TEN COMMON CAUSES OF BACK PAIN

Never grow a wishbone, dear daughter, where your backbone ought to be.

- Clementine Paddleford

Back pain is any kind of pain or discomfort felt in the back, and can arise from injury of or irritation to any of the soft or bony tissues from below the neck to within the backside (Healthdirect, 2024). Around 4 million people, or 16% of the Australian population were estimated to be living with back pain and problems according to self-reported data in 2022, where the prevalence of back pain and back problems increased with age at similar rates for males and females (Australian Institute of Health and Welfare, 2024). Roughly one-in-six Australians will experience back pain in their lives, though the number may be higher (Australian Physiotherapy Association, 2023). Most episodes of lower back pain can self-resolve without any kind of invasive or involved treatment within anywhere between a few days to a few weeks (See et. al., 2021; Pirotta et. al., 2024;), and most low back pain is non-specific, whereby no causes or structures can be identified to account for a person's perceived pain. Because of this, back pain can sometimes be concerning because there may be no definable cause for its onset. Everyday movements are normal human movements that only become problematic when load, repetition, or fatigue exceed your current capacity.

People use their backs and their bodies every moment of every day, even without engaging in active physical activity. The muscles of the diaphragm, core, and pelvis attach to the spine and are active in breathing, even when people are not vigorously active (Bordoni & Zanier, 2013). The muscles of the abdomen and the core, which attach to the lower back, are responsible for maintaining posture, respiration, and stabilising the trunk to allow the arms and the legs to function properly (Kibler et. al., 2006). Every time someone is active in walking, reaching, carrying, and sporting, as well as every time someone is relaxed in sitting, lying down, resting, or otherwise taking it easy, the muscles and bones of the spine are working. Because the muscles of the back and the spine are always working and so are always engaged, back pain can arise from innocuous, everyday causes. Below are some examples of how lower back pain may arise from normal activities. These examples are not presented to cause fear, alarm, or distress, but more to illustrate that back pain is something that can be understood, managed, and whose risk may be minimised by awareness, preparation, and a little light prevention. With that in mind, the following sections outline common contributors to back discomfort and simple ways to reduce their impact.

Prolonged sitting

Back pain can arise from sustained and prolonged sitting (European Agency for Safety and Health at Work, n.d.). Sustained, prolonged, or static postures are those positions of the body where the trunk and sometimes the limbs do not move very much, either for the convenience of the task being performed or because of the need to restrict the body from movement. People might sit still at a desk or when they're buckled up in a plane, or they might need to adopt static postures in order to do fine, precise, or technical work (Anghel et. al., 2007). Static postures impose ongoing load on postural muscles supporting the position of the spine (Markova et. al., 2024). The cumulative effect of loads imposed on the muscles within and around the spine from static postures may lead to perceived discomfort from muscular fatigue (Garcia et. al., 2015), and soft-tissue creep in the muscles themselves (Sánchez-Zuriaga et. al., 2010). To this end, stretching (Angelova, 2019), ergonomic interventions (Jaromi et. al., 2012), and dynamic sitting are useful in preventing the onset of discomfort in the back from static postures, but should be used in combination rather than as a one-size-fits-all approach (O'Sullivan et. al., 2012). Movement is safe - your spine benefits from regular, comfortable motion.

Simple actions:

Stand up every 30–45 minutes and change your posture when you can.

Add small movements such as shoulder rolls or gentle trunk rotations so long as they are comfortable, practical, and sustainable.

Poor desk and workstation ergonomics

There is a significant amount of literature examining the relationship between poor ergonomics and the onset of lower back pain and of the use of good ergonomics to prevent back pain. The word ergonomics is used in this more colloquial sense to describe the comfort of fitting a person into an environment, though the field of ergonomics encompasses things like design, psychology, and organisation (Koirala & Nepal, 2022). In the context of desk and workstation ergonomics, good ergonomics refers to an arrangement of the space and its elements that allows a person to do the work in that space comfortably, whether in the office, onsite, or at home (Yeow et. al., 2021). Poor ergonomics can give rise to discomfort in the back, hips, shoulders, and neck as well as contribute to strain in the eyes and the arms (Kibira et. al., 2023). Poor ergonomics in this case thus refers to an arrangement of the space and its elements that imposes undue strain on the person using that space, which can give rise to discomfort (Rodrigues et. al., 2017). The effect of poor ergonomics can be felt quickly if working in a space that is cramped, awkward, or difficult to navigate, or those effects can arise over time if slight deficiencies give rise to discomfort through accumulated strain. The solution, it would seem, is to tailor the ergonomics of the space to the person (Agarwal et. al., 2018). However, people are all different, not just among themselves but within themselves, and a person's comfort in a space may change with things like the work being done within that space, within time of day, and with age. To this end, ergonomic monitoring isn't a once-off exercise but should be undertaken repeatedly. Make sure that the environment is a support for your wellbeing as much as your spine supports your posture.

