Why Does My Back Keep Hurting? Common Causes of Recurring Lower Back Pain

Lower back pain is one of those annoying problems that can disappear completely, convince you everything is fine… and then randomly decide to make another appearance three months later.

You bend down to put your shoes on.

Pick something up.

Go back to the gym.

Sit at your desk for a particularly long week.

And suddenly:

“For f*** sake, not this again.”

If that sounds familiar, you're definitely not alone.

Recurring lower back pain is something we see all the time at our physiotherapy clinic in Archway, North London.

And one of the biggest worries people have is:

“If it keeps coming back, does that mean there's something seriously wrong with my back?”

Usually, the answer is much less dramatic.

Let's go through it.

First: back pain doesn't necessarily mean you've damaged your back

This is probably the most important thing to understand.

Pain and damage aren't the same thing.

Obviously, injuries happen. And there are situations where back pain needs further investigation.

But having pain doesn't automatically mean you've slipped a disc, damaged your spine or that something is “out of place”.

Your back is actually an incredibly strong structure.

Think about pain a little like a smoke alarm.

A smoke alarm is there to warn you about potential danger.

Sometimes there's a genuine fire.

Sometimes you've just absolutely cremated a piece of toast.

Either way, the alarm goes off.

Pain can behave similarly. It's your body's warning system, and that system can become more sensitive depending on lots of different factors.

That's why two people can have very similar findings on a scan but completely different experiences of pain.

So why does my lower back pain keep coming back?

Usually there isn't one single answer.

It's often a combination of things.

Here are some of the most common patterns we see.

1. You feel better, so you immediately go back to doing everything

This is probably one of the biggest ones.

Your back hurts.

You stop exercising.

You rest for a couple of weeks.

It settles down.

Fantastic.

Then because it doesn't hurt anymore, you immediately return to everything you were doing before.

Same weights. Same running. Same football. Same five gym sessions.

Your pain may have settled, but that doesn't necessarily mean you've rebuilt your body's capacity to tolerate all of that activity.

It's a bit like not driving your car for six months and then immediately entering it into the Formula 1.

Okay, slightly dramatic.

But you get the idea.

Often the missing piece isn't getting somebody out of pain.

It's getting them from:

“My back doesn't hurt anymore”

to:

“My back can comfortably cope with everything I want it to do.”

Those are two different things.

2. You've stopped moving because you're scared of hurting it

The opposite can happen too.

Someone experiences a really painful episode of lower back pain and understandably becomes nervous about triggering it again.

So they stop bending.

Stop lifting.

Stop exercising.

Start moving incredibly carefully.

Six months later they're still treating their back like it's made of glass.

But your back needs movement and load.

If you progressively expose it to the things you want it to do, it generally becomes better prepared to tolerate them.

That might mean gradually returning to:

bending

lifting

squatting

running

strength training

carrying things

playing sport

The answer usually isn't to avoid movement forever.

It's to build your confidence and capacity back up gradually.

3. You're not as strong as you think you are

This doesn't mean you need a six-pack or need to deadlift twice your body weight.

But strength matters.

Your lower back doesn't work in isolation.

Your:

legs, glutes, hips, abdominal muscles and back muscles

all contribute when you're walking, running, lifting, carrying and exercising.

If you're repeatedly experiencing back pain when performing certain activities, sometimes part of the solution is simply increasing your physical capacity.

For example, if lifting 20kg is currently very close to your maximum ability, it's a big demand every time you do it.

If you've gradually trained until you're comfortably capable of lifting considerably more than that, the same 20kg represents a much smaller challenge.

Think of it like your phone battery.

If an activity requires 80% of your available battery, you're going to run into trouble pretty quickly.

If you've built your capacity so the same activity requires 30%, you've got much more left in reserve.

That's one reason strength training for lower back pain can be so useful.

4. You've been told your posture is terrible

This comes up constantly in physiotherapy.

“My posture is awful.”

“I sit badly.”

“I've been told one hip is higher.”

“My spine isn't straight.”

People can become incredibly worried about posture.

But there isn't one magical sitting position that guarantees you'll never experience back pain.

The bigger issue is often staying in one position for ages.

Even the world's most beautifully ergonomic posture can become uncomfortable if you sit there for eight hours without moving.

So rather than obsessing about:

“What is the perfect posture?”

I'd rather you think:

“How often am I changing position?”

Sit.

Stand.

Walk around.

Stretch.

Lean back.

Change position.

Then carry on working.

Your best posture is often your next posture.

5. Sleep, stress and general life can play a role

This one sometimes surprises people.

You might think:

“What has stress got to do with my back?”

Potentially quite a lot.

Pain isn't just influenced by muscles and joints.

Your sleep, stress levels, previous experiences of pain, general health and even how worried you are about the problem can influence how sensitive your system becomes.

Think about how everything feels harder after a terrible night's sleep.

Training feels harder.

Work feels harder.

Getting out of bed feels harder.

Even somebody chewing loudly next to you suddenly becomes grounds for divorce.

Your body's ability to tolerate things changes.

That doesn't mean your pain is “all in your head.”

The pain is absolutely real.

It just means the human body is slightly more complicated than:

pain = damaged body part.

When should I see a physiotherapist for back pain?

You don't need physiotherapy every time your back feels slightly stiff.

But if your lower back pain keeps coming back, you're repeatedly stopping the same activities, or you're unsure how to safely return to exercise, an assessment can be useful.

Rather than simply asking:

“Where does it hurt?”

we want to understand:

Why does it keep happening?

That might involve looking at your:

movement

strength

mobility

training programme

work/activity demands

previous injuries

symptoms

recovery

Then we can actually make a plan.

At Thrive Physiotherapy Clinic & Studio in Archway, we work with people from Archway, Tufnell Park, Holloway and across North London dealing with lower back pain and returning to exercise after injury.

Treatment might include hands-on physiotherapy where appropriate, but importantly we'll also look at exercise rehabilitation, strength and gradually rebuilding your tolerance to activity.

Because the aim isn't just:

“Let's make your back feel better today.”

It's:

“Let's get you back doing what you want to do and give you a better idea of what to do if it starts grumbling again.”

When is back pain something to worry about?

Most lower back pain isn't caused by anything serious.

However, there are symptoms that shouldn't simply be ignored.

Seek urgent medical advice if back pain is associated with things such as new changes to bladder or bowel control, numbness around the saddle/genital area, significant or progressive weakness in the legs, major trauma, or feeling systemically very unwell.

And if you're simply unsure about your symptoms, get them assessed rather than trying to diagnose yourself through Google at 1am.

Google at 1am has never diagnosed anyone with anything pleasant.

The main thing to remember

If your back pain keeps returning, it doesn't necessarily mean your back is damaged or weak.

Often the question is:

What is your body currently prepared for, and what are you asking it to do?

Build your activity gradually.

Keep moving.

Get stronger.

Don't obsess over perfect posture.

Pay attention to recovery.

And if the same problem keeps coming back, get someone to actually look at why rather than repeating the cycle of:

pain → rest → feel better → immediately do everything → pain again.

Your back is designed to move.

Sometimes it just needs a sensible route back to doing more.

Struggling with recurring lower back pain?

If back pain is stopping you from running, training, working or doing the things you enjoy, we can help you work out what's going on and build a plan to get you moving again.

Thrive Physiotherapy Clinic & Studio is based in Archway, North London, close to Tufnell Park, Holloway, Highgate and Islington.

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