Not necessarily… Most people I have dealt with who experience lower back pain have ‘problem’ positions. Let’s take the example of Kev.
Kev sits at a desk all day. When he’s sat his back is fine. When he stands his back hurts. Does he have a back problem? Not at all. Quite the opposite, arguably his back is the bit that IS working.
I assessed Kev and his lower back performed just fine. His hips however did not. So why does he get pain in the back when he stands and not in the hips? Well, the hips have lost range of motion, but are ‘stuck’ in positions that don’t cause him pain in normal life.
When Kev goes to stand up his hip joint should extend up to the ‘neutral’ position with zero degrees of flexion. In his case he can’t get there, his hips stop extending when he still has some degree of hip flexion. This would leave him bent over if his spine was in a good position. Now, nobody is going to walk around bent in half. What Kev and many other folk do is then hyperextend their lower back to compensate for the lack of hip extension. This compresses the lower back and then in turn can lead to back pain. Is the back therefore the problem? No, it’s doing the work the hip should be, the hip is the problem!
Now in reality these issues rarely exist in isolation so other things are likely to be needed to improve too in order to manage the problem. By simplifying it to one issue hopefully this illustration helps you see how back pain might well not be a back problem, and crucially instead of guessing what the problem really is why assessment is essential.
Legs straight, hips flexed, a position nobody would walk around in.
Legs straight, hips still flexed, core disengaged and lower back hyper-extended and posteriorly compressed to approximate a standing position. Although exaggerated in the photo this is a very common position that compromises lower back health.
Hips extended, spine neutral, standing position.