Simple actions:

Adjust your chair and screen height so you can sit comfortably without reaching or hunching if possible.

Keep frequently used items within easy reach to avoid unnecessary twisting where you are able.

Awkward postures

The word posture has been used a few times so far, so it's probably good to build the definition out a little. An acceptable definition is that a posture is any arrangement that the body assumes while completing a task (Rosario, 2017). There are an infinite number of people completing an infinite number of tasks, and so there are a potentially infinite number of postures that people can adopt when going about their lives. Sleeping, eating, watching TV on a large or small screen, and even petting a cat require the assumption of a specific posture. Awkward postures are those arrangements of the body that are uncomfortable, unbalanced, or which require a significant degree of effort to maintain. Awkward postures have been identified as a potential contributing factor to the development of lower back discomfort (Khan et. al., 2019), where the strain imposed on the body may be magnified by the complexity of the activity and the intensity of the effort required (Chen et. al., 2017). Maintaining effortful lifting, handling large or difficult-to-hold-objects, pushing and pulling and balancing on uneven surfaces all impose additional demand on the muscles of the body generally and the back specifically (Seri et. al., 2013). Awkward postures can also result from poor ergonomics, with the combination of the two giving rise to a concentration of risk. To this end, monitoring and assessing work tasks and being aware of the manner in which we are going about our lives is a good preventative measure to head off the risk ahead of time, and to do some stretches afterward to keep things limber and loose. Even with good ergonomics, the way we position ourselves during daily tasks can influence comfort.

Simple actions:

Bring tasks closer to your body instead of reaching or leaning where possible.

Change position when something starts to feel effortful or strained if safe and practical.

Bending and twisting movements

Bending and twisting movements are those that require rotation through the lower and middle back. The human body (usually) has two arms and two legs, where the legs are typically planted on the ground and the arms are going about work in coordination overseen by the eyes and (usually) the brain. When the feet are firmly set and the arms and chest are moving, rotation occurs within the lower back from between the base of the ribcage to the tops of the hips (Kenyon & Kenyon, 2009). Rotation through the lower back is a dynamic movement and engages many of the intermeshed muscles of the abdomen, flanks, and around the spine, all of which act on the bones within the spinal column and on other structures, producing movement (Kumar, 2002). Rotation of the trunk and of the lower back during daily life and working are understood risk factors in the development of lower back pain (Hoogendoorn et. al., 2000). The likelihood that bending and twisting movements either alone or in combination may give rise to discomfort in the spine increases when those movements are being undertaken against resistance, under load, or repetitively (Keyserling et. al., 1988). Bending and twisting movements are common when the working area is distributed to workers' sides, like in kitchens, when stacking shelves or fridges, when packing and unpacking dishwashers or laundries, or when the load is awkward. To this end, minimising exposure to bending and twisting movements through organising a task to minimise the need to bend, twist, and turn awkwardly or breaking up the tsk to minimise the need to complete movements repetitively are effective means in managing strain from repetitive bending, twisting, and other movements. Many everyday tasks involve rotation or reaching, and these movements are normal and healthy when done within your capacity.

Simple actions:

Turn your whole body toward the task instead of twisting from the waist where possible.

Bend your knees slightly when reaching low to share the load if safe.

Handling of heavy objects

By percentage, body-stressing injuries from manual handling are the most common non-serious injury for which compensation claims are made in Australia, year-by-year (Safe Work Australia, 2025). The relationship between the handling of heavy objects and the onset of back pain has been described in medical literature since antiquity, when ancient Egyptian physicians described spinal strain in workers (Osti & Cullum, 1994). The handling of heavy objects is common in occupations as well as daily life (Rahman & Palaneeswaran, 2018). While most people might not need to regularly lift bags of cement powder or heft power tools, heavy everyday loads include baskets full of wet laundry, overfull garbage bins, enthusiastic large animals, and recalcitrant children. Heavy loads can give rise to lower back pain that comes on quickly if a person experiences a strain while handling something heavy, or gradually as the consequence of accumulated strain that arises from constant engagement with heavy objects in the environment (Troup, 1984). To this end, the solution might seem to be to increase bodily strength to handle heavier objects (Chaffin, 1974), but where gym attendance might not be practical it is just as easy to decrease the weight of loads being handled. Take bins out before they are overflowing. Try not to overload a washing machine with clothes to get laundry done in one go. Be mindful of how heavy containers of liquid can slosh from side to side. Heavy loads add physical demand, but simple planning can make these tasks safer and easier - mind over matter, after all.

Simple actions:

Split loads into smaller trips when possible, but be mindful that doing the same thing more often may introduce repetitive strain.

