What Causes Lower Back Pain? A Physio Explains

 In Back and Neck Pain

Lower back pain is an enormous burden on society with up to 80% of society being affected by lower back pain in their lifetime.

Having suffered debilitating lower back pain whilst at university POGO’s founder Brad Beer finds it very easy to empathise with back pain sufferers.

The fear, the anxieties, the confusion, and unfortunately the well-meaning stories from friends and family members about their ‘bad back’ experiences, all contribute to what is often an overwhelming experience and ‘dark patch’.

Fortunately your recovery doesn’t have to be this way. Research has shown that successful and permanent treatment for back pain must be based on educating back pain sufferers.

According to Trish Wisbey Roth and Nick Sinfield authors of The Back Pain Personal Health Plan -Bounce Back Edition it’s important to teach back pain sufferers to:

Recognise and change ingrained perceptions and beliefs about their pain and the resulting emotional stress this produces. This holistic approach which treats lower back pain as a physical, mental, an emotional issue, offers a more effective and lasting treatment option.

Understanding the causes of lower back pain is crucial. In this video Brad will outline the concept of ‘contributory factors’ to the onset of lower back pain.

Discover how factors such as the below can affect your lower back:

-body weight
-tight hip structures
-your feet
-previous injury history
-and more


Hi there, it is Brad Beer, POGO‘s founder and also senior physio. Today I would like to talk to you about the chief causes of lower back pain. Lower back pain is an enormous burden for society, and certainly even a more enormous burden for the back pain sufferer. Statistics are as high as 60 to 70% of Australian’s experiencing lower back pain in any given year.

The causes of lower back pain are many and varied, however through my many years of clinical practice I have come to understand and observe that there are several key contributing factors. These contributing factors tend to exist no matter what the condition or the pathology of the lower back pain sufferer is experiencing.

Let’s take a look at these common causes of lower back pain:

I’m going to start at the bottom – Lower back pain is here in the middle but what you can already see is there are several arrows/circles feeding to create lower back pain. Just to clarify this is exampling the fact that it is not just one factor causing lower back pain, but there is a combination of factors. In practice when I explain this to my patients that are lower back pain sufferers, I normally use the analogy that it is a little bit like baking a cake, you need just the right amount of ingredients, mixed together to get an outcome. In terms of this analogy you are talking about lower back pain, and if we mix enough of each of these together you will experience lower back pain. So let’s find out what these ingredients are.

The first key ingredient for lower back pain is stiff thoracic spine. The thoracic spine is the part of the back that sits above the lower lupus spine. The thoracic spine is incredibly stiff just in just day to day activities. In fact there are very few people walking the earth that are not stiff between their shoulder blades. The problem with this is the thickness through here will put excessive load or strain on the lower back. In addition to stiffness in the spine there is also the problem with tight muscles. Tight muscles predominately refer to tight muscles around the pelvis. Technically I refer to this as lumbo pelvic muscles and the muscles are a key contribution to the lower back pain, tightness in the glutes, tightness in the hamstring, tightness in the quads, tightness in the hip flexes.  Each of these muscles if they are tight will disadvantage the lower back by putting more strain or load on it and making it more susceptible to create pain.

The 3rd key factor on top of the thoracic spine stiffness, tight muscles, is body weight. This is often a delicate subject, one that many people don’t easily digest. So in practice I tend to be very diplomatic when I approach or discuss back pain sufferers body weight with them.  The irony is the message that I hear time and time again, is that because people are in pain, experiencing lower back pain, they don’t feel they can do the activities that they normally would, and as a result they end up increasing body weight and as a result escalated lower back pain. It is a vicious cycle. However the realities of lower back pain even if you are 5 kilos, 10 kilos, or even possibility 30 or 40 kilos over your ideal frame weight then that extra weight is sitting on your lower back irrespective of what I tell you to do.  The reality of that is the load through your lower back is exceptionally larger. This greater load will put more pressure on all the structures that line the lower back. It will be one of your key contributing factors or causes of your lower back pain.

Going down the body we also need to address low back pain sufferers  foot type and their foot position. In simple terms one of the chief causes of lower back pain is an over pronated foot. An over pronated foot is synonymous with a dropped arch foot. Such a foot will tend to internally rotate the hips and thighs inwards and you will drop the pelvis in a downwardly positioned, inclination. This will load up the lower back increasing those loads and increasing the pain.

In summary, if you are a lower back pain sufferer, there is never just one course for your lower back pain. There will be several drivers that if you are serious about getting the right outcome that is  not just a quick fix but rather a comprehensive , entailed, successful, return, for lower back pain then you really need a therapist to help you identify the chief factors or causes of your lower back pain.

Back pain does not have to be a death sentence, so see your local physiotherapist. If you are a Gold Coast resident I would love to see you at POGO physio. Back pain is something that we have great success with in helping people overcome it, and getting back to doing the things that the love to do.  So they can have daily fun, whether that is picking up the kids, running in a park, playing a game of soccer, tennis, a round of golf, having a surf, or going for a run, we would love to help you and all the very best.  I hope this has been of some benefit.

Physio With A Finish Line,

Brad Beer physiotherapist gold coast

Brad Beer (APAM)

Physiotherapist (APAM)
Author ‘You CAN Run Pain Free!
Founder POGO Physio

discover-recover-physio gold coast


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