A Closer Look at What Causes Low Back Pain

Our Western approach to health and healing often addresses the body as a sum of individual parts. This makes treatment more simple and, quite honestly, more profitable. However, this segmental perspective often allows the holistic functioning of the body and its systems to get missed. One specific problem that illustrates this is back pain. While x-rays and specific treatment aimed at the lumbar spine can be beneficial, the majority of people seeking treatment would benefit greatly from a more global assessment of how the hip functions relative to the spine and down the chain to knees, ankles, and feet. It’s time to take a closer look at what causes low back pain.

What’s Causing your LBP?

Referred pain.

In the midst of a pain crisis, it’s hard to keep an open mind. It’s normal to want a practitioner to address your specific problem and feel frustrated if they take a different approach. However, many times, the culprit of low back pain is found elsewhere.
But how?
This phenomenon is called pain referral. Pain referral is when the dysfunction or dis-ease is in one location but the pain shows up in another area. A brain freeze from eating ice cream is a great example of this. Nerves from one part of the body send signals to the brain which, in turn, sends out signals to a different part of the body, resulting in pain sensations.
In relation to low back pain, particularly when imaging does not show any structural issues, the injury or dysfunction might actually reside in the hips or other areas of the body, but the signals are presenting as pain in the lower back.
Furthermore, SI (sacroiliac) joint pain can often be confused with low back pain. The SI joint absorbs the force and weight of the upper body and distributes it to the hips. Here are some symptoms of SI joint dysfunction:

  • pain in the lower back, hips, groin, or pelvis
  • clicking sound/sensation from
  • numbness or tingling in the hip or down one leg
  • pain down the back of the hip, leg, or the knee
  • feeling of instability (like the legs will buckle)


Another possible cause of low back pain is the body protecting other areas of the body that are injured or not moving well. This is called compensation. If, for example, your hips do not have the mobility to move in ways that you need them to, the lower back is one area that will “make up for” the hips to create the movement. A healthy hip joint needs to flex, extend, abduct, adduct, and rotate both internally and externally. When any of these functions close down, often the lower back will help out. This can lead to those muscles and joints doing more work and absorbing more force than is optimal – which can lead to overuse and even pain in the area. Additionally, when there is pain or lack of mobility in the foot, ankle, or knee, problems can surface in the lower back.

Posture potential

Daily posture can also be a common culprit of low back pain. Many practitioners say that “there is no bad posture – except the one you stay in for too long”. If you tend to sit for long periods at a desk or table, take inventory of what position your lower back stays in. Is it arched? Or rounded? Too much time spent in either one of these positions can cause irritation and tension within the structure of the lower back, hips, and legs.
Footwear also affects posture. Wearing high heels or constricting shoes changes both your gait and your standing posture, requiring your entire body to shift to maintain balance.

Tying it all together

Movement patterns, injuries, and genetics can all play a part in low back pain. An injury, muscular imbalances, or lack of mobility in the hips, knees, and feet can all cause issues up the chain to the lower back. In some ways, the lower back bears the brunt of many other mobility and structural issues.

So, what can be done with this information? When you’re experiencing low back pain, the most prominent goal is just to get rid of it. But hopefully, this article sheds some light on why your particular issue may take some time to address. Usually, the root cause is not one issue, but several, and it takes time and intention to sift through your particular issue.

This is one reason that having integrated care is so beneficial. Practitioners with different perspectives and modalities can address your issues and collaborate to find a few root causes. A combination of manual therapy and movement therapy will likely play a part in creating long-term healing.

If you’re in the Willamette Valley and looking for integrated care, come check us out at Well Balanced Center!

Want to learn more?

Here is an interesting article about Lower Back and Hip Pain.

Here is an interesting explanation of referred pain.