Do you experience lower back pain when walking? If so, you aren’t alone. Back pain is a prevalent complaint amongst adults in the United States. For most, back pain may occur when lifting things or during exercise, but for others, their back pain extends to average daily activities.

Once you begin to experience lower back pain when walking or standing, the pain may start to interfere with everyday life and happiness.

Whether your pain comes and goes, you have severe lower back pain when walking or standing, or your lower back pain is combined with hip or knee pain, the root cause may be the same.

And to prevent it from interfering with your daily quality of life and work duties, it’s always helpful for you to know and understand the cause of that pain. Then, you and your doctor or physical therapist can address both the surface level symptoms and the root cause with various treatment options.

In this article, I will outline some of the most common reasons people experience lower back pain when walking, and detail one that is often overlooked. From there, I’ll explain some anatomical aspects of your body that you need to know for treating and preventing your lower back pain.

Why do I feel pain in my lower back when walking?

As you may know, there are a multitude of reasons why you may have lower back pain when walking.

Maybe you’re reading this article because you’ve gone to the doctor and they’re having a hard time treating your pain. Or maybe you want to understand what issue you’re experiencing before you go to your first physical therapy appointment.

Whatever brought you here, my goal is not to clinically diagnose your issue, but to help give you some possible causes of your lower back pain so you can move forward to treat it with a medical professional.

So, here are some common causes of lower back pain when walking:

1. Stress on your back

For some, back pain comes on somewhat suddenly, while for others, it is a slow build-up that begins as a subtle ache and turns into severe back pain and even hip pain when sitting, walking or standing. In either case, stress on your back may be the culprit.

Stress, especially on your lower back, comes in many different forms.

For instance, if you are overweight, your body is continuously under additional stress because your joint structures and muscles are put under the extra weight. Being overweight can also impact the pressure placed on your vertebrae, leading to lower back pain.

Other common examples of stress on your back include lifting weights, poor posture when sitting for long periods, general muscle fatigue, pregnancy or a labor-intensive job that requires difficult movements or repetitive motions.

Your back can experience different stressors, but identifying if there was one particular activity or moment when you feel pain in your lower back can help narrow down the cause of your pain.

2. A sedentary lifestyle

Just as overuse can contribute to lower back pain when walking or standing, so can underuse.

Many of us work at a desk all day, looking down at a computer. Although you may adjust your posture from time to time, if you work a desk job, you most likely are not sitting in a way that supports your back.

Additionally, when you sit for long periods and don’t engage your muscles in movement, you contribute to the weakening and tightening of your musculoskeletal system.

Even if you are not sedentary to the point of developing a disuse syndrome, sitting for too long can lead to lower back pain when walking. The build-up to this pain has a lot to do with your muscles, which we will explain in more detail later in the article.

When you sit while driving in the morning, at work during the day, and even when you’re relaxing on the couch at home to unwind after a long day, you put two of your most essential muscles into a shortened position.

These two muscles include the psoas and iliacus, and they make up a part of your hip flexor muscles. Together, they are known as the iliopsoas.

When the iliopsoas is continuously in a shortened position, it begins to develop knots and trigger points, creating a bit of a domino effect with the surrounding muscles and joints, leading to lower back pain when walking.

It doesn’t help that gravity works against you when you are sitting and encourages you to slouch. Your body naturally goes into a slouching position when it thinks you are resting. This is an old instinctual habit to conserve energy, but you are most likely not using as much energy as your ancestors did, so having poor posture and slouching is doing more harm to your back and muscles than good.

3. Spinal stenosis

A more specific medical condition that can cause lower back pain when walking or standing is spinal stenosis. Spinal stenosis causes your spinal column to narrow and compress the spinal cord. It often happens quite gradually and will take a while for severe symptoms to occur. In some cases, no symptoms will occur because the compression is so minimal.

However, in more severe cases, spinal stenosis can put additional pressure on nerves within the spine, causing pain. Spinal stenosis is a condition that can occur anywhere along your spine, which means that the pain may not be isolated to your lower back.

When spinal stenosis is isolated to your lower back, it is known as lumbar spinal stenosis.

4. Muscle tightness

Muscle tightness and muscle fatigue can sometimes be correlated, and both can lead to lower back pain when walking or standing. As I mentioned before, sitting for too long can cause muscle shortening and eventually muscle tightness.

The main reason the iliopsoas impacts your body so intensely is that it is engaged in almost every movement. The iliopsoas is used when sitting, standing, walking, running, stepping up, squatting, hinging, etc. It is rarely at rest, which means that it is easily overused and easily tightened.

Since the hip flexors are a central part of movement and in a central part of your body, they interact with many neighboring muscles, joints, bones, nerves, and other connective tissues. The interaction with these neighbors can lead to lower back pain when walking or standing, especially since the iliopsoas are being engaged during both.

How tight muscles can cause lower back pain when walking

Understanding how tight hip flexor muscles can contribute to lower back pain when walking requires a section of its own.

You see, your primary hip flexor muscles, as mentioned before, are also known as the iliopsoas. The iliopsoas is made up of two connecting muscles: the iliacus, and the psoas.

The iliacus connects to your pelvic bone and the top of your femur bone (your bone in your thigh). The psoas connects to your mid and lower spine, joins to the iliacus, and also attaches to your upper thigh bone.

