Hypermobile Lower Back Pain? Strengthen, Don’t Stretch

Think of your spine’s ligaments as the steadying ropes that support a tall mast. If those ropes are too slack, the mast becomes wobbly and unstable. In your body, this instability forces your muscles to act like an emergency crew, constantly pulling and straining to keep everything upright. This is the core issue behind hypermobile lower back pain. The “tightness” you feel isn’t from shortened muscles that need stretching; it’s from exhausted muscles that are overworked. The solution isn’t to loosen the ropes further. Instead, you need to build a stronger structure around the mast. This article will show you how to shift your focus from flexibility to stability, building the muscular support your spine needs to stand tall without pain.

Key Takeaways

• Your pain comes from instability, not tightness: Hypermobile back pain is caused by excessive joint movement, which forces muscles to overwork for support. The key to relief is building strength to create stability, not stretching already flexible ligaments.
• Strengthening is the solution, not stretching: Focus on exercises that build a muscular “corset” around your spine, particularly your core and glutes. Be cautious with deep stretches and certain yoga poses that can increase instability and make pain worse.
• Pain management creates a path to progress: If pain prevents you from exercising, professional treatments can provide the relief needed to start a strengthening program. This approach addresses the immediate pain so you can build the long-term stability your back needs.

What is Hypermobile Lower Back Pain?

If you’ve ever been called “double-jointed” or you’re the most flexible person in your yoga class, you might be familiar with hypermobility. When this extra flexibility shows up in your lower back, it can cause a unique kind of discomfort. Unlike pain from stiffness, hypermobile lower back pain stems from your joints moving too much without enough muscle support to keep them stable. This lack of stability forces your muscles to work overtime just to hold you together, leading to strain, fatigue, and that nagging ache. Understanding that your pain comes from instability—not tightness—is the first step toward finding real relief. Instead of stretching already loose joints, the key is to build strength and support from the inside out.

What is Joint Hypermobility?

Joint hypermobility simply means your joints can move beyond the typical range of motion. For some people, it’s just a trait—they can easily touch their palms to the floor or bend their thumbs back to their forearm. For others, it’s associated with a condition like Ehlers-Danlos Syndrome (EDS) or Hypermobility Spectrum Disorder (HSD). Whether it’s an isolated characteristic or part of a larger diagnosis, the common factor is that the body’s connective tissues, like ligaments, are more pliable than average. This extra give in the joints means your muscles have to step up and do the work of providing the stability that ligaments normally would.

How Hypermobility Affects Your Spine

When you have hypermobility, the ligaments that connect your spinal vertebrae can be too lax. This creates what’s known as spinal hyper-mobility, where certain segments of your spine move more than they should. This excessive movement can make your back feel weak, unstable, or like it might “give out” at any moment. Your body’s awareness of its position in space, called proprioception, can also be reduced, making coordinated movements feel clumsy. To compensate, the muscles around your spine are forced to constantly contract to keep you stable, which can lead to chronic muscle fatigue and persistent back pain.

Common Myths About Hypermobile Pain

A few common misconceptions about hypermobility can get in the way of finding relief. One of the biggest is that if you’re hypermobile, back pain is just part of the deal. While hypermobility can be a contributing factor, it doesn’t guarantee a lifetime of pain. With the right approach focused on stability and strength, many people manage it very effectively. Another myth is that certain treatments are off-limits. The truth is, people with hypermobility often benefit greatly from specialized care. The key is working with a professional who understands the condition and can create a personalized treatment plan that avoids overstretching and focuses on building support where you need it most.

What Causes Hypermobile Lower Back Pain?

Hypermobile back pain is more than just being extra flexible. It’s a complex issue stemming from your body’s unique makeup, daily habits, and sometimes, underlying health conditions. Understanding where the pain comes from is the first step toward finding effective relief. It’s not about a single cause, but how different factors interact to create instability and discomfort in your lower back. Let’s look at the main contributors.

Genetic Factors and Connective Tissue

The tendency for hypermobile joints is often inherited. It’s linked to the makeup of your connective tissues—the “glue,” made of proteins like collagen, that holds your body together. If your connective tissue is naturally more pliable, your ligaments will be stretchier, allowing your joints to move beyond the typical range. This means your joints, including those in your spine, have less built-in stability. This can lead to chronic back pain as your muscles are forced to work overtime to keep your spine properly aligned.

