6 Unexpected Causes of Back Pain (Including Tight Trousers)

ByEditorial Staff

Back pain is often blamed on obvious culprits like poor posture, heavy lifting, or injuries. But sometimes, the cause of that nagging ache can be something you’d never suspect. Surprisingly, everyday habits and choices – from your fashion to your lifestyle – might be contributing to your back pain. We’ll explore six unexpected causes of back pain (including those trendy tight trousers you love). Let’s dive in!

1. Tight Trousers and Skinny Jeans

Squeezing into ultra-tight pants might look stylish, but it can put your back in a bind. Tight trousers (like skinny jeans) restrict movement in your hips and pelvis. This forces your lower back to compensate with extra motion, which can strain muscles and joints.

In one study, people who wore pants a size too small had to move their spines more and use their back muscles less effectively during bending tasks. They also reported significantly more low back discomfort compared to when they wore properly fitted pants (Tight Pants & Back Pain ). In other words, skintight pants alter the natural movement pattern of the hips and spine, overloading the spine’s joints and ligaments and leading to pain (Tight Pants & Back Pain). Over time, this added stress can contribute to lower back pain.

Signs and Symptoms

  • Aching or stiffness in the lower back after wearing tight-fitting pants for extended periods.
  • Feeling restricted in your movement – you may find it hard to bend or squat comfortably.
  • Possible tingling or numbness in the upper thighs if a nerve is compressed by a very tight waistband (sometimes called “skinny jean syndrome”).

Solutions and Prevention

  • Wear well-fitted clothing: Opt for pants with a bit of stretch or a comfortable fit at the waist and hips, especially on days you’ll be sitting or bending a lot. Your lower body should be able to move freely.
  • Take movement breaks: If you must wear tight trousers, avoid staying in one position too long. Stand up, stretch, and do a few gentle hip swings or back bends during the day to relieve tension.
  • Mind your activities: Don’t do heavy manual work or strenuous exercise in restrictive clothing. For example, if you’re moving boxes or doing yard work, wear looser pants or activewear to allow a full range of motion.

2. Unsupportive Footwear (High Heels and Flip-Flops)

The shoes you wear can have a surprising impact on your spine. High-heeled shoes are a notorious culprit – they alter your posture by pushing your center of gravity forward, causing you to arch your lower back. This can strain the lumbar muscles and compress spinal joints. In fact, up to 58% of women who wear high heels report low back pain. Prolonged use of tall heels can tighten your calf muscles and tilt your pelvis, contributing to discomfort from the lower back all the way up to the neck.

On the flip side (no pun intended), even ultra-flat shoes like flip-flops can cause trouble. Flip-flops lack arch support and stability. You have to clench your toes and shorten your stride to keep them on, which changes how you walk. This subtle change in gait causes extra pressure on the outer edges of your feet and alters the angle of your pelvis, twisting your lower spine abnormally (Flip-Flops and Back Pain: Its No Coincidence | AdventHealth Orlando). The result? Stiffness and pain in the lower back can sneak up on you after a day of wobbling in unsupportive shoes.

Signs and Symptoms

  • Lower back ache or fatigue after a day of wearing high heels – often accompanied by sore calves or feet.
  • Hip or back soreness after walking in flimsy shoes like flip-flops or unsupportive flats, especially if you notice your feet or ankles also feel strained.
  • Changes in posture when wearing certain shoes: you might notice you’re leaning forward or your lower back is more arched than usual. Over time this posture can lead to pain.

Solutions and Prevention

  • Choose supportive footwear: Reserve sky-high heels for special occasions and avoid all-day use. For regular wear, choose lower heels (2 inches or less) or wedges, and look for shoes with good arch support and cushioning. Orthotic inserts can also help support your arches.
  • Limit flip-flop time: Flip-flops are fine for short stints (like at the beach or gym shower), but don’t walk long distances in them. Instead, wear sandals or shoes with straps and support.
  • Stretch and strengthen: If you love your heels, counteract their effects by stretching your calves and hip flexors regularly. Strengthening your core and hip muscles can also help stabilize your gait and reduce back strain from tricky footwear.
  • Listen to your body: If a pair of shoes consistently leaves your back or legs hurting, it’s a sign to retire them or wear them only sparingly.

