Last updated on January 17th, 2019

Low Back Pain and Posture

Man having low back pain

If you are one of the millions who have suffered from low back pain, you know how debilitating it can be. It is estimated that 1 in 1,000 people will experience low back pain! Low back pain keeps you from sitting, standing, bending, putting on your clothes or just taking care of your basic needs. It is the number one reason someone seeks my help. Often times they would enter the clinic in pretty bad shape.

After more than 16 years working with people I have found a strong connection between low back pain and posture. This article will describe the two most commonly missed areas associated with posture that contribute to low back pain.

The psoas muscle

Pronounced as “so- az”, this muscle combined with the iliacus muscle is a major player in low back pain. The psoas and iliacus, when addressed together are called the iliopsoas. They connect on the spine on one end and leg on the other. It’s primary function is to flex the thigh on the pelvis and forward tilt the pelvis. I have found in the case of low back pain, the state of the iliopsoas is one of either being too contracted (short), atrophied (weak) or both. A short iliopsoas typically comes from lack of proper stretching of the muscle.

In today’s world of technology people are sitting more than ever and thus allowing the iliopsoas muscle to be in a sustained position of contraction. In addition to this, there is an increase in obesity in the U.S. which reflects the near absence of physical activity. We are designed to be upright and standing, so when a person sits 6-8 hours a day with no exercise or stretching routine the result is contracted muscles.

If this sounds like you, then your iliopsoas muscle needs to be stretched. If you lack an exercise routine then you will also be dealing with atrophy of the same muscles that are short. Seek a professional’s help in developing an exercise routine that will strengthen and a stretching routine that will lengthen the iliopsoas muscle.

The neck

I have written about forward head posture and how it is seen in poor posture. The piece I want to emphasize is the connection between the position of the head/neck and the low back. For many years I had clients who dealt with chronic low back pain. Although I was very effective at helping relieve pain, often times they would return 6 to 8 months later with another episode.

In many of these cases, the client’s low back was unstable due to the secondary condition of forward head posture. The connection is the reciprocal relationship between the neck and low back via their curves. They both have what is called  a lordotic curve or “C” curve. They are separated by the thoracic kyphotic curve- which curves in the opposite direction.

Seen as a one integrated unit, the neck, back and low back create a spring like structure. When one end of the spring is flatten than the opposite end of the spring must compensate. This is what we see with forward head posture. The forward head flattens the neck and forces the low back to compensate. Once the clients forward head posture was corrected their low back was more stable. Their experience of low back pain was nearly zero.


Low back pain and posture are intimately connected. Address your posture and you will make dramatic changes to your health. Look at more than just your low back when dealing with low back pain. The health of your neck and head position are critical for achieving lasting relief from low back pain. You will find the article on How to Improve Your Posture helpful.

Dr. Paul Paez, DC, NRT, NET, CMT

National Board Certified Doctor of Chiropractic (DC), trained in clinical nutrition (NRT), neuro-emotional release (NET), and Massage Therapy (CMT). Dr. Paul holds the rare triple distinction of Certified Posture Expert, Certified Posture Neurologist and Certified Posture Ergonomist by the American Posture Institute. Posture Possible is the very best resource for posture information.