

This is probably the 3rd most common question we get. I don’t mean to offend anyone, but it's asking the wrong thing (but I 100% understand why it gets asked). 

When you go to the doctor, their medical diagnosis is based on identifying the type of tissue (muscle, nerve, disc, etc.) so they can potentially prescribe a pain medication that will best assist with your painful symptoms. 

Identifying whether your painful tissue is coming from a disc, muscle, or nerve doesn’t offer a permanent solution. Pain medication doesn’t heal anything. That isn’t what it's designed to do.

Finding the reason WHY the tissue became painful in the first place is the better question to ask (if you don’t want to have back pain again, and don’t want the problem to get worse).

I can have 3 different patients with different types of pain all have the same treatment. 

And I can have 3 patients with the same pain all have different treatment. 

Figuring out WHY the tissue became painful is how lives change. Treating the painful tissue for pain only leaves the door open for the pain and limitation to come back again, and again, and again.

Morning back pain is really common. From a physical standpoint, our discs and bones have more water in them. When we go to stand up there is fluid in our back and gut that readjusts itself to being upright. 

If the fluid doesn’t have anywhere to go, then it makes it very difficult to stand up straight. 

A similar thing happens when sitting for long periods of time. Depending on how you sit and how long you have sat (and if you have enough hip range of motion to comfortably sit), you’ll find you have fluid shift in your spine that is uncomfortable to shift again once you stand up. 

The problem isn’t the morning or sitting, it's that you need your ribs and hips to have more motion so the pain stops.

This is a tricky question.

The biggest reason being is there is no defined “core.”

In physical therapy school we were taught we needed to strengthen the core for back pain, but there is literally no anatomical definition of what the core is, so it’s impossible to say if an undefined structure needs to be strengthened.

Getting your body into an optimal position, specific to you and not someone else, and learning how to use your muscles to “pressurize” yourself is how you can help your back pain. 

Meaning you can stack your center of gravity over the center of your feet, squeeze your muscles so you squish yourself straight down into your feet, and keep that sensation when you do heavy things will typically fix your back pain. 

Just doing resistance exercises for muscles attached to your abdominal wall won’t help your back pain. For some people it makes it less bad for years, then it eventually stops working.