Lifestyle and Environmental Influences

Your genetics might set the stage, but your lifestyle plays a leading role in whether hypermobility becomes painful. Many people with hypermobility have plenty of joint movement (mobility) but lack the muscle control and strength (stability) to support their spine. A sedentary job, inconsistent exercise, or focusing only on stretching can create a significant imbalance. When the small stabilizing muscles around your spine are weak, the larger muscles have to compensate. This constant overwork leads to fatigue, strain, and persistent joint pain. Your daily habits are key to managing hypermobility.

Related Conditions like Ehlers-Danlos Syndrome

For some, joint hypermobility is a primary symptom of a broader connective tissue disorder, like Ehlers-Danlos Syndrome (EDS) or Hypermobility Spectrum Disorder (HSD). These conditions are diagnosed when hypermobility is accompanied by other related symptoms. Chronic low back pain in people with HSD or hEDS (the hypermobile type of EDS) is often complicated. It involves more than just the spine; factors like chronic fatigue, balance issues, and how the brain processes pain signals also play a significant role. Getting an accurate diagnosis from a specialist is crucial for creating a treatment plan that addresses all these interconnected issues.

Do You Have Hypermobile Lower Back Pain?

Figuring out the root cause of your back pain can feel like solving a puzzle. If you’ve always been “flexible,” it might not occur to you that this could be related to your discomfort. Hypermobility in the lower back presents with a specific set of symptoms that distinguish it from other types of pain. Understanding these signs is the first step toward finding the right kind of relief—one that focuses on building stability, not just stretching. Let’s walk through some of the key indicators to help you determine if hypermobility might be what’s behind your lower

Key Symptoms to Look For

Does your lower back just ache for no apparent reason? Hypermobility often shows up as a persistent, localized ache or stiffness, especially after you’ve been sitting or resting for a while. You might also experience sharp pain when you try to lift something, bend over, or even just extend your back. Many people with hypermobile lower back pain also deal with frustrating muscle spasms as the surrounding muscles work overtime to protect the unstable joints. If you can point to a specific spot that hurts when you touch it, or if your back pain feels like a constant, dull throb, joint instability could be the culprit.

Neurological Signs and What They Mean

When your spinal joints are too mobile, they can sometimes shift enough to press on nearby nerves. This is often called a “pinched nerve,” and it can cause symptoms that travel far beyond your back. You might feel numbness, a “pins and needles” tingling sensation, or shooting pain that runs down your leg—all classic signs of sciatica pain. Some people even experience weakness in their leg muscles, making it feel difficult to stand or walk. These neurological signs are your body’s way of telling you that a nerve is irritated and needs attention before the issue becomes more serious.

When Your Symptoms Are a Red Flag

While most back pain can be managed with conservative care, some symptoms are red flags that require immediate medical attention. If your back pain lasts for more than 10 days without improving, it’s time to see a doctor. You should also seek help right away if your pain is accompanied by a fever, sudden weakness or numbness in your arms or legs, or any loss of bladder or bowel control. These can be signs of significant pressure on your spinal nerves. Getting a prompt and accurate diagnosis is crucial for creating a treatment plan that addresses the true cause of your pain and helps you get back to feeling your best.

How Doctors Diagnose Hypermobile Lower Back Pain

Figuring out if hypermobility is the source of your lower back pain requires a thorough and thoughtful approach. It’s not always something that shows up on a standard X-ray, which can be frustrating if you’ve been searching for answers. A proper diagnosis involves a combination of a detailed physical exam, specific assessment tools, and sometimes specialized imaging to see how your spine moves under pressure.

Getting an accurate diagnosis is the most critical step toward finding effective relief. Because hypermobility-related pain requires a different treatment strategy—one focused on building stability rather than increasing flexibility—pinpointing it early is key. A pain management specialist will look at the full picture, from your personal health history to a hands-on evaluation of your joints and movement patterns. This comprehensive process ensures your treatment plan is built on a solid foundation and tailored specifically to what your body needs. It’s about moving beyond guesswork and getting you on a clear path to feeling better.

