

Back pain is one of the top reasons for missed work and second only to upper-respiratory infections for causing doctor visits.
Most of the time, back muscle pain is diagnosed then “treated” with little more than a prescription of rest, painkillers and muscle relaxants.
Follow this advice and you’re taking one more step down the path to more serious back pain– and possibly doctor-recommended back surgery to deal with it.
And it’s all because you’ve never been told why you have back muscle pain – or how to get lasting relief by treating the cause rather than the symptoms.
That all ends today as we pull back the covers and see exactly what is going on… why your back hurts… which muscles are behind your back pain… and most importantly, what you can do about it (besides taking more pain pills).
Why your back muscles hurt
This may sound suspiciously like common sense, but your back muscles hurt when you pull them too far or place them under too much strain.
But contrary to common misperception, the underlying cause of this back muscle pain is not poor posture, how much you exercise or even your genetic history.
Instead, poor posture can be strong evidence of the real cause. Exercise of the wrong kind can make it worse (but the right kind can relieve your pain). And the good news is you can do something about this underlying cause of back pain – regardless of your genetics.
The root cause of virtually all non-trauma related back muscle pain – and a major contributor to many back conditions like herniated discs – are muscle imbalances.
One way to visualise muscle imbalances and how they cause back pain is to think of your car. If the wheels are out of alignment, the tires will wear unevenly, making them more susceptible to an early blowout.
Imbalanced muscles do the same thing to your back. Muscle pain results when one muscle or group of muscles overpowers an opposing set of muscles that get stretched out of shape.
And here’s the kicker… many of the muscles affecting your back pain aren’t in your back!
For example, sitting all day long leads to weak abs, glutes, and hamstrings which go unused much of the day. In the meanwhile, your hip flexors, quadriceps and lumbar muscles remain tight to keep you in an upright position.
Over time, this imbalance between the muscles of your lower back, legs and stomach can cause severe lower back muscle pain – even when you’re not sitting down.
So which muscles are behind your back pain? Let’s take a quick look at the four most common postural dysfunctions behind nearly all back pain… and the muscles behind those dysfunctions.
Forward head and neck
If you’re wondering what muscles cause neck pain, these are some of the culprits. Forward head posture and shoulders rounded forward are common signs of this set of muscle imbalances.
For every inch your head moves forward out of alignment from your shoulders, your neck effectively carries an additional ten pounds of weight. Forward head and neck postural dysfunction is a frequent cause of neck and upper back pain, not to mention headaches, shoulder pain and more.
Tight muscles:
- Anterior deltoid
- Pectoralis
- Latissimus dorsi
Weak muscles:
- Middle trapezius
- Lower trapezius
- Infraspinatus
- Teres minor
Forward tipped pelvis
By far the most common postural dysfunction we see, a forward tipped pelvis is extremely common among office workers, truck drivers and others who spend a large portion of each day sitting.
A forward tipped pelvis is also the most common cause of lower back muscle pain. Let’s take a look at muscles that cause lower back pain.
Tight muscles:
- Lumbar
- Hip flexors
- Quadriceps
Weak muscles:
- Abdominal
- Gluteal
- Hamstrings
Backward tipped pelvis
The opposite of a forward tipped pelvis, a backward tipped pelvis is the least common of the four primary postural dysfunctions behind back muscle pain. It’s most frequently found in the older population.
Tight muscles:
- Pectoralis
- Upper abdominal
- Gluteal
- Hamstrings
Weak muscles:
- Thoracic erector spinae
- Hip flexors
- Quadriceps
High hip
A misaligned pelvis (one side higher than the other) is often related to back pain or restriction in movement that affects one side of your body more than the other. Here are some of the muscles that cause hip pain when they’re too tight or weak.
Tight muscles:
- Quadratus lumborum
- Psoas
- Adductor
Weak muscles:
- Gluteal
- Hamstrings
You may have one, two or even three different postural dysfunctions. Identifying which postural dysfunction(s) you have will give you the insight you need to eliminate the muscle imbalances behind your back pain using The Emmett Technique.
The concept is actually very simple:
Once the tight muscles have relaxed and weak muscles have been strengthened enough to carry their normal load, your body will naturally return to a neutral posture — relieving back muscle pain and most other back pain, neck pain and sciatica pain in the process.