What causes low back pain? Posture!

Posted on 09 February 2020

What causes low back pain? Posture!

You might not realise this but low back pain causes a huge impact not only to individuals but also the economy. It costs the UK £4billion per year - £500million in care costs but £3.5billion in lost workforce productivity. It is one of the most common reasons people stop working.

I started thinking about this a lot after an Urban Massage I had recently. I have a longstanding shoulder issue from a gym injury in 2015 which I have been doing rehab for on and off as well as hip pain that seems to have cropped up in the last year. In the last year I have gone from being on my feet most of the day as a junior doctor to doing a lot more sitting at my desk running my business. The masseur was also a physio by background and had plenty of useful insights for me, including a series of stretches but also lots of advice on setting up my workstation to optimise my posture. I know I have always been prone to slouching, which would exacerabate my shoulder and hip issues but likely cause low back pain in future so I went away and researched how to manage this risk. Let’s briefly consider low back pain causes and low back pain exercises before diving deeper into preventing low back pain by optimising posture.

What causes low back pain?

Most low back pain causes are non-specific or mechanical - to do with the joints, bones and soft tissues in the spine. This tends to be worsened with positioning or movement and may be due to a minor injury or stress. You can read about more serious causes here.

What are some low back pain exercises I can do?

The key with low back pain is to stay as active as possible. Too much rest will make it worse. Walking, swimming, yoga and pilates may be helpful but here are some exercises you can do to help. Group exercise classes are an option too. In more serious cases you can see a physio, osteopath or chiropractic and should consider psychological approaches like cognitive behavioural therapy (CBT). Psychology plays a huge role in pain perception and how you think should always be a part of managing any chronic pain.

What lifestyle approaches are there for low back pain?

Check out the infograph below for a summary on the lifestyle approaches you can take to manage low back pain:

Low back pain by D K

If poor posture causes low back pain, what can I do to optimise it?

If we sit typing at a desk all day our tendency is to lean into our computers, especially if we have laptops, leading to low back pain, hunched shoulders, achy hips and even dodgy wrists. This is exactly what I have been experiencing with it exacerbating my shoulder and hip issues. Thankfully there is lots you can do to optimise your workstation for posture. Yes, all you corporate types should have listened to the Health & Safety training in your first week. Here is a great summary from Zapier showing how to optimise your workstation:


For me as someone who runs my own business, I need to have a portable workstation that works anywhere at any time without compromising my posture and causing low back pain. I therefore set out to find a series of products that would help (please note some links are affiliate links). Here are my recommendations:

  • Measure your ideal desk and keyboard height Use an ergonomic calculator to work out the optimal desk and keyboard heights for you when sitting or standing. The top of the monitor should be level with your eyes and it should be 20-40” away from your eyes. You should be able to type with your wrists flat or angled downwards.

  • Exercise ball as a chair I was inspired by a colleague who was a trained yoga teacher years ago to use an exercise ball as my chair. It forces you to use your core all day long and therefore build strength. Be careful though, as you tire throughout the day you can end up slouching. This is best combined with posture braces.

  • Upper back posture brace I have always had a tendency to roll my shoulder forward towards my chest, especially after a chest workout. My upper back posture brace has helped me to correct this and ease the tension that builds in my shoulder after long days at my desk.

  • Lower back posture support Here is the key product for preventing low back pain: a lower back posture support. By creating a brace between your lower back and your knees this support leads your spine naturally into an optimal posture. I notice that everytime I wear this I come away from my desk with no low back pain at all.

  • Portable laptop stand For laptop users to get the monitor to the appropriate height for an ergonomic workstation, a laptop stand is needed. I got a Kensington one but there are tonnes of even more portable laptop stands.

  • Sitting/standing desk converter Sitting at the desk all day is always a risk for low back pain; therefore it is a great idea to mix it up between sitting and standing at your desk. To make this switch possible, you’ll need a sitting/standing desk converter.

  • Mouse and keyboard With your laptop on a stand to optimise the display height, you’ll need a mouse and keyboard, ideally wireless so you can position them at the ideal height. I already had an Apple Magic Mouse, which works perfectly with my Macbook. Your keyboard needs to sit so your wrists can be flat or angled downwards, so I picked up this brilliant Arteck keyboard that is bluetooth, super slim, types like a dream and has a battery lasting forever - 2 months later I still have not had to charge it!

For more thoughts on a portable ergonomic workstation suitable for a digital nomad, check out this awesome Intentional Travelers blog post.

If you are suffering from low back pain, book yourself in at Hippocrates Lounge.

Dr Dilraj Kalsi uses Lifestyle Medicine and Digital Health to empower patients to reverse disease via his online clinic Hippocrates Lounge. He is a Lecturer in Digital Health at the University of Warwick and publishes regularly on patient empowerment with colleagues from Oxford University. For all his latest health tips straight to your inbox, sign up here!

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