What Actually Causes Back Pain (And How to Avoid It)

Around 80% of adults experience low back pain at some point. The reasons are surprisingly consistent across the patients we see at our Burlington clinic — and most of them are preventable.

The most common causes

1. Movement pattern overload

Far and away the most common cause we see. Your low back ends up doing work it shouldn't because something else isn't pulling its weight — typically tight hips, a stiff mid-back, or weak glutes. The back muscles overwork, get tight, and eventually flare up. The trigger might look like "shoveling" or "a long flight," but the setup was already in place.

2. Disc-related issues

Disc bulges, herniations, and degeneration are real causes of back pain — but they're far less common than people think, and they often look worse on imaging than they feel. Most disc-related pain resolves with conservative care over weeks to months.

3. Joint and muscle strain

Facet joints (the small joints between vertebrae) can get irritated, and the muscles around them can spasm protectively. Often the result of a sudden movement combined with the underlying overload pattern from #1.

4. Sitting too much (with poor positioning)

Sitting itself isn't evil. Sitting in the same position for hours, with a forward head and rounded back, while shortening your hip flexors — that's a problem. The combination loads the discs and stiffens the soft tissue.

5. Sudden increases in load or activity

Weekend warrior syndrome. You sit all week, then go hard at hockey, golf, gardening, or a lifting session. Your tissue isn't conditioned for the demand and something gives.

6. Stress

Underrated, but real. Stress changes muscle tension, breathing patterns, and how your nervous system processes pain signals. Many patients can pinpoint flare-ups to stressful periods even when nothing physical changed.

What actually prevents most back pain

Move regularly throughout the day

Not a workout — just movement. Stand up every 30-45 minutes, walk, change positions. Tissue tolerates almost anything in moderation; what it doesn't tolerate is staying in one position for hours.

Build hip and glute strength

Strong, well-coordinated hips take load off the low back. Squats, lunges, hinges, and glute work in any form — done consistently — make a measurable difference.

Maintain mid-back mobility

If your thoracic spine doesn't rotate well, your lumbar spine ends up rotating in its place. Daily mid-back mobility work (rotations, extensions over a foam roller, open books) is one of the highest-leverage things you can do.

Address hip flexor tightness

If you sit a lot, your hip flexors are almost certainly tight. Stretch them daily. It pulls your pelvis back into a more neutral position and unloads the low back.

Get assessed before things get bad

If you have a niggling back issue that's been hanging around for weeks, that's a signal — not normal. The best time to address it is before it becomes a debilitating flare-up.