Understanding the Hidden Cause of Back Pain Does your lower back hurt without any clear reason? You might think it is because of bad posture or lifting something heavy. But the real problem could be hiding in a different place. A deep muscle in your hip called the psoas (pronounced “so-ezz”) might be causing all your back pain. Many people in Nepal and around the world suffer from lower back pain. They try different treatments but nothing works. This is because they are treating the wrong area. The answer might be in your hip flexors, not your back. What is the Psoas Muscle? The psoas is a special muscle that runs from the top of your thigh bone, over your hip, and up to your lower spine and ribs. It is like a long ribbon inside your body. This muscle is part of a bigger group called the iliopsoas complex. What makes the psoas so important? It is the only muscle in your body that connects your rib cage to your leg. This means it plays a huge role in almost everything you do. When you sit, stand, walk, or bend, your psoas muscle is working. The psoas also helps keep your lower back stable and your body balanced. It even connects to your breathing muscle through a tissue called fascia. This means the psoas links breathing and walking together. Why Does the Psoas Cause Back Pain? When your psoas muscle becomes tight or weak, it can pull on your spine. This creates pain in your lower back, hips, or groin area. The pain might feel like a deep ache where your buttocks meet your back.Sitting for long hours is the biggest problem. Research shows that people sit for more than 10 hours each day on average. When you sit, your psoas stays in a shortened position. Over time, this makes the muscle tight and weak at the same time. After you turn 30 years old, you naturally lose 4 to 6 percent of your psoas muscle every ten years. Men over 60 lose it even faster. This does not mean you cannot do anything about it. With the right exercises and changes, you can make your psoas strong again. How Sitting Hurts Your Psoas Think about your daily routine. You might sit while eating breakfast, sit during your commute, sit at work or school, and sit while watching TV at night. Your psoas muscle stays in a bent position for most of the day. When the psoas is tight, it pulls on both ends where it attaches. This changes how your pelvis lines up with your spine. The result is strain and stress on your lower back. The pain you feel might not actually come from your back at all. Many people also tighten their stomach muscles without knowing it. They do this because they expect pain or want to protect themselves. This constant tightening puts even more stress on the hip flexors.Your kidneys sit right on top of the psoas muscle. Your brain wants to protect these important organs. So the tissue around the psoas might get extra tight, adding more tension to the area. How to Know if Your Psoas is the Problem Lower back pain from the psoas has specific signs. The pain is usually a deep ache at the border between your buttocks and back. The pain might get worse when you sit still. It often feels better when you move around. A doctor or physical therapist can do a simple test called the Thomas Test. This test shows which part of your hip flexor is tight. If moving makes no difference to your pain, the problem might be with an organ inside your body instead of a muscle. Simple Ways to Help Your Psoas You cannot fix years of sitting in just one day. If you have worked at a desk for 10 or 20 years, you will need many weeks or months of stretching and strengthening. But do not worry, you can start feeling better soon. Foam Rolling for Quick Relief Foam rolling is a simple way to start feeling better. Roll along your spine, hip flexors, thighs, and the sides of your hips. For smaller areas, use a tennis ball. This helps relax tight muscles and the tissue around them. Change How You Sit and Sleep Stop hunching over your desk. Do not keep your stomach tight for long periods. When you tighten your abs, you pull the front of your pelvis up. This pushes your spine back and rounds your lower back. Your psoas ends up in a shortened position. Do not just replace sitting with standing all day. The key is to avoid staying in any position without moving. Get up and walk around every hour. A standing desk can help, but only if you still move regularly. Think about how you sleep too. If you sit all day at work and then sleep on your side, your psoas stays in a chair position for up to 18 hours out of every 24 hours. Try sleeping on your back. If this hurts, put pillows under your knees to make it more comfortable. Stretching and Mobility Work Before you make your muscles stronger, you need to make them more flexible. Start with gentle stretches. Try pulling one ankle toward your buttocks while standing. Keep your pelvis in a neutral position. You can also do lunges. Yoga poses work very well for the psoas. Try the cat and cow poses. The 90/90 stretch is also helpful. These movements improve how well your joints can move. Building Strength Once you can move better, start making your psoas stronger. Most people never train their hip flexion movements. But the psoas can become very strong if you work on it. Try seated leg lifts. Lift your knee while sitting in a chair. You can also do standing marches. Lift your knees high as you walk in place. Flutter kicks are another good exercise. Lie

