The 25 Things You Must Know About Lower Back Pain

Earlier this month I presented at the IDEA World Fitness Conference. It is a conference I’ve had the privilege of presenting at for quite a few years. Fitness professionals from around the globe come to learn and connect.

One of my presentations this year that was filmed by IDEA to share with others was,”The 25 Things Your Client Must Know About Lower Back Pain”.

I thought I would share with you the list of items in the presentation. Of course during the presentation each topic was discussed and explained in detail. But I’m sure you’ll find some great tips from the list alone!

1. A bad back is not always a weak back.

2. A weak back can be a precursor to a bad back.

3. Muscle endurance is initially more important then muscle strengthening for your back.

4. Acute episodes of back pain respond better to ice than heat.

5. Positive finding on an MRI often have less to do with your pain than you might think.

6. Stretching alone is an incomplete answer to solving your back problems.

7. Your body adapts to exercise, so doing the same “back” exercises for months or years has diminishing returns.

8. Chronic back pain can be months or years in the making.

9. Sleeping on your stomach is good for some people.

10. Lower back pain can be caused by your feet.

11. Lower back pain can be caused by your neck.

12. Never roll out of bed and immediately stretch in the morning.

13. Pulling your knees to your chest may be bad for your back.

14. Lumbar supports when sitting are helpful.

15. More serious medical problems sometimes mimic lower back pain.

16. Stretching your hamstrings when you have sciatica can make the symptoms worse.

17. Pregnancy and monthly cycles with increased hormone production can decrease the stability of the sacroiliac joint in women leading to LBP.

18. The best back exercises are those that are designed for you following an evaluation.

19. An old injury to another part of your body can contribute to your back pain.

20. Lying on your back with your hips and knees bent to 90 degrees and legs supported can passively mitigate back pain.

21. Repeated work or recreational postures or movements will lead to imbalances in your body and impact the back.

22. Back surgery can almost always be rescheduled.

23. If medication is your only intervention, you’ll be medicating for life.

24. Hinging from the hip can spare your back.

25. Good spinal ROM is not correlated with an absence

Is there anything you’d like to add to this list?

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11 Responses to “The 25 Things You Must Know About Lower Back Pain”

  1. Rich Shulman says:

    26. LBP can be caused by hip and thoracic spine immobility.

  2. Tom Sadowski says:

    Sometimes lifting 200+ lbs. will not cause LBP, but lifting a twig, pen or a loaf of bread immediately after the 200+ lbs. lift will.

  3. Anthony,

    As always great information. Thank you for your contributions to the industry!


  4. Stephen Lewis says:

    LBP is almost always associated with movement assymetry. Any lack of motion in the key areas of foot, hips, thoracic, cervical, scapula, can cause too much motion and hence instability in the lumbar segments.

  5. Brian says:


    Great information. Some very good points.


  6. Mike says:

    A good rule of thumb: Try not to do anything stupid.

  7. mike morris says:

    In Asian countries people dont stand or sit as often as people here in the US. They take a rest in the full squatted position, focusing on there breath as well as posture. If in pain go to the bottom in small sequential movements. Take ur time n use the pain response as an indicator, move slowly. Take this position as often throughout the day(at least 5x/day for a minute). Thank you again, Anthony for such a wonderful resource.

  8. Peggy says:

    Rest and heat are not always the solution for back pain (and in some situations will make the condition worse).

  9. Peggy says:

    Not all conditions that cause back pain will show up on an MRI or xray (especially soft-tissue damage). Just because they can’t ‘find’ anything does not mean there isn’t anything wrong.

  10. Susan says:

    Anthony…I would not be dancing and passion filled if it were not for you and your magic. I am a sponge at every appointment! I just wish I would have had the knowledge 30 years ago…but hey, I have it now, and that is a GIFT! Thank you my friend.

  11. Jason Ross says:

    Learn to stretch the psoas muscle. Learn to use your glutes. Learn to not stay in the same positions for very long, fidgeting is a great thing!