What to Expect During a Physical Exam

The physical exam is where a skilled doctor can really get a sense of what’s happening in your lower back. During this part of your appointment, your doctor will likely ask you to move in certain ways to observe your range of motion. More importantly, they will use their hands to gently feel for movement between your spinal bones. An experienced specialist can often detect subtle instability or excessive motion that won’t show up on a typical imaging scan. This hands-on assessment is crucial because it provides direct feedback about how your joints are functioning, helping to confirm if hypermobility is contributing to your back pain.

Using the Beighton Score for Assessment

One of the common tools a doctor might use is the Beighton score, a simple 9-point system that measures joint flexibility throughout your body. You might be asked to bend your thumb to your forearm, hyperextend your elbows and knees, or place your palms flat on the floor with your legs straight. While this score is a helpful starting point for identifying generalized hypermobility, it’s not the final word. A high score doesn’t automatically mean hypermobility is causing your pain, and you can still have localized spinal hypermobility with a low score. It’s just one piece of a larger diagnostic puzzle that helps your doctor understand your body’s unique characteristics.

Imaging and Other Diagnostic Tests

While standard X-rays or MRIs of a hypermobile spine can sometimes appear normal, specific types of imaging can be very revealing. Your doctor may order flexion-extension X-rays, where images are taken while you bend forward and backward. This allows them to see how your vertebrae move in relation to one another and identify any instability that isn’t visible when you’re lying still. In some cases, diagnostic injections may be used to pinpoint the exact source of your pain. These tests help rule out other conditions and give your doctor a clear, dynamic picture of what’s happening in your spine when you move.

Why Strengthening Is Better Than Stretching for Hypermobile Backs

When your back hurts, the first piece of advice you often hear is to stretch it out. For most people, that’s a solid suggestion. But if you have joint hypermobility, that common wisdom can actually make your back pain worse. Your ligaments and connective tissues are already more flexible than average, which means your muscles have to work overtime just to keep your spine stable. Adding aggressive stretching to the mix can increase that instability, leading to more strain and discomfort.

The goal for a hypermobile back isn’t to become more flexible—it’s to become more stable. Think of it like building a strong internal support system for your spine. Instead of pulling on already loose structures, the focus should be on strengthening the muscles that hold everything together. This shift in perspective from flexibility to stability is the most important step you can take toward finding lasting relief. By building strength, you give your spine the support it needs to move correctly and without pain, helping you manage your condition and get back to your life.

The Problem with Overstretching

If you have hypermobility, your connective tissues are like well-worn elastic bands—they’re already quite long and don’t snap back into place as effectively as they should. When you stretch, you’re pulling on these already lax tissues, potentially making them even looser over time. This can worsen the instability in your lower back, forcing your muscles to work even harder to prevent your joints from moving into painful positions. While a gentle stretch might feel good in the moment, consistent overstretching can contribute to a cycle of chronic pain and instability. Instead of helping, it can actually undermine your body’s ability to support itself.

Tension vs. Tightness: What’s the Difference?

It’s common for people with hypermobility to feel like their back muscles are incredibly “tight.” But what you’re likely feeling isn’t true muscular tightness—it’s tension. Your muscles are constantly firing and working overtime to compensate for loose ligaments and stabilize your spine. They’re exhausted, not short and contracted. Stretching these overworked muscles might provide a brief sense of relief, but it doesn’t solve the underlying problem. In fact, it can make those muscles weaker and less capable of doing their job. Identifying the true source of your discomfort with procedures like diagnostic facet joint blocks can help create a more effective treatment plan.

Building Stability with the Right Exercises

The most effective way to manage hypermobile back pain is to build a strong, muscular “corset” around your spine. Strengthening exercises are your best friend here. By focusing on your deep core muscles, glutes, and back extensors, you create the internal stability your body lacks naturally. This muscular support takes the pressure off your ligaments and joints, allowing them to function without strain. A targeted strength program helps you regain control over your movements and reduces the risk of your joints slipping into painful ranges of motion. It’s a proactive approach that empowers you to manage your condition as part of a comprehensive set of pain management treatments.

