Why does my lower back hurt?

Most everyday lower back pain isn’t damage to your spine — it’s your lower back doing work your hips and mid-back stopped doing. Long hours seated shorten the front of the hip and quiet the glutes, and the lumbar spine absorbs the difference.

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Lower back pain, in plain terms

Lower back pain is the most common musculoskeletal complaint there is, and the overwhelming majority of it is mechanical — a loading and movement problem rather than a structural one. That’s genuinely good news, because loading and movement are things you can change.

Pick whichever of these sounds most like yours. The answer is different for each, and the fix follows the cause.

Which one is you?

Find your version

Common

It’s worst when I stand up after sitting

The ache builds through a long sit and peaks the moment you stand, then loosens after twenty or thirty steps. Sustained flexion plus dormant glutes.

Common

I’m stiff every morning

Worse on waking, easing within half an hour of moving. Usually normal overnight stiffening — but stiffness lasting more than an hour is worth mentioning to a doctor.

Common

It hurts on one side only

Almost always a one-sided loading habit: the bag, the standing hip, the way you twist to reach the back seat.

Common

It hurts when I bend forward

Flexion-sensitive backs usually respond well to extension work and to hip mobility, so the hips supply the bend instead of the spine.

Caution

Whichever version is yours, see a doctor first if

  • The pain began after a fall, a crash, or a direct blow
  • You have numbness, pins and needles, or weakness anywhere
  • The area is hot, red, or swollen, or you have a fever
  • The pain is worst at night and doesn’t ease in any position
  • You have unexplained weight loss or a history of cancer
  • Any change in bladder or bowel control, or numbness around the groin or inner thighs — this needs emergency assessment

These are uncommon, but they point to problems that movement work won’t touch and that get harder to treat the longer they wait.