Use lifting aids or devices where possible to reduce the strain from manual handling, and always spot-check your loads for safety.

Repetitive movements

Repetitive strain injuries refer to injuries, irritations, and other discomfort that arises when a person undertakes the same movement repeatedly (Van Tulder et. al., 2007). Repetitive movements of the back are those where the back moves in the same or reciprocating (back and forth) direction multiple times in short order so as to accomplish a task that requires the same movement to be done a few times in a row. An example of this is loading cans into a shelf, which may require repeated bending, turning, lifting, and reaching. Alone, these movements may not pose much of a difficulty, but when movements are performed multiple times in short order or without sufficient rest then strain may accumulate to the point of discomfort (Latza et. al., 2002). Think about this differently - resistance training programs in gym settings require you to complete movements repetitively. Individually the effort required to complete one movement is minor, but when the movement is done repeatedly, strain begins to accumulate. Repetition is necessary where tasks cannot be automated or otherwise reduced past a point of stereotyped simplicity, and is present in many everyday tasks: sweeping, vacuuming, scrubbing, folding laundry, getting into and out of cars all impose repetitive strain on the muscles of the limbs and the lower back, where accumulation of that strain can lead to discomfort. Just as heavy loads can accumulate strain, so too can small movements repeated many times.

We've written a post on ten common sources of repetitive strain - go check it out.

Simple actions:

Break up periods of repetitive tasks with short movement breaks if you are able, or ask if you can do so by organising your work.

Alternate sides or hands when possible to share the workload if this is practical and safe, and if you are able to do the work comfortably.

Unbalanced tasks

Contrary to what you might read on Facebook, Instagram, or the Website Formerly Known as Twitter, the world is not flat. The world around us has variations in height, angle of flooring, deformities in the surfaces on which we walk, and changes in the firmness of the ground. These differences can occur and be found even over short distances - take a walk down the street and feel the different tilt in the pavement, the firmness of concrete versus the yielding softness of grass or the scattering instability of shale. Balance is the ability of the body to maintain its position in space during static or dynamic activities (Pollock et. al., 2000). Awkward, unbalanced, heavy loads, and the occurrence of two or more of these factors in combination has been found to increase the risk of sudden-onset acute low back pain (Steffens et. al., 2015). While most episodes of sudden-onset acute low back pain are not representative of more serious damage or instability (See et. al., 2021; Margetis et. al., 2025), the sudden onset of discomfort can be disquieting and disorienting, especially if it happens unexpectedly and without any precipitating factor. Posturally and physically dynamic movements like pushing a shopping trolley through a supermarket, moving furniture across the floor, carrying packages or boxes up a sloped or winding driveway, or even hiking on uneven terrain can all precipitate some discomfort in the lower back.

Simple actions:

Slow down and stabilise your stance when carrying awkward or uneven loads if you can, and plan out the path you might need to take when carrying something or navigating over uneven terrain

Use both hands or redistribute weight to improve balance when possible, or ask for help.

Forceful movements and strain

The muscles of the abdomen and the lower back, collectively the trunk muscles, are a comprehensively interwoven mesh of tissue, responsible for maintaining posture, stabilising the arms and orienting the legs, and of protecting the abdominal viscera (your guts). Forceful or powerful movements of the arms and legs can cause strain in the lower back (Cole & Grimshaw, 2003). All kinds of movements can load the trunk, the spine, and the muscles of the back: lifting can increase the pressure on the discs in the spine (Leskinen et. al., 1983), pulling with the arms can increase the tension on the muscles on either side of the spine (Lee et. al., 1989), pushing can increase the pressure within the abdomen (Harman & Frykman, 1987), and that's to say nothing of the action of the diaphragm when breathing. The muscles of the abdomen, core, and lower back, many of which come off the spine, are responsible for supporting the stability of and generating force from the trunk. As with awkward tasks, manual handling, and the like, this kind of discomfort can come on quickly or slowly. If you've ever felt discomfort after a period of heavy lifting, that's probably just general exhaustion. If you've felt a sharp pain or even felt a pop while lifting a heavy load, you know how unpleasant it can be. Luckily, with a little mindfulness and preparation, this sort of thing can be avoided through understanding the nature of the load being handled, where it is going, and always being deferential to your own capacity in terms of strength and power. Forceful tasks add intensity to movement, and understanding your limits helps keep these tasks safe.

Simple actions:

Plan the movement before you start so you know where the load is going.

Build safeguards like breaks, stops, or swapovers when lifting or moving heavy objects to minimise strain.

