What can Cause Low Back Pain

You’ve just hurt your back so you want to know what can cause your low back pain? The first and most useful step is figuring out your pain pattern. Figuring out the actual cause can be helpful, but the pattern is more consistent, therefore more helpful to guide the treatment. Here’s how to figure out your pattern. These are the same questions I ask patients in the clinic to figure out their back pain.

The causes of low back pain

Here the patterns and characteristics we will discuss.

patterns to find the cause of your patin

Wait. You said 5, but I only see 4?!


Pattern 5 means go to the Emergency Room.

Diagnose your Cause of Pain

Use this flow sheet to find your back pain pattern.

This chart is based on 3 questions (yellow boxes)

  1. Is your pain in your back or leg?
  2. Is your pain constant or intermittent?
  3. Does bending forward make your pain worse?

Question #1: Is your pain in your back or your leg?

Above the line = back Below the line = leg

The red line across the bottom of the butt cheek separates back and leg pain, so above = back, below = leg.

Questions 2: Is Your Back Pain Constant or Intermittent?

Constant means just that. The pain does not stop regardless of positions.

If there is a position or time of day that alleviates your pain or anything really, consider it intermittent.

Question #3: Does bending forward cause more back pain?

“YES” means sitting or bending forward causes your pain, also called spinal flexion.

“NO” means standing, walking, or leaning back causes your pain, also called spinal extension.

Summarizing the patterns that cause your back pain

flow chart to find source of pain

I included the flow chart again so you don’t have to scroll up and a table below to summarize the results

causes of pain and patterns

How to Treat the Patterns that Cause Your Back Pain

Pattern 1 – probably caused by a herniated disc

  • Find pain relief tips here
  • Sitting is often painful, so use these tips here

Pattern 2 – maybe caused by joint or ligament

Toe Touch
  • Do 5-10 reps of the toe touch for short term pain relief as often as needed.
  • Make your back stronger. Here are my favorite exercises here.

Pattern 3 – likely herniated disc

Use the same treatment listed in Pattern 1 since this is just a more painful version. It will take longer to heal, sorry.

Pattern 4 – nerve blood flow issues

This is called spinal stenosis (LINK) and usually affects people age 65+. The treatment is to be more fit. This is not easy once you become 65., so ideally you have the fitness level of someone 10-20 years younger when you actually get to 65. The keys to that:

  • Zone 2 conditioning 30′ 3+ times/week
  • Strength training 1-3x/week
  • Be a healthy body weight


These are generally for new back pain, so it may be different for chronic back pain. Although it likely will follow the same pattern. Since chronic back pain is usually less irritable, you’ll be able to start the same things that you should be doing to PREVENT Pattern 4 back pain.

Regardless of the cause, science tells us a GENERAL back pain program is THE most effective at combating low back pain.

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