Lower back pain is the most common health problem in the world. Nearly everyone will have it at some point, but each person can have a very different experience of lower back pain.
This variability makes it tough to give general advice about activities and exercise that will work for everyone. The LBPfix system aims to fix that problem by categorizing the 3 types of lower back pain, and then give you just what you need based on your pain type.
Contents
- The 3 Types of Lower Back Pain
- Symptom checker
- Matching strategies
- Next‑step guide
Disclaimer:
You should consult with a healthcare provider before starting any new physical activity. This article is for educational purposes and is not meant to replace an assessment, diagnosis, or treatment from a qualified professional. Note; no doctor patient relationship has been formed.
The 3 Types of Lower Back Pain
Flexion intolerant
Flexion is when your spine rounds forwards like when you are slouching or bending forward. Pain with flexion movements or flexed positions is the most common pattern. With this pattern the pain was most often initiated by prolonged sitting, repeated or heavy lifting.
Extension Intolerant
Extension is the opposite of flexion. It is the arching backwards movement or position of the spine as if you are looking up at the sky or stretching over the back of a chair. With this pattern prolonged standing or walking is likely uncomfortable. Often this is initiated by prolonged standing, walking or working overhead.
Functional Instability
Instability is a word you have probably heard if you have been to a physiotherapist or chiropractor. The term is often misused or used too broadly in practice. To boil it down, instability in general means inability to resist perturbation. So for your body that means being unable to control movement or resist the forces placed upon it. There are two basic reasons why this might be the case:
- Something is broken or torn so a physical barrier has been lost – we call this structural instability
- Not enough strength, power, coordination etc to control movements – we call this functional instability
The functional instability pattern is that seen with various movements or tasks often in those who are not physically active. It is not specific to the direction of movement, and is often associated with muscle spasm.
It is important to state that currently, these are simply patterns seen in clinical practice. They are not diagnoses, nor are they scientifically validated classifications.
Symptom Checker
In addition to the patterns mentioned above, each pain type will have characteristic activities that usually cause pain, and potentially some that consistently reduce pain.
As mentioned, the flexion intolerant pattern usually feels worse from sitting or bending forward/lifting. It often improves from standing or walking or laying flat on your stomach. When there is leg pain it will most often go down the back of the leg potentially past the knee.
The extension pattern will feel worse standing or walking, or even laying flat on your back. It usually feels better sitting or even bending forward to do a toe touch. It will less often be associated with pain going further down the leg past the knee, and may have pain in the front of the hip or thigh.
The functional instability pattern will feel worse seemingly at random. Perhaps more often with sudden movements like quickly bending forward to pick something up, or quickly twisting to put on your seatbelt. This pattern may or may not have some dull pain in the thigh, but often is associated with back muscle spasm.
Matching Strategies to Pain Type
The strategies for each pattern will overlap in principle, but in practice they will be different, sometimes opposite. The positions and movements that will provide relief are typically the opposite of those that aggravate.
So for flexion intolerance, standing or walking will likely provide relief after sitting, stretching backwards into extension may provide relief after flexing.
For extension intolerance we see the opposite. Sitting down and even bending forward can provide significant relief, especially after standing or walking for long periods.
For functional instability, since there is often no specific ‘directional preference’ we don’t typically do the same ‘therapeutic exercises’ as with the other patterns. What we focus on is different types of stabilization exercises along with typical resistance and endurance training exercises and of course activity and lifestyle modifications.
The common thread between all of them, is after getting some relief you need to build up your tolerance to these things over time to prevent relapse. The only way to do this is through exercise. Resistance training is particularly helpful in this regard and is the modality we focus on in the LBPfix program.
Next Step Guide
If you want to try to work through your back pain on your own, the first step is to start keeping track. Relying on memory is not going to cut it over the long term. Do you even remember what you had for breakfast a few days ago?
Keep a journal or a note on your phone where you track pain levels, activity, sleep medications or other therapies or anything else you think is important. After a while you will start to notice patterns. You will notice that the days after certain activities, or during stressful periods at work are typically more painful. As the saying goes – what gets measured, gets managed.
Now you have the information needed to make a targeted intervention. Change the variable that seems to correlate most strongly with worsening pain and see what happens. Try to change one thing at a time for objectivity. The more things you change at once, the less confidence you can have in any one of them being a helpful change.
Here’s the tricky part – the 3 types of lower back pain usually overlap to some extent. It is pretty rare to have a textbook case of anything in the real world.
If you want to skip the trial and error, and get straight to the point – take the quiz to see if you qualify for the LBPfix program today. You will go through the self assessment and be categorized based on a series of tests to make sure you get the strategies that are most likely to work for you.
Our Framework: How LBPfix Can Help
1. Identify Your Pain Driver: We classify your pain into one of four movement intolerance types
2. Prescribe the Right Movement Strategy: Once we know your pain type, we match it with corrective movements
3. Build Long-Term Resilience: As pain settles, we help you:
Move confidently without flaring up
Rebuild core control and lifting mechanics
Return to work, sport, or life without setbacks
Ready to Fix Your Low Back Pain?
Take our 2-minute quiz to find out if you’re a good candidate to our program – no strings attached!