Sedentarism

Sedentarism is the tendency to indulge in low-energy expenditure activities throughout the day (Goyal & Rakhra, 2024). Sedentarism is not a bad thing in and of itself - if everything during the day was as hard as it possibly could be, then nobody aside from Jocko Willink or David Goggins, not the other Goggins from Django Unchained. Sedentarism is the consequence of mechanised convenience - the use of technology to accomplish tasks that were previously labour intensive like using a vacuum instead of sweeping, a washing machine instead of hand-washing dishes, and a laundry machine instead of hand-washing clothes has given us more time and energy to use throughout the day (Thivel et. al., 2018). Sedentarism is linked to the incidence of chronic and non-communicable diseases - those illnesses that arise over time and which are not to do with infection by a bug or from a physical injury like cardiovascular diseases, diabetes, cancer, and respiratory illnesses (World Health Organisation, 2025). Sedentarism is also linked to the incidence of back pain in workers (Moore, 2012), students (Mahdavi et. al., 2021) and across the lifespan. The phrase use-it-or-lose-it is applicable here for its effectiveness in spite of its pithiness - the human body needs stimulus from movement to stay healthy, vital, and well, and generalised sedentarism gives rise to static postures, sustained sitting, and a poor level of overall muscle activity. Just as forceful tasks can overload the back, too little movement can also underload structures that need stimulation for health.

Simple actions:

Add short bouts of light activity throughout the day, such as a brief walk or stretch.

Set small movement goals, like standing during phone calls so long as it is not too inconvenient.

Stress

There is a relationship between the incidence of psychological stress and the sensation of physical discomfort (Lin et. al., 2009). Being exposed to psychological stressors at home and at work can elicit a stress response characterised by increased cognitive arousal, the increased circulating concentrations of adrenaline, cortisol, and inflammatory substrates (Hogh et. al., 2012). Psychological stress may not cause back pain in the same way that an impact, an awkward movement, a sustained posture, or prolonged loading of the muscles and bones of the spine may, but sustained psychological and mental stress can worsen the perceived discomfort from an episode of back pain and negatively impact the course of a person's resolution (Crofford, 2015). Psychological stress affects processes of recovery (George & Beneciuk, 2015), the experienced intensity (Severeijns et. al, 2001), and the severity of exacerbations of back pain (Lampe et. al., 1998). Just as pressure can influence the felt comfort in the spine, so too can the way we respond to life’s pressures influence the felt comfort of our bodies. With this in mind, every episode of lower back pain that presents to the clinic is also evaluated with respect to the patient's psychological context and the emotional life stage in which it occurs. It's not as simple as reducing it to a question of whether someone is depressed or not, but the illustrated point of the earlier paragraphs is that back pain can arise from and affect a person's physical capacity to engage in activity, recreation, and life across many domains and often from no definite cause. With this in mind, the impacts of back pain on a person's occupational, educational, recreational, social, and so many other dimensions of life are crucial to consider and, where possible, to control so as to manage the discomfort a person is experiencing not just definitively, but holistically as well.

Simple actions:

Use brief relaxation strategies such as slow breathing or a short walk.

Smell the roses. That's what they're there for!

Nearly every person will experience some form of lower back discomfort in their life, and that episode may be simple, swift, severe, sustained, or anything inbetween. Managing a person's back pain requires understanding the behaviour of the symptoms, how things have changed and may change over time, and the person themselves. The regardless of where in the back the back pain is occurring, it is occurring in the body of a person. Regardless of how the back pain came about, it has happened to someone in pain. Back pain may be something that is an unfortunate consequence of living everyday life, but it does not need to be an everyday occurrence. All of the above everyday causes of back pain are everyday activities as well - they will not cause back pain as a definite rule, but may give rise to it.

Because back pain arises from many everyday factors, timely assessment helps you understand your pattern, build confidence in movement, and return to the activities that matter to you.

At Atlas Physio, we provide expedient management, structured rehabilitation, and consistent monitoring both in‑clinic and at home, ensuring your progress is guided at every stage. We focus on delivering targeted interventions that promote fast recovery while supporting your independence and confidence in daily life. To ensure timely, responsive, and accessible care, we are open seven days a week, Monday to Sunday, from 8:00AM to 8:00PM. We offer Bulk Billing for Medicare referrals, and provide No‑Gap services for WorkSafe, TAC, DVA, and NDIS participants. Contact us today to arrange your assessment and begin a course of supportive, one‑on‑one care designed to manage your discomfort, promote fast recovery, and help you maintain long‑term independence and wellbeing. Our goal is to help you understand your back, move with confidence, and maintain long‑term wellbeing through personalised, one‑on‑one care.

We've got your back.

Alex Phillipos

B-Sci, B-HSci, GD-OHS, M-PHTY, M-ESH, M-OHT

Atlas Physio

2 Bruce Street, Preston

Melbourne, VIC, 3072

None of this information constitutes medical, legal, occupational health and safety, best guidance, standard, or other guidance, instruction, or prescription.

No artificial intelligence or assistive intelligence was used in the creation of this work.

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