Since both of these muscles are so heavily used throughout your day, especially during ordinary activities like sitting and walking, they can easily become too tight and overused.

The iliopsoas gets its more common name “hip flexors” because it describes the hip flexion motion. The hip flexion motion is what moves your leg forward at your hip when you are walking. Although these hip flexion movements engage your iliacus and the psoas when walking, they also stabilize the pelvis continually through the day and help keep you upright while sitting. These muscles are constantly engaged. Since they rarely have an “off” time, you can easily see how they can form knots, tighten, and become irritated.

Why do tight iliopsoas muscles cause lower back pain when walking, though?

Tight hip muscles are associated with lower back pain due to their interactions with surrounding muscles, joints, and other functional body parts. You see, once your iliacus or your psoas muscle starts to tighten, one begins pulling on the other, sort of like a game of tug-of-war.

This pull between the muscles then begins to strain the bones and joint areas they attach to, most predominantly your hip and your lower spine.

The pull of tight hip flexor muscles on your bone structures can lead to alignment problems, specifically in your hips themselves. Over time, misaligned hips cause your joints to rub and your posture to change.

The iliopsoas pulls on rear hip muscles like the piriformis and hamstrings as well. As other muscles around your hips and low back are pulled on, those muscles too will tighten. A common example of this would be tightness in your quadratus lumborum muscles (or QL).

It’s easy to see how one muscle’s tightness can lead to many other issues, including back pain when walking. If this one vital part of your body, used in nearly every movement from walking to turning your trunk, is too tight, it can lead to several other issues down the line.

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How to prevent lower back pain when walking

One of the first steps in mitigating lower back pain when walking is identifying the root cause of the issue. Since there are a variety of reasons why you could be experiencing lower back pain, I want to encourage you to seek medical advice on the issue.

If your doctor refers you to a physical therapist, then begin to open up a discussion with them about the possibility of tight iliopsoas muscles contributing to your lower back pain when walking.

After you’ve consulted a medical professional, they can direct you in deciding the right course of treatments to help alleviate symptoms and perhaps get rid of the pain altogether.

Some things a physical therapist may recommend will be simple lifestyle changes and habits like improving your posture, integrating more stretching or yoga into your routine, muscle strengthening, and performing muscle release techniques.

Improving your posture

If you have to sit a lot during the day for work or while driving, then ensuring that you have better posture can help reduce your lower back pain.

For many people, improving posture can be as simple as setting up a more ergonomic desk setup, so their feet are touching the ground, their knees put their legs near 90 degrees, their back is straight, and they don’t need to look down to see their computer screen.

You may also try to change the type of chair you use or choose a standing desk.

Stretching and strength training

Moving more can help reduce back pain when walking, especially if you are sedentary for work. Adding in more stretching throughout your day doesn’t have to be anything intense, and it can be as simple as a 5-10 minute yoga or stretching sequence you do in the morning or before you go to bed.

Beyond stretching, muscle balance is something that should be discussed with your physical therapist as well. If one muscle is stronger than another, it can cause an imbalance and add additional stress to opposing areas.

So, you may want to integrate some lower back and hip-strengthening exercises into your routine as well.  

Muscle release

One of the most effective ways to address tight hip flexor muscles is to release them. Releasing the iliacus, in particular, can be difficult because of its location on the inside of the pelvic bone (or ilium). Most of the time, people can only get a proper iliacus or psoas release when they are at the physical therapist because another person applies the pressure at the best angle.

Still, if you only go to your physical therapist once a week or less, then your muscles are not being released often enough to make much of a difference in your pain levels. That’s why I invented the Hip Hook.

The Hip Hook allows many of my clients to perform psoas and iliacus muscle release at home as often as they need. For some, this is every day, and for others 2-3 times a week will suffice. Either way, the benefit is that it allows for prolonged pressure on the hard-to-reach psoas and iliacus muscles, achieving a better release of tightness.

Over time, as you continue to release the iliopsoas muscle, the tension created on other parts of your body, like your lower spine, also decreases. That’s why continued care of the hip flexor muscles is an integral part of addressing lower back pain when walking or standing.

Frequently asked questions about lower back pain when walking

How do I stop my lower back from hurting when I walk?

Making sure that you are holding yourself in good posture as you walk is one way to help reduce your lower back pain. This helps to properly engage your core and use the stronger muscles in your legs and hips to propel you forward with each step.

Some other ideas include doing various exercises to stretch and strengthen your muscles, as well as other corrective exercises that address potential muscle imbalances causing misalignment of the lower back and pelvis. This could include using muscle release techniques for muscles in the hip flexors and also the lower back.

Is it okay to walk with lower back pain?

Walking can be a great low-impact form of exercise for people with lower back pain. Walking can help get more movement into the hips and pelvis and increase circulation to the surrounding muscles, allowing them to loosen up a bit and even reduce the pulling on your lower back.

Why does my back hurt after walking for a longer period of time?

Walking for longer periods of time can cause the muscles supporting your lower back and pelvis to become fatigued, potentially leading to them feeling sore and overused. Slowly increasing the length of your walks over time along with the proper stretches and releases can help the muscles to recover and grow stronger, allowing you to walk longer distances.