Your back may not be the only place you need to look.
When back pain shows up, most people immediately focus on the lower back itself. They may stretch their back, massage the painful area, or try to strengthen their core.
But sometimes, the areas below—or even in front of—the lower back can influence how your body moves and loads your spine.
Three commonly overlooked areas are the big toe, hips, and psoas muscle.
These areas don’t explain every case of back pain, and they aren’t necessarily the direct cause. However, when they are stiff, weak, or not moving well, they may influence movement patterns throughout the body.
Let’s take a closer look.
Start With Your Big Toe
It might seem strange to connect your big toe with your back, but your feet are your foundation.
Every time you stand, walk, climb stairs, or change direction, your feet help your body absorb and transfer force. Your big toe also plays an important role during the push-off phase of walking.
So, does your big toe move well?
A stiff big toe can make normal walking mechanics more difficult. One condition associated with limited big-toe movement is hallux rigidus, a form of arthritis that affects the big-toe joint.
If the joint is painful, swollen, or increasingly difficult to move, it’s worth having it evaluated by a qualified healthcare professional.
For people without significant pain or injury, gentle movement can be part of maintaining normal mobility.
One simple way to check your mobility is to sit comfortably and gently move your big toe up, down, and side to side without forcing it. Pay attention to whether the movement feels comfortable and unrestricted.
If the movement is significantly restricted or painful, don’t push through it. A podiatrist, physical therapist, or other qualified healthcare professional can help determine what’s happening.
Your feet may be the foundation, but your entire body works as a connected system.
Don’t Forget Your Hips
Your hips are designed to move. However, sitting for long periods, repetitive activities, previous injuries, or simply not moving through a full range of motion can contribute to stiffness.
Your hips work closely with your pelvis and lower back during everyday movements such as walking, bending, and rotating.
When hip mobility is limited, your body may compensate by asking other joints, including the lower back, to move differently.
One simple place to start is with gentle hip mobility.
A modified lunge or hip-flexor stretch can help you explore movement around the front and sides of the hip. You don’t need to force yourself into an extreme position. Instead, keep your movements slow and controlled, maintain a comfortable range of motion, and breathe normally.
If you need additional support, use a wall or stable surface for balance. Stop if you experience sharp or worsening pain.
You can also incorporate gentle hip rotation exercises into your routine.
The goal isn’t to stretch as far as possible. The goal is to move well.
The Psoas: A Muscle Worth Understanding
The third area is the psoas, a deep muscle located toward the front of the lower spine and pelvis.
The psoas is involved in movements of the hip and trunk and works with other muscles to help stabilize and control movement.
Because of its location, people sometimes refer to it as an important “bridge” between the upper and lower body.
But there’s an important distinction: tightness or discomfort in the psoas doesn’t automatically mean it’s causing your back pain.
Back pain can have many different causes, and trying to aggressively press or massage a deep abdominal area isn’t appropriate for everyone.
Instead, gentle movement may be a safer starting point.
Try a Gentle Half-Kneeling Stretch
Place one knee on a comfortable surface and the opposite foot in front of you.
Keep your torso upright and gently shift your pelvis forward until you feel a mild stretch around the front of the hip.
Don’t force the movement. Hold comfortably while breathing normally, then return to the starting position.
If you experience pain rather than a mild stretching sensation, stop and seek professional guidance.
What Do Your Toes, Hips, and Psoas Have in Common?
They all contribute to how your body moves.
Your body doesn’t operate as a collection of completely independent parts. Your feet interact with your knees, your knees interact with your hips, your hips interact with your pelvis, and your pelvis and trunk work together to control movement of your spine.
That doesn’t mean every back problem starts somewhere else.
It means that looking only at the painful area may not always give you the complete picture.
A good assessment considers the whole movement system.
Before You Blame Your Back, Look Beyond Your Back
If you’ve been dealing with back discomfort, it can be tempting to search for one muscle, one stretch, or one exercise that will “fix” everything.
Unfortunately, back pain is rarely that simple.
Factors such as physical activity, strength, mobility, posture, previous injuries, sleep, stress, work demands, and underlying medical conditions can all play a role.
That’s why the goal shouldn’t simply be to find something to stretch. The goal is to understand why you’re hurting and how your body is moving.
Start with gentle mobility and pay attention to how your feet, hips, and trunk move. If pain persists, worsens, or interferes with your daily activities, consider getting an individualized evaluation from an appropriate healthcare professional.
Your back may be where you feel the pain, but it may not be the only part of the story.
Move better. Understand your body. And don’t ignore the signals it’s giving you.
Important Disclaimer
This article is for general educational purposes only and is not intended to diagnose, treat, or replace professional medical advice. Back pain can have many causes. If you have severe, persistent, worsening, or unexplained pain, or symptoms such as weakness, numbness, changes in bladder or bowel function, fever, or significant injury, seek appropriate medical evaluation promptly.