Spinal Flexion and and Low Back Pain

Bending over into hip and spinal flexion
Bending over into hip and spinal flexion. Andy Reynolds/Collection:The Image Bank/Getty Images

Believe it or not, the movements you take your spine through (or don't if you're stiff) have names These names are based on the directions into which your spine goes. They are: Flexion, or bending forward, extending (aka arching backward), side bending, which you may know as tilting, and rotation, which is the same as twisting.

In this article we'll talk about spinal flexion, including what it may mean to your back's health.

Spinal Flexion - Definition

A familiar movement for most of us, spinal flexion is the act of bending forward. It's the position that brochures and websites about lifting or gardening tell you not to use. This is because it can affect your intervertebral discs, including causing an injury to one or more of them. Just the same, spinal flexion is one of the 4 basic back moves.

As far as day to day habits are concerned, gravity has the tendency, incrementally over time, to compress the spine. In turn, this may lead to a posture in which your spine is more flexed than upright on a regular basis.  Sitting at the computer, driving and carrying children are examples of the activities that lend themselves to this type of spinal misalignment.

have the tendency to incrementally pull the spine forward into flexion. This can happen over time, and unless you are very astute about your posture, you might not even notice it until it starts getting extreme, or it results in pain or injury.

Spinal Flexion and its Relationship to Posture, Injury and Pain

Spinal flexion can contribute to postural imbalances including kyphosis, scoliosis and sway back. In these conditions, the spinal flexion is what they call a "saggital" component. Saggital refers to movement into the forward or back directions.

And, as I mentioned above, if your spine is constantly in flexion, it may set you up for a herniated disc injury. Herniated disc occurs when the annulus fibrosus of the spinal disc (cushion in between vertebrae) frays or breaks, and the liquid center (nucleus pulposus) squirts out. If the nucleus pulposus lands on a spinal nerve root, which it often does, you'll llkely experience pain and other nerve symptoms, which are known as radiculopathy.

Herniated disc injuries sometimes get better without surgery, but it can take a year or so. In this case, the symptoms tend to dissipate once the disc is resorbed into the body, which, again, takes time.  Physical therapy can help manage the pain while you wait, should you decide to go this route. 

But many people want a quicker fix than that, so they opt for a discectomy surgery.

Spinal Flexion and Spinal Stenosis

In some cases, extra spinal flexion is desired. For example, if you spinal stenosis, you may experience the classic symptom of neurogenic claudication. Generally, get your spine into a flexed position helps relieves pain and cramping that are associated with neurogenic claudication. The best way to use this bit of knowledge, though is to consult with a physical therapists.

Prevent Back Problems Related to Spinal Flexion

The easiest way to prevent back problems due to spinal flexion is to keep your back and core both flexible and strong. Studies show that people with low back pain often move proportionately more in their upper back (as compared to the lower) during very basic activities such as walking or bending over to pick something up.

A back exercise program should help you do this. In particular, yoga and Pilates not only strengthen muscles but they also develop your spinal alignment. With these systems, you'll exercise your back in all the directions your spine can move.

They emphasize balanced action and whole-body alignment to help bring your posture into neutral. Incorporating them into your regular routine may well help you reduce pain and increase back flexibility.

Working in balance and alignment means that some of the strength exercises are done with your back arched and/or twisted. Because arching, and to some degree twisting, are opposite actions to spinal flexion, such exercises may counter any tendency toward spinal flexion and thereby reduce associated risks to your back.

NOTE: There are some spinal conditions such as arthritis, facet joint problems and others that may be irritated by arching and/or twisting your back. And twisting may irritate a herniated disc, as well. If you are unsure about your symptoms, ask your doctor or physical therapist for back exercises that are appropriate to your particular condition.


Elnaggar IM, Nordin M, Sheikhzadeh A, Parnianpour M, Kahanovitz N. Effects of spinal flexion and extension exercises on low-back pain and spinal mobility in chronic mechanical low-back pain patients. Spine Aug. 1991. http://www.ncbi.nlm.nih.gov/pubmed/1835157

Gombatto, S., Brock, T., DeLork, A., Jones, G., Madden, E., Rinere, C. Lumbar spine kinematics during walking in people with and people without low back pain. Gait Posture, Oct. 2015. https://www.ncbi.nlm.nih.gov/pubmed/26380913