Part of Golf injuries: where they land and what the rates mean
Golf back pain: what the swing does and does not explain
Warning signs, and when to get help
How common is this, really?
Common enough that it is the defining golf complaint. In 303 UK golfers surveyed retrospectively, the lower back had the highest incidence of any site at 9.94 injuries per 1,000 hours, with a confidence interval of 7.48 to 13.22, and a mean time loss of 54 days before full recovery with a standard deviation of 89 days (Williams and colleagues, 2025). That standard deviation is the part worth noticing. Some golfers lost a fortnight and some lost most of a season.
The prevalence figures move around a lot, and knowing why stops you being misled by whichever one you meet first. A review of 19 studies reported cross-sectional prevalence of golf-related low back pain from 12.4 percent to 26.9 percent in recreational golfers and 40.0 percent to 58.1 percent in professionals, and said plainly that it was unclear whether those figures described pain at one moment, over a year, or over a lifetime. Its two longitudinal studies gave 31.6 percent in novice recreational golfers and 57.1 percent in young elite golfers over a year or a season (Smith and colleagues, 2018).
An older review frames it differently again, putting low back conditions at approximately 25 percent of all golf injuries with reported rates from 18.2 percent to 54 percent (Lindsay and Vandervoort, 2014). All of those are true statements about different groups of golfers. None of them is your chance of getting back pain this season.
Is the golf swing bad for your back?
A golf swing is a fast rotation with side bending and extension in it, repeated at speed, with the spine finishing in a position it does not visit anywhere else in daily life. That much is not in dispute. What is in dispute, and much less settled than the coaching content suggests, is whether a particular way of doing it brings the pain on.
The review that looked hardest at this says so in its own words. Having pooled 19 studies, 12 of them case-control, 5 cross-sectional and 2 prospective longitudinal, Smith and colleagues concluded that there is no clear evidence regarding swing mechanics and the development of low back pain in golfers (Smith and colleagues, 2018). On the two mechanisms that get named most often, the crunch factor did not differ significantly between golfers with and without back pain in either of the two studies that measured it, and the two X-factor studies disagreed with each other.
So when a coaching article tells you that reverse spine angle is the number one cause of lower back pain in golf, what you are reading is a plausible mechanical story rather than a finding. It may still be worth fixing for your golf. It has not been shown to be the explanation for your pain, and treating it as a settled one can cost you a season of swing changes while the things that do predict pain go untouched.
What actually predicts golf back pain
What came out of the pooled analyses is duller than any swing fault, and a good deal more useful.
Increasing age and higher body mass were both significantly associated with golf-related low back pain. The mean age of the recreational golfers in the pooled data was 51.5 years, which is a reminder of who this research is about. And the prospective data pointed to a previous history of back pain as the strongest single predictor of future episodes, with the review naming one high-quality longitudinal study for that result (Smith and colleagues, 2018).
Read together, those say that golf back pain is mostly back pain that happens to golfers. If you have had episodes before, you are the person most likely to have another one, and golf is the activity that will reveal it. That is not a reason to give up the game. It is a reason to treat your back as something you maintain between rounds rather than something you only think about when it hurts.
There is one finding that gets misquoted more than any other here. Limited hip rotation does change how a spine moves during a swing: in 30 asymptomatic professional golfers, all off scratch, the group with less than 20 degrees of hip internal rotation showed greater lumbar flexion, greater rotation to both sides, greater side bending and more pelvic posterior tilt during the swing than the group with 30 degrees or more (Kim and colleagues, 2015). Every one of those golfers was pain free and a professional. When the same question was asked of pain, pooling four studies of hip range of movement found no association with low back pain at all, in either hip and in either direction of turn (Smith and colleagues, 2018). The honest version is on golf mobility, and it reads the same there as here: limited hip rotation changes how your spine moves, it has not been shown to cause your pain, and the asymmetry between your sides has more support behind it than the absolute number on either side.
Why does it hurt on one side?
Because you only swing one way. Golf's injury patterns are not symmetrical, which is why the 2020 international consensus statement recommends recording the injured side and the golfer's handedness, and defines the lead side as the left in a right-handed golfer (Murray and colleagues, 2020).