3. Heavy Bags on One Shoulder

That oversized purse or shoulder bag might be convenient, but carrying heavy loads on one shoulder can literally be a pain in the back. When you sling a bag over the same shoulder every day, it creates an uneven weight distribution. You’ll naturally start leaning to one side and hiking up one shoulder to keep the bag in place. Over time, this habit can cause muscle imbalances in your neck, shoulders, and upper back.

Studies show that carrying a heavy shoulder bag on one side causes you to subconsciously lean to the opposite side to compensate for the weight ( Back Pain and Neck Pain – how your bag may affect it – Norman Marcus Pain Institute ). This distorted posture stresses the muscles and ligaments along your spine. The upper trapezius (the muscle between your neck and shoulder), in particular, may go into overdrive trying to support that bag, leading to tightness and pain. If the bag is very heavy, even your lower back can feel the strain as it tries to stabilize your body.

Signs and Symptoms

  • Shoulder and neck pain on the side where you carry your bag. You might notice one shoulder sits higher than the other when you look in the mirror.
  • Upper back ache or between-the-shoulder-blades pain, especially after walking around for a while with your bag.
  • Tension headaches (in some cases), which can result from chronically tight shoulder and neck muscles due to one-sided load bearing.
  • Over time, you might even experience lower back twinges as your lower spine compensates for the uneven weight above.

Solutions and Prevention

  • Lighten your load: Take a look at what you carry daily and remove non-essentials. Aim to carry no more than about 10% of your body weight in your bag to reduce strain. (For example, if you weigh 150 lbs, keep your bag under 15 lbs).
  • Switch sides or styles: If you use a shoulder bag, make a habit of switching it from one shoulder to the other periodically to distribute the stress. Even better, consider using a backpack with two straps, which spreads the weight evenly across your shoulders and back. Backpacks are generally kinder to your spine than one-sided bags ( Back Pain and Neck Pain – how your bag may affect it – Norman Marcus Pain Institute ).
  • Use a wide strap: Thin straps can dig into your shoulder and muscle. A wider, padded strap can help distribute the pressure. Also, adjust the strap so the bag sits close to your body – a dangling bag can swing and pull more on your shoulder.
  • Strengthen your shoulders and core: Conditioning the muscles of your upper back and core will make you more resilient to any carrying load. Simple exercises like shoulder blade squeezes, rows, and planks can help build support so an occasional heavy bag won’t knock you out.

4. Sitting on Your Wallet

Believe it or not, that bulging wallet in your back pocket can be a real pain in the backside – and the back. Keeping a thick wallet in your rear pocket and sitting on it (often for hours if you drive or sit at a desk) tips your pelvis unevenly. It’s like sitting on a small wedge all day. This posture tweak can irritate the sciatic nerve that runs from your lower back through your buttocks and down your leg. In fact, there’s even a nickname for the resulting pain: “wallet sciatica” or “fat wallet syndrome.” Doctors have documented that a chronically compressed sciatic nerve from a wallet can cause pain in one buttock, with tingling or burning sensations radiating down the leg ( Wallet Neuritis – An Example of Peripheral Sensitization – PMC ). Essentially, the wallet presses on the piriformis muscle and the sciatic nerve underneath, a bit like sitting on a trigger point. Over time, this can lead to inflammation and nerve pain that mimics a true herniated-disc sciatica. The good news is that it’s usually reversible once you remove the offending object.

Signs and Symptoms

  • Pain on one side of the buttocks or hip, especially if it starts after you’ve been sitting a while (like during a long drive or movie). The pain can range from a dull ache to a sharp piriformis pain.
  • Sciatica-like symptoms: tingling, numbness, or burning that travels down the back of one thigh or into the lower leg on the affected side. This happens because the sciatic nerve is being irritated.
  • You might notice the discomfort improves when you’re not sitting (for example, it might hurt in the car but feel better when standing or lying down). This is a clue that sitting posture (and possibly that wallet) is involved.
  • Over time, if unaddressed, it can lead to chronic lower back aches on one side as your spine and muscles adapt to the uneven seating posture.

