Poor function of the stabilising muscles of the region (often referred to as the ‘core’) is one of the more common causes. Research has demonstrated that pain itself causes inhibition of these stabilising muscles. Further to that these muscles do not recover their function unless specifically retrained, even if the pain magically disappears overnight. This is thought to one of the reasons back pain is so recurrent in nature. In more recent years studies have shown that retraining of this stabilising musculature significantly decreases the rate of recurrence.
Poor sitting and standing posture is common amongst low back pain sufferers, especially those that relate their pain to sustained postures. Good postural alignment and posture correction is also needed to facilitate activity in the stabilising muscles.
Other underlying causes include altered movement patterns, instability of the pelvis during walking/running, lack of hamstring and quadriceps flexibility, and ergonomics of the workstation / desk environments, particularly in those whose pain is aggravated by sitting.
We commonly feel that one minor incident has caused the pain such as bending to pick up a shoe. This is usually just the final minor trauma in a system that has been dealing with gradual progression of problems. The body is actually very good at accommodating mild damage especially if the progression is slow. The problem with this is that once the damage has become so severe that pain is felt the structures involved can be quite irritated.