The Best Strengthening Exercises for Hypermobile Back Pain

When your joints have extra range of motion, the goal of exercise shifts from flexibility to stability. Your muscles need to become the strong, reliable support system that your ligaments can’t be on their own. Think of it as building a natural corset around your spine to keep it protected and properly aligned. The right exercises will teach your body how to create and maintain this stability, not just in the gym, but through every movement you make during the day. It’s about building a foundation of strength that allows you to move with confidence and less pain.

Core Stability Exercises

Your core is more than just your abs; it’s the entire group of muscles that supports your trunk. This includes your diaphragm, pelvic floor, and the deep muscles in your abdomen and back. The first step in strengthening your core is learning how to engage these muscles together. Start with isometric exercises, like a plank or a bird-dog, where you hold a steady position. This teaches you to brace your core without movement. Once you’ve mastered that, you can progress to exercises that challenge you to keep your core stable while your arms or legs are moving. This builds the deep, functional strength needed to support your back pain throughout the day.

Glute Strengthening Moves

Your glute muscles are powerhouses for your entire lower body and play a huge role in supporting your lower back. When your glutes are strong, they help stabilize your pelvis and take a significant amount of strain off your spine during activities like walking, standing, and lifting. Building strength here means your back muscles don’t have to overwork to keep you upright, which can dramatically reduce muscle tension and pain. Simple but effective moves like glute bridges, clamshells, and bodyweight squats are excellent for targeting these muscles without putting your back in a vulnerable position. Consistently working on glute strength is one of the best things you can do for a hypermobile back.

Postural Stability Training

Building strong muscles is only half the battle; you also have to teach them how to work correctly during your daily life. Postural stability training is all about retraining your movement patterns to protect your spine. This means learning how to maintain a neutral spine and engage your core and glutes when you bend, lift, sit, and stand. It’s about breaking old habits that contribute to pain and replacing them with safer, more stable movements. Working with a professional who understands hypermobility can be incredibly helpful here, as they can provide personalized feedback and ensure you’re moving in a way that supports your body’s needs. Our team of specialists is experienced in identifying these patterns and helping you build better ones.

Exercises to Skip If You’re Hypermobile

This might be the most important tip: if you have hypermobile back pain, you should be very cautious with stretching. While it feels intuitive to stretch a sore back, for hypermobile individuals, it can actually make the problem worse. Stretching already-loose ligaments and muscles can increase instability in your spine. Be especially careful with deep forward folds, intense backbends, and certain yoga poses that push your joints to their end range of motion. The feeling of “tightness” you have is often your muscles working overtime to create stability, not a sign that they need to be stretched further. Instead, focus on the strengthening exercises that provide support. If you need guidance on what movements are safe, exploring professional pain management treatments can provide a clear path forward.

Lifestyle Tips for Managing Hypermobile Back Pain

Beyond specific exercises, your daily habits play a huge role in managing hypermobile back pain. Small adjustments to how you move, work, and rest can create a more supportive environment for your spine and reduce the frequency of flare-ups. The goal is to build routines that prioritize stability and minimize strain on your already flexible joints. Think of these tips not as a restrictive set of rules, but as a toolkit for living more comfortably. By making mindful choices throughout your day, you can take an active role in your pain management and build a foundation for long-term relief.

Daily Movement and Positioning Habits

If you have a desk job or spend long hours sitting, your body will thank you for frequent breaks. Try to stand up, stretch gently, and walk around for a few minutes every hour. When you have hypermobility, your joints can easily settle into unsupported positions, and prolonged sitting can make stiffness and pain worse. The key is to change your position often. Remember, the issue with hypermobility isn’t a lack of movement in your joints—it’s a lack of control. Focusing on maintaining gentle, active engagement of your core muscles throughout the day can provide the stability your spine needs to feel secure and reduce your overall back pain.

Setting Up Your Workspace and Home for Success

Creating an environment that supports your body can make a world of difference. Start with your workspace. An ergonomic chair with good lumbar support can prevent you from slumping and putting extra stress on your lower back. You might also find that using pillows or cushions helps you maintain a more comfortable and stable posture. This principle extends beyond your desk. Pay attention to how you move around your home. When you’re doing chores like loading the dishwasher or doing laundry, be mindful of your posture. Bend at your knees instead of your waist, and keep your core engaged to protect your back from unnecessary strain.