Solutions and Prevention

  • Remove the wallet (or phone) from your back pocket whenever you sit. This is the simplest fix – take it out and put it on the table or in a bag while you’re seated. Doctors have noted that patients’ pain often improves just by doing this “wallet-ectomy” ( Wallet Neuritis – An Example of Peripheral Sensitization – PMC ).
  • Slim it down: Consider using a thinner wallet or a front-pocket wallet to carry your essentials. The thinner profile won’t tilt you as much if you do accidentally sit on it.
  • Even out your seat: If you’re often sitting on an uneven surface (like a wallet or anything else), make changes. At the office, ensure your chair is flat and supportive. In the car, adjust your seating position once the wallet is out so that both sit-bones are bearing weight evenly.
  • Stretch the piriformis and hips: If you’ve had wallet sciatica, gentle stretches of your piriformis muscle (located in the buttock) can help relieve the pressure on the nerve. Figure-four stretches or yoga pigeon pose can be useful. And, of course, keeping up with general low-back mobility exercises will help keep the sciatic nerve gliding freely.

5. Smoking

Smoking is widely known to harm your lungs and heart, but many people don’t realize it can hurt your back too. Lighting up cigarettes (or using nicotine in any form) can contribute to back pain in a few ways. First, smoking has a systemic impact: it reduces blood flow and oxygen to tissues, including the spinal discs and muscles. Nicotine causes blood vessels to constrict, meaning your spine’s shock-absorbing discs get fewer nutrients. Over time, this can accelerate disc degeneration and make them prone to bulging or herniation. Essentially, smoking can age your spine faster. Research over decades has established a strong link between smoking and back problems (Can Smoking and Vaping Cause Back Pain? | National Spine Health Foundation). One large study even found that smoking was associated with pain in almost every area of the body – but its strongest effect was on the spine (Can Smoking and Vaping Cause Back Pain? | National Spine Health Foundation). Chronic smokers have higher rates of chronic low back pain and more frequent painful episodes. There’s also evidence that smokers are more likely to suffer osteoporosis (bone thinning) and reduced bone healing, which can contribute to back pain and slow recovery from spinal injuries.

Another factor is that smokers often cough more than non-smokers – chronic coughing can strain back muscles and lead to micro-injuries. Plus, smoking can alter your brain’s perception of pain, potentially lowering your threshold so you feel aches more intensely. All these factors make smoking a sneaky but significant contributor to back pain.

Signs and Symptoms

  • Chronic back pain that doesn’t have an obvious mechanical cause (like you didn’t pull a muscle or strain your back recently), but you have a long history of smoking. Smokers are much more likely to report persistent back pain than non-smokers.
  • Slower healing of back injuries. For instance, a strained back muscle or a mild disc injury may take longer to improve if you smoke because of impaired blood flow and tissue repair.
  • If you have degenerative disc disease or osteoporosis, these conditions might progress faster than expected in a smoker, potentially causing increased back pain, stiffness, or susceptibility to fractures. (Your doctor might note your spine “looks older” than your age on an X-ray or MRI.)
  • You might experience more frequent flare-ups of back pain. Some smokers report that every cough or cold (which makes them cough more) triggers a bout of backache – this can be a clue that smoking is impacting your back’s resilience.

Solutions and Prevention

  • Quit smoking (or vaping): Quitting is the single best thing you can do, not just for your back pain but for your entire body. Studies have found that people who quit smoking often have improvements in their back pain over time as circulation improves. It’s never too late – the body starts healing pretty quickly once smoking stops.
  • Stay active and strengthen your spine: Smoking can weaken muscles, so counteract that by maintaining a regular exercise routine focusing on your core and back. Strong muscles help support degenerating discs.
  • Nutrition and hydration: Make sure you’re eating a nutritious diet and staying hydrated. While this advice applies to everyone, it’s especially important for smokers or ex-smokers to provide the best building blocks for tissue repair. Adequate calcium and vitamin D, for example, support bone health (ask your doctor if supplements are needed).
  • Cough carefully: If you have a smoker’s cough, support your lower back with a hand or lean into a pillow when you cough hard to help brace the area. Better yet, work with a healthcare provider on strategies to reduce chronic coughing as you work on quitting.
  • Seek professional help: Quitting smoking can be very challenging due to nicotine addiction. Don’t hesitate to seek support – whether it’s nicotine replacement therapy, medications, or counseling programs. Not only will your back thank you, but your overall health will vastly improve.

