The 6 Real Causes of Lower Back Pain (and What Actually Works)

The truth about “mystery” back pain

If you’ve ever Googled your back pain and left more confused (and a little scared), you’re not alone. Back pain isn’t random—and it isn’t one-size-fits-all. Most cases fall into six predictable patterns. When you know which pattern you’re in, you can choose the right plan and get your life back.

At Atlas Rising, we see these patterns every day and match them with targeted, conservative care—so surgery becomes the last resort, not the first thought.

What you’ll learn

• The 6 most common root causes of lower back pain

• How to tell which pattern fits your symptoms

• Exactly which treatments help each pattern (and why)

• When to consider imaging—and when you probably don’t need surgery

Quick self-check: Take our 2-minute Back & Neck Pain Quiz to see which cause fits you best → https://backandneckpain.scoreapp.com

The 6 Patterns of Lower Back Pain

1) Disc Problems (bulge or herniation)

How it feels: Worse with sitting, bending, or first thing in the morning. Coughing/sneezing increases pain. May send pain, tingling, or numbness into the butt, thigh, or leg (sciatica-like).

What’s happening: The disc (a jelly-like cushion) gets compressed and bulges—sometimes pressing on nearby nerves.

What helps (and why):

• Spinal Decompression: Cycles of gentle pull-and-release create a pumping effect that helps draw nutrients into the disc and restore hydration/height, reducing bulge pressure.

• Chiropractic (posture-focused): Often adjusted above the painful area to unload the lumbar segments.

• Cold Laser + Trigenics® (neuromuscular): Calm inflamed tissues and reset tight/guarded muscles.

When to image: MRI is most useful if symptoms are severe, progressive, or not improving with a conservative trial.

2) Facet Joint & Arthritic Pain

How it feels: Ache across the low back, not usually into the leg. Worse with standing, walking, or arching back; better with sitting or bending forward.

What’s happening: The small “guide-rail” joints on the back of the spine get overloaded (often from sway-back posture), leading to joint capsule irritation and, over time, arthritis.

What helps:

• Decompression & Chiropractic: Offload compressed joints and restore segmental motion.

• Posture coaching & home exercise: Re-train movement patterns to stop the overload.

• Custom Orthotics (when indicated): If feet collapse, your spine pays for it—orthotics can unload the low back by correcting foundation mechanics.

• Cold Laser: Targets inflamed joint capsules.

3) Muscular & Soft-Tissue Strain

How it feels: Dull, tight, achy after a weekend of yardwork or a long day. Usually no leg symptoms. Often improves within days—unless a deeper joint/disc issue is driving it.

What’s happening: Muscles guard to protect irritated joints or discs.

What helps:

• Targeted mobility + stretching, followed by core stabilization (think McGill “Big 3”) to balance the trunk “tube.”

• Chiropractic & Trigenics® to restore clean movement so the muscles can relax for real.

4) Nerve Compression / Spinal Stenosis

How it feels: Sharp, burning, tingling, or weakness in the back/leg. Feels better leaning forward on a shopping cart; worse standing upright or waiting in line.

What’s happening: The opening where the nerve travels is narrowed (from disc height loss, arthritis, or both), irritating the nerve.

What helps:

• Decompression & Chiropractic: Offload compressed joints and restore segmental motion.

• Posture coaching & home exercise: Re-train movement patterns to stop the overload.

• Custom Orthotics (when indicated): If feet collapse, your spine pays for it—orthotics can unload the low back by correcting foundation mechanics.

• Cold Laser: Targets inflamed joint capsules.

5) Instability (“my back catches or gives out”)

How it feels: Pain when changing positions—rolling in bed, sit-to-stand, stand-to-sit—but feels better once you’re settled.

What’s happening: The stabilizers aren’t doing their job, so segments shear and feel unsafe.

What helps:

• Start with gentle mobility, then progress to stability training (anti-rotation, bracing, hip hinge patterns).

• Chiropractic to re-center movement and reduce “catching.”

6) Postural Overload

How it feels: Stiffness and fatigue after sitting all day or repeated screen time; flares with small twists/reaches (like grabbing something from the back seat).

What’s happening: Hours in a static posture remodel tissues in the wrong direction. The spine is strong in motion, not in marathon sitting.

What helps:

• Posture assessment with measurable re-checks every 4–6 weeks.

• A short, realistic micro-break routine (1–2 minutes, every 30–60 min).

• Chiropractic + Decompression to restore lost motion; exercise progression based on your posture photos.

Why decompression succeeds where “just stretching” doesn’t

Traction simply pulls and holds. True decompression uses calibrated cycles that create a fluid exchange, pulling nutrients from the vertebral endplates back into the disc—helping it rehydrate and thicken over a series of sessions. More height = more space = less nerve pressure and fewer pain signals.

“Do I really need surgery?”

Sometimes, yes. But the majority of lower back cases are mechanical and respond to conservative care. Even if you have a known disc bulge, it may not be the pain generator—hands-on exam plus smart imaging decisions matter. When surgery is necessary (especially for certain fusions), we’ll explain the implications and help you build the strongest prehab/rehab plan possible.

Start with clarity (and a plan)

Take the quick assessment to pinpoint your pattern and get next steps:

• Back & Neck Pain Quiz → https://backandneckpain.scoreapp.com

Then, if you’re in central Ohio, let’s get you a thorough evaluation and a tailored, conservative plan.

FAQ

What is spinal decompression?

A non-surgical therapy that applies precisely controlled, cyclical traction to the spine to reduce pressure, encourage disc hydration, and relieve nerve irritation.

How do I know if my pain is from a disc or a joint?

Disc pain is usually worse sitting/bending and may radiate down the leg. Facet/joint pain is often worse standing or arching and stays across the low back. Our exam clarifies the pattern.

Can flat feet really cause back pain?

Yes. Foot collapse changes knee/hip mechanics and increases lumbar load. Custom orthotics can offload the chain and reduce low back stress.

When should I get an MRI?

If you have red flags (severe/progressive weakness, bowel/bladder changes) or if conservative care fails to improve symptoms appropriately. Otherwise, a precise exam can save unnecessary imaging.

Is posture actually fixable in adults?

Absolutely. We measure, train, and re-measure. While severe bony changes won’t vanish, pain, mobility, and function can dramatically improve.

Your Next Step

• Take the Back & Neck Pain Quiz → https://backandneckpain.scoreapp.com

• Book your consultation → https://www.atlasrising.com/schedule

We serve patients at Atlas Rising in Westerville, Ohio—combining chiropractic, decompression, Trigenics®, cold laser, and posture rehab to deliver lasting results.