Improving Your Sleep and Recovery

A good night’s sleep is essential for muscle recovery and pain management. Finding a comfortable sleeping position is key. Some people with hypermobile back pain find relief by sleeping on their back with a pillow under their knees or on their side with a pillow between their knees. This helps maintain spinal alignment and reduces pressure on your joints. Beyond sleep, gentle daily activity is crucial for recovery. Activities like walking, swimming, or a modified Pilates routine can help build strength without over-stressing your joints. Consistent, low-impact movement helps your muscles provide the support your flexible spine needs to stay healthy and pain-free.

How to Lift and Move Mindfully

When you live with hypermobility, learning how to lift and move correctly is non-negotiable. Always engage your core muscles before you lift anything, no matter how light it seems. Keep the object close to your body and use the strength in your legs to lift, not your back. It’s also important to be cautious with activities that emphasize extreme flexibility, like certain types of yoga. While they may seem helpful, overstretching can destabilize your joints and make your pain worse. The most important thing you can do is build strength. Strong muscles act as a natural brace for your spine, providing the stability that your ligaments can’t. If lifestyle changes aren’t enough, various pain management treatments can offer additional support.

How We Treat Hypermobile Back Pain at Kentuckiana Pain Specialists

Living with hypermobile back pain means you need a treatment strategy that understands the root of the problem: instability. At Kentuckiana Pain Specialists, we don’t just treat the pain; we create a plan that helps you build strength and regain control. Our approach is built on the understanding that your body needs support, not just stretching. We focus on providing targeted relief that allows you to engage in the right kind of physical therapy and lifestyle adjustments for long-term success.

Dr. Nair and our team recognize that managing hypermobility is a collaborative effort. We see ourselves as a key part of your wider care team, working to reduce pain so you can focus on building a stronger, more stable foundation for your spine. We combine advanced, minimally invasive procedures with a deep commitment to personalized care, ensuring your treatment plan is tailored specifically to your body and your goals.

Advanced Injection Therapies

When you’re dealing with a severe flare-up of hypermobile back pain, the pain can be so intense that even thinking about exercise is impossible. This is where advanced injection therapies can make a significant difference. The goal isn’t to mask the problem, but to calm the inflammation and pain enough to create a window of opportunity for you to start rehabilitation. For these acute episodes, treatments like epidural steroid injections can reduce swelling and irritation around the nerves. Similarly, diagnostic and therapeutic facet joint injections can pinpoint and relieve pain originating from the small joints along your spine, giving you the relief needed to engage with physical therapy and build strength.

A Comprehensive Approach to Pain Management

Effectively managing hypermobile back pain requires a team effort. We know that the best outcomes happen when pain doctors, physical therapists, and other specialists work together. Our role at Kentuckiana Pain Specialists is to serve as the expert pain management part of your team. We focus on addressing the specific pain signals that are holding you back. Procedures like radiofrequency ablation can provide long-lasting relief by interrupting pain signals from irritated nerves, which is especially helpful for chronic joint pain associated with hypermobility. By managing the pain, we help you get the most out of your work with physical therapists and other healthcare providers, ensuring a truly comprehensive approach to your well-being.

Your Personalized Treatment Plan

There is no one-size-fits-all solution for hypermobile back pain. Your body, your symptoms, and your lifestyle are unique, which is why your treatment plan must be, too. We start by listening to you and conducting a thorough evaluation to understand exactly how hypermobility affects your spine. From there, we design a personalized plan that aligns with the core principle of strengthening, not stretching. Our treatments are designed to support your physical therapy goals, helping you regain function and learn to manage your condition effectively. Dr. Ajith Nair works with you to find the right combination of therapies to reduce your pain, allowing you to build core stability and improve your quality of life.

When to See a Specialist for Your Back Pain

Knowing when to manage back pain at home and when to call a professional can be tricky. While a few days of discomfort after a long drive or a tough workout is usually nothing to worry about, persistent or severe pain is your body’s way of telling you something isn’t right. Listening to those signals is the first step toward feeling better. If your back pain is interfering with your daily life, it’s time to get an expert opinion. A specialist can provide an accurate diagnosis and get you on the right path to recovery, which is especially important when dealing with issues like hypermobility.

