Have you ever woken up with stiffness in your lower back? Or noticed it tightening up after hours at a desk or behind the wheel? You're not alone. At least 80% of people will experience some form of lower back pain (LBP) in their lifetime (Freburger et al., 2015). This article focuses on non-specific LBP, pain with no link to a specific cause, diagnosis, or pathology. LBP can be physically and mentally debilitating, but there are effective options beyond medication or prolonged rest. Exercise is medicine, and motion is lotion; your body wants to move. The key is learning how to do so safely and effectively, respecting the limits of your current LBP.
The anatomy behind it
The lower back, or lumbar spine, is made up of five vertebrae (L1-L5) and connects with the sacrum and pelvis below. Several muscles help support and control this region, including the quadratus lumborum (QL), erector spinae, and multifidus, which work together to produce movement and provide stability throughout the spine and pelvis.
Non-specific low back pain is complex, which is why focusing only on the area that hurts may not address the full picture. The pelvis, hips, and ribcage can all influence how forces are distributed through the lower back, while factors such as activity levels, work demands, stress, sleep, and fear of movement may also contribute to the experience of pain. Effective long-term management means looking beyond the symptoms and working backward to understand why the lower back may be taking on more than it should in the first place.
What hip mobility has to do with it
A systematic review by Avman et al. (2019) analyzed studies comparing hip range of motion in individuals with non-specific LBP. The majority of studies (10 of 14) showed a tendency toward limited hip internal rotation, with five reaching statistical significance. Improving hip internal rotation is associated with improvement in non-specific LBP.
Rethinking "neutral" spine
There is a lot of conflicting advice about the "correct" lower-back position during lifting. A systematic review by Saraceni et al. (2020) found that 9 of the 11 included studies showed no prospective association between lumbar flexion during lifting and the development of disabling low back pain, challenging the idea that the lower back must remain perfectly neutral at all times.
Excessively arching the lower back is not necessarily the answer either. A pronounced lordotic position can limit the ability of the pelvis, hips, and ribcage to move and coordinate effectively, potentially making it harder to breathe, brace, and manage load efficiently. Rather than chasing one universally "correct" spinal position, the goal is to develop the strength, control, and pressure-management strategies needed to tolerate and move through a variety of positions under load.
Breathing is the missing piece
To create internal pressure, start by positioning the ribcage over the pelvis. A full exhale through pursed lips helps bring the ribs down, engage the abdominal wall, and establish a more stable position from which to breathe and brace under load. Zhou et al. (2024) found that elite weightlifters with chronic low back pain demonstrated reduced diaphragm contractility compared with pain-free lifters, with diaphragm strength also associated with lifting performance. Think of the trunk like an unopened soda can: when the system is pressurized, it can better resist external forces.
Humans are not fragile; we are antifragile. We adapt to the demands placed on us. The goal is to match the load to your current ability to control and stabilize the trunk, then progressively increase that demand as your capacity improves.
References
Freburger et al., 2015. Avman et al., 2019, "Is there an association between hip range of motion and nonspecific low back pain?" Saraceni et al., 2020, systematic review on lumbar flexion and lifting-related LBP. Zhou et al., 2024, diaphragm function in elite weightlifters with and without chronic LBP.