As the cold season arrives in Nepal, many people notice something familiar: their lower back starts to hurt more. From December to February, when temperatures drop to 2°C in Kathmandu and even lower in the hills, back pain becomes a common complaint. But is winter really to blame? Let’s look at what research tells us. What Does Science Say About Weather and Back Pain? You might be surprised to learn that scientific research shows that common weather factors like rain, humidity, wind, air pressure, and temperature changes do not actually increase the risk of getting a new episode of low back pain.  A major study looked at nearly 1,000 people with new back pain and found no strong link between weather changes and when their pain started. This finding goes against what many people believe. So why do so many of us feel like our back hurts more when it gets cold? Why Your Back Might Feel Worse in Winter Even though weather doesn’t directly cause back pain, there are real reasons why winter makes existing back pain feel worse. Cold makes your joints stiffer When temperatures drop, something happens inside your joints. The liquid that covers your joint surfaces, called synovial fluid, becomes thicker in cold weather, which can make movement harder and joints feel stiff and painful. Think of it like oil in a machine. When it’s cold, it doesn’t flow as smoothly. Your muscles tighten up In Nepal’s winter, when temperatures in Kathmandu range from 2°C to 12°C, your body tries to keep warm by tightening your muscles. This natural response means the muscles around your spine become tense and stiff. When muscles are tight for a long time, they can start to hurt and are more likely to get strained. Blood flow to your muscles also decreases in cold weather. Less blood flow means less oxygen and nutrients reaching your muscles, making them even stiffer. We move less in winter Let’s be honest.  When it’s cold outside, don’t you just want to stay under your warm blanket? Most of us become less active in winter. We stop our morning walks, skip exercise, and spend more time sitting or lying down. This lack of movement is actually one of the biggest problems. When you don’t exercise regularly, your back muscles become weak. Weak muscles cannot support your spine properly, leading to more pain and a higher risk of injury. Low vitamin D levels Research has found a connection between low vitamin D levels and painful joint and muscle conditions. During winter in Nepal, we get fewer daylight hours and spend less time outside. This means our bodies make less vitamin D, which might make back and joint pain feel worse. Winter activities can hurt your back In some parts of Nepal, winter activities like carrying heavy loads, poor posture from hunching to stay warm, or slipping on icy paths can lead to back injuries. Even simple activities done with cold, stiff muscles are more likely to cause strains. What You Can Do to Feel Better The good news is that you can take steps to reduce back pain during winter. Keep yourself warm This is the simplest and most important thing you can do. Wear layers of warm clothing, especially around your lower back. Tuck your shirt into your trousers to prevent cold air from reaching your back when you bend. At night, use extra blankets or a hot water bottle to keep your muscles from tightening. Stay active Yes, it’s hard to exercise when it’s cold, but staying active is one of the best ways to prevent back pain. You don’t need to go outside. Try these indoor activities: Simple stretching exercises when you wake up Walking around your house or courtyard Indoor exercises like yoga or basic strength training Climbing stairs   Even 15-20 minutes of gentle movement daily can make a big difference. Movement keeps your joints flexible and your muscles strong. Apply heat to sore areas Heat helps blood flow to your muscles and makes them relax. Use a hot water bottle, warm towel, or heating pad on your lower back for 15-20 minutes when it hurts. Taking a warm bath or shower can also help ease muscle tension. Eat well and stay hydrated It’s easy to forget to drink water in winter, but staying hydrated helps your spine stay healthy. Drink plenty of warm water, tea, or soup throughout the day. Foods rich in omega-3 fatty acids, like fish, nuts, and seeds, can help reduce inflammation. Also try to eat foods with vitamin D, such as eggs, milk, and fortified foods. Watch your posture When you’re cold, you might hunch over without realizing it. This puts extra strain on your back. Try to stand and sit straight, with your shoulders relaxed and your spine aligned. Get some sunlight On sunny winter days in Nepal, spend at least 15-30 minutes outside in the sun. This helps your body make vitamin D and also lifts your mood, which can help with pain. When to See a Doctor Most back pain gets better with these simple steps. However, you should see a doctor if: Your pain is very severe or getting worse Pain travels down your leg You have numbness or tingling You have trouble controlling your bladder or bowels The pain doesn’t improve after a few weeks   The Bottom Line While winter weather itself doesn’t cause new back pain, it can make existing pain feel worse. The good news is that you have control over many of the factors that matter most: staying warm, keeping active, and taking care of your body. Don’t let winter keep you from moving. Your back needs movement to stay healthy, even when it’s cold outside. With these simple steps, you can enjoy the beautiful winter season in Nepal with less pain and more comfort. Remember: winter in Nepal may be cold, but it doesn’t have to mean months of back pain. Stay warm, stay active, and