Warning Signs to Take Seriously

Most backaches get better with a little time and self-care, but some symptoms are red flags that shouldn’t be ignored. If your back or neck pain lasts for more than a week or two, it’s a good idea to get it checked out. You should seek medical attention right away if your pain is accompanied by other concerning symptoms. These include fever, unexplained weight loss, or loss of bladder or bowel control. Also, pay close attention to any weakness, numbness, or tingling that travels down your arms or legs. These signs could point to a more serious underlying condition that needs immediate evaluation from a specialist.

The Importance of Early Intervention

It’s tempting to adopt a “wait and see” approach, hoping the pain will eventually go away on its own. But when it comes to back pain, especially chronic pain, delaying care can make the problem harder to manage down the road. Seeking treatment early often leads to better outcomes and gives you access to a wider range of treatment options. Getting an accurate diagnosis sooner rather than later can help you avoid complications and prevent acute pain from settling in and becoming a chronic issue. Think of it as being proactive—addressing the root cause now can save you a lot of discomfort in the long run.

Why Your Treatment Plan Needs to Be Different

If you have hypermobility, your approach to treating lower back pain needs to be different from standard protocols. A generic treatment plan that works for others might not work for you and could even make things worse. Because hypermobility involves excess movement in your joints, your treatment must focus on building stability and strength, not just stretching. A pain management specialist will create a personalized treatment plan tailored to your unique body. This plan will address the specific needs of your hypermobile spine, helping you regain function and manage your condition effectively for lasting relief.

Related Articles

• Pain in Lower Back on Both Sides of Spine: Key Causes
• Degenerative Joint Disease Back Pain Explained
• 10 Ways to Relieve Severe Lower Back Pain Fast

Frequently Asked Questions

If stretching is bad for my hypermobile back, does that mean I have to give up yoga? Not necessarily, but you will need to change your approach. The goal is to use yoga to build stability, not to push your flexibility. This means focusing on poses that strengthen your core and glutes while being very mindful not to lock your joints or sink into deep stretches. You might need to modify certain poses, shorten your range of motion, and actively engage your muscles to support your joints. It’s about shifting your mindset from “how deep can I go?” to “how stable can I be?”

Can treatments like injections or radiofrequency ablation cure my hypermobility? These treatments are not designed to cure the underlying hypermobility, which is a trait of your connective tissue. Instead, their purpose is to manage the pain that results from it. By significantly reducing inflammation and interrupting pain signals, procedures like facet joint injections or radiofrequency ablation can provide a crucial window of relief. This relief makes it possible for you to effectively engage in the strengthening exercises and physical therapy needed to build long-term stability and control.

My back muscles feel incredibly tight. Are you sure I shouldn’t be stretching them? This is one of the most common points of confusion, and it makes perfect sense why. What you’re feeling is muscular tension, not true tightness. Your muscles are working overtime, constantly contracting to provide the stability your looser ligaments can’t. They’re exhausted and strained from this constant effort. Stretching them might offer a brief moment of relief, but it doesn’t address the root cause and can actually increase instability, forcing those muscles to work even harder later. The real solution is to build strength in your deeper stabilizing muscles so the bigger ones can finally relax.

How do I know if my back pain is from hypermobility or something else? While this post can offer some clues, the only way to know for sure is to get a thorough evaluation from a specialist. A doctor experienced in this area will perform a hands-on physical exam to assess the movement between your spinal bones, which often reveals instability that doesn’t show up on a standard MRI. They will also consider your overall joint flexibility and listen carefully to your specific symptoms to distinguish hypermobility-related pain from other common causes of back pain, like a disc herniation or arthritis.

Is this a condition I’ll have to manage for the rest of my life? Hypermobility is a characteristic of your body, so in that sense, it is a lifelong trait. However, that does not mean you are destined for a lifetime of pain. With the right approach focused on building strength, improving posture, and making mindful lifestyle choices, many people learn to manage their hypermobility so effectively that it no longer causes them significant problems. It’s about learning to work with your body’s unique needs to build a strong, stable foundation that keeps you active and comfortable.