Everything and nothing causes low back pain
The topic of low back pain and how to address it isn’t as simple as it seems. There isn’t one clear answer that fits everyone, and different clinicians often point to different root causes. Yet that doesn’t mean there’s no truth to it: back pain comes from many factors, and what helps one person may not help another. In recent years, it’s easy to argue about what’s best, but the reality remains that there isn’t a single, universal fix.
It’s common to hear about culprits like tight hamstrings or poor posture, but those explanations are usually incomplete. There isn’t a single right way to treat all LBP. Most of us who work with clients aren’t diagnosing; that job belongs to qualified health professionals. Still, as trainers and coaches, we’re often the first to notice faulty movement patterns and limitations, and we can do a lot to help.
1) REST IS LAME
Rest is often not the best advice. A little downtime is sometimes necessary, but too much rest can stall healing. Movement and gradual loading tend to produce better results. There are times to back off and allow healing, but making rest a default mindset can be a recipe for long-term trouble. Movement helps the body adapt, and staying active is key to long-term success. Sitting around all day won’t help.
2) MOVE, BUT MOVE WELL
Movement has three important elements:
– Structure: People are anatomically different. Hip shape, shoulder mobility, and other factors influence how you move. Being efficient with energy isn’t always the same as being better for the back.
– Coaching/Technique: Exercises should fit the lifter. Not everyone needs to deadlift from the floor with a straight bar; adapt to the person.
– Programming: If someone lacks hip or shoulder mobility, don’t force a movement that doesn’t fit. Even how you coach a simple plank can change how the back is loaded.
3) FINDING SPINAL NEUTRAL (PAIN-FREE ROM) MATTERS
The goal is to find a pain-free range of motion and help the back tolerate more movement over time. Identify which actions hurt or aggravate symptoms, and avoid them while building endurance and strength. Start in a good position, then test how the spine responds to flexion and extension. If someone is flexion-intolerant, focus on posture and controlled movements to reduce excessive spinal flexion, and build endurance with safe planks and supported work. If extension is problematic, approach with care and choose movements that don’t over-arch. Finding spinal neutral and gradually expanding movement beyond it, as symptoms allow, is a central idea. Over time, you can train fuller ranges in a controlled way.
4) DON’T TREAT PEOPLE LIKE A PATIENT
The deadlift can be a valuable tool for many with back pain when it’s coached properly and progressed thoughtfully. It’s about the hip hinge and learning to separate hip movement from the lumbar spine. There are many ways to work around assumptions or fear: use kettlebell or trap-bar deadlifts, farmer or suitcase carries, offset loading (one weight held to the side), one-arm presses or rows, lunges or Romanian deadlifts with a single weight, and even slideboard drills. The aim is to tailor movements to the individual, stay out of risky positions, and find a training approach that strengthens the core and supports the person’s goals, injury history, and abilities.
In short, back pain has many possible causes—tightness, weakness, poor kinesthetic awareness, or other factors. There isn’t a single root cause or a universal fix. But focusing on movement quality, gradual loading, and individualized training can greatly improve outcomes.