6. Dehydration

Surprise – not drinking enough water can literally be a pain in the back. Your spine’s vertebrae are cushioned by spongy intervertebral discs, which are composed of up to 75% water. Throughout the day, these discs slowly lose a bit of water and then rehydrate at night when you lie down. But if you’re chronically dehydrated, your discs may not get fully rehydrated, and they begin to flatten and lose elasticity. When the discs “dry out” (a process called disc desiccation), they can’t absorb shocks as well, and your spine ends up taking more impact. As one spinal surgeon explains: “When you are dehydrated, the spinal discs lose water and your spine is in distress… the spine takes on the full shock of your movements, which can lead to pain.” (This Is Why Your Back Hurts, According to a Spinal Surgeon | livestrong). In essence, dehydration makes your back more vulnerable. The lack of fluid can cause the discs to shrink, which might put pressure on nerves or facet joints, resulting in pain or stiffness. Over time, dehydrated discs are more prone to bulging or herniation (Dehydration and Back Pain- Is There a Connection?), especially if combined with other factors like aging or strain.

Moreover, dehydration can contribute to muscle cramps and tension. Your muscles (including those supporting your spine) work best when they’re well-hydrated and electrolyte-balanced. If you haven’t been drinking enough, you might experience tightness or cramping in the back muscles, adding to the discomfort.

Signs and Symptoms

  • Generalized back pain or stiffness that’s worse when you’ve been active and maybe slightly better in the morning (after your discs have had a chance to rehydrate overnight). If you notice your back aches more on days you skimp on water, dehydration could be a factor.
  • You might feel less mobility or “sponginess” in your spine, almost like your back is compressed. Some people describe feeling “shorter” or more stiff in the evening – which actually happens because we all lose a bit of disc height during the day, especially if dehydrated.
  • Muscle spasms or cramps in the back, particularly during exercise or in hot weather. This can be a sign your muscles are dehydrated, and electrolytes are low.
  • Other dehydration clues often accompany a dehydration-related backache: thirst, dark yellow urine, dry mouth, headache, or fatigue. If you have these and your back is hurting, it strengthens the case that you might simply be dehydrated.

Solutions and Prevention

  • Drink water throughout the day: The simplest cure is to hydrate. Aim for at least 6–8 glasses of water a day (more if it’s hot or if you’re exercising). Keep a water bottle handy and take sips regularly. Remember that by the time you feel very thirsty, you’re already dehydrated – so drink proactively.
  • Limit diuretics: Be mindful of drinks that dehydrate you. Excess caffeine or alcohol can make you lose more fluid than you take in. You don’t have to cut out coffee entirely but balance each cup of joe or alcoholic drink with a glass of water to stay hydrated.
  • Eat water-rich foods: Fruits and veggies like watermelon, cucumbers, oranges, and berries can help with hydration. They also provide important minerals (electrolytes) that keep your fluid balance in check, helping your muscles and discs function optimally.
  • Establish a routine: If you have trouble remembering to drink, build it into your day – for example, a glass of water first thing in the morning, one with each meal, and one every time you take a break.
  • Listen to your body: If you notice you’re getting a dull backache and you haven’t had much water today, try drinking a tall glass or two of water. You might find that your back feels better an hour later, which is a pretty good hint that dehydration was part of the problem!

Sources:

Editorial Staff

The editorial staff at Mayor Boss is a team of expert writers who are passionate about health and wellness. They are dedicated to creating well-researched, highly detailed content that is easy to read and trustworthy. You can count on them to provide you with authentic and up-to-date information.