17 Back Muscles That Cause the Most Back Pain (and how to get relief!)

back muscles

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 visualize 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.

This video explains how muscle imbalances affect your pain, and how to fix them. 

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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 Head and Neck Muscle Imbalance

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

Forward Tipped Pelvis Muscle Imbalance

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

Backward Tipped Pelvis Muscle Imbalance

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

High Hip Muscle Imbalance

Back muscle pain relief in two simple steps

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 muscle balance therapy.

Don’t let the formal name throw you off, though. The concept is actually very simple:

1) Identify which muscles are weak and strengthen them through targeted exercise

2) Identify which muscles are tight and relieve the tightness through targeted stretching.

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.

But there is a catch: you must accurately identify the muscle imbalances you have and use the correct stretches and exercises or you may accidentally strengthen or stretch the wrong muscles, leaving you in pain longer.


Back Pain Facts & Statistics. American Chiropractic Association. 2012.

Filed Under: Back Pain, Muscle Balance Therapy
Written By:
Jesse Cannone, CFT, CPRS, MFT

Jesse Cannone, CFT, CPRS, MFT

Jesse is the co-founder and visionary CEO of The Healthy Back Institute®, the world-leading source of natural back pain solutions. His mission as a former back pain sufferer is to help others live pain free without surgery and pharmaceuticals.

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12 thoughts on “17 Back Muscles That Cause the Most Back Pain (and how to get relief!)”

  1. Avatar Alistair Taylor says:

    Thanks on your marvellous posting! I really enjoyed reading it. This website has got some really useful info on it! I was looking for this. It was excellent and very informative. As a first time visitor to your blog I am very impressed and I found a lot of informative stuff in your article. Thanks for posting. PLEASE keep it up!

  2. Avatar Stephen says:

    I have never seen such a well explained details about back aches. Thank you from the bottom of my heart

    1. Avatar Admin says:

      Thank you for your kind comment Stephen, we appreciate it

      (The Healthy Back Institute)

  3. Avatar John Smith says:

    It is really nice that you shared tips to get rid of back pain. Well explained thanks for sharing

    1. Avatar Admin says:

      We appreciate your kind comment John, Thank you
      (The Healthy Back Institute)

  4. Avatar JOSEFINA CARBONELL says:

    I look forward to receiving you tips to correct my muscle imbalance. I have been told by my physical therapist that my muscles are weak especially my abs.. I slouch a lot and i do have scoliosis. My present issue is how to relieve my sciatica. I do have spinal stenosis, herniated disc cause by degenerative OA. I am against back surgery and besides the neurologist says I don’t need it yet.

    1. Avatar Admin says:

      Hi Josefina,

      Thank you for your comment. We believe education is key to dealing with back pain/sciatica and we would suggest you get yourself a copy of our free book the “7 Day Back Pain Cure”. The book discusses back pain issues,muscle imbalances, sciatica and related pains, various treatment options you can consider, pain relief suggestions, action plans and other helpful information for when dealing with pain.

      Do please read more details and information about the 7 Day Back Pain Cure book via the link below


      Our Best Wishes
      Admin (The Healthy Back Institute)

  5. Avatar Lourdes S. says:

    Hello, can muscle imbalances also cause leg length difference? If so, can correcting leg length difference resolve people’s pains and vice versa?

    1. Lourdes, To be clear, there is a bit of semantics, Muscle imbalances can cause what are called Leg Length discrepancies (a perceived difference in the lengths of the legs).

      Which is different than a leg length difference (where the lengths of the bones are not the same)

      So Leg Length discrepancies can be corrected as the muscle are rebalances and the pelvis goes back to a more neutral position…

      leg length differences are congenital and are different from birth or post surgeries like a knee or hip, and they can be fixed only the use of adaptive inserts can support leg length difference…

      Hope this helps


  6. Avatar Crecilio Jabagat says:

    Thank you very much for giving me a chance to read all very important and useful information regarding the facts and stories of back pain. I’m sure it would help a lot. Thank you.

  7. Avatar Admin says:

    Hi Crecilio,

    Thank you so much for taking the time to leave your kind comment. We are very happy to hear that you are finding our articles useful to you.

    You may wish to also consider our Free Book the 7 Day Back Pain Cure. The book discusses back pain and related issues, treatment options to consider, pain relief suggestions, action plans and other helpful information for coping with pain. If you wish you can read more about it via the link below


    Thank you. Our Best Wishes
    Admin (The Healthy Back Institute)

  8. Avatar Mihir says:

    Thank you very much, it was very helpful!

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