In practice, golfers describe two moments. Pain at the top of the backswing, usually felt on the trail side, and pain at the end of the follow through, where the lead side has taken the weight and the spine has side bent away from the target. Noticing which of the two it is gives a physiotherapist something concrete to work with.
One-sided back pain is not a golf diagnosis though, and some of its causes have nothing to do with sport. Lower back pain on one side sets out the range, and lower back pain when bending forward is the page for the version that shows up as you reach into the hole.
Can I keep playing golf with back pain?
Usually, with the volume turned down, provided none of the warning lines on this page apply to you. Stopping completely is rarely the best option, and it is not what national back pain advice recommends for most people.
What works is removing the biggest loads first and keeping the game. The practice balls go before the round does, since 60 full swings at a mat in half an hour asks more of a spine than 18 holes spread over four hours. A trolley or a cart replaces a carry bag, because carrying the bag was reported as hazardous to the lower back in a study of 703 golfers (Gosheger and colleagues, 2003). Nine holes replaces eighteen for a few weeks, and putting and chipping stay in, because they ask almost nothing of the spine while keeping you playing.
Then let the next morning be the judge. Stiffness that eases in the first hour is ordinary. A back that is clearly worse the day after means the dose was too high whatever it felt like on the course. Pain that has begun traveling below the knee, or new numbness, tingling or weakness in the leg, is a different matter: stop playing and get it assessed rather than only cutting the volume.
Where the exercises and the dose live
This page is about golf and your back. It is not the program, and splitting the two is deliberate: the exercise selection, the sets, the repetitions and the progression sit on the low back pain program, where they are staged and where your physio will adjust them to you. Treat anything on this page as context for that program rather than a substitute for it.
When back pain is serious goes through the warning signs in more detail than a list can, and exercises to avoid with back pain covers the movements people add in a hurry and regret. If you have had spinal surgery or a spinal injection, follow your surgical team's plan first and ask them before adding anything here.
What to do about the week, not the swing
The fortnight before a flare almost always contains the explanation, so start there. Count the rounds, the range sessions and the balls, and look for the jump rather than the total.
Then build the two jobs that are not golf into the week. The weekly mobility work for the hips and mid back sits on golf mobility, and the ten minutes before you tee off sits on the golf warm up. They are separate tasks and doing one does not cover the other. The shape of the sport, and where your complaint sits among the others, is on the golf hub.
Strength work has a place too, and it is a longer game than either. Nobody has run the trial that would tell you how much it lowers the risk of golf back pain, so it is offered here as general practice rather than as a golf finding.
When to see a physio
Book when the same back pain has lasted two weeks, when it returns every time you play two days running, or when you have started changing your swing or your schedule to avoid it. Bring your handedness, the side, the moment in the swing where it bites, and the fortnight before it began.
A physiotherapist, or a physical therapist in the United States, will usually spend most of a first appointment watching you move rather than pressing on the sore spot, and will want to know what your spine does under rotation rather than how far it bends forward. Read the warning list below before your next round, and follow the timing each line sets rather than waiting to see how the back feels on Saturday.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: if chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
- Emergency: numbness, tingling or altered feeling around or under your genitals, between your inner thighs, or around your bottom (anus), for example it feels different when you wipe after using the toilet. Call emergency services or go to an emergency department straight away, and do not drive yourself. This can be a sign of pressure on the bundle of nerves at the base of the spine (cauda equina syndrome), which needs emergency treatment.
- Emergency: you find it hard to start peeing, cannot pee, cannot feel yourself peeing or cannot control when you pee, or you do not notice when you need to poo or cannot control when you poo, and this is not normal for you. The same applies to a new change in how your genitals feel during sex, new trouble getting or keeping an erection, new trouble ejaculating, or new trouble reaching orgasm. Call emergency services or go to an emergency department straight away, and do not drive yourself. These can also be signs of cauda equina syndrome.
- Emergency: sciatica in both legs, or pain, tingling, numbness or weakness in both legs. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away, and do not drive yourself.
- Emergency: back or leg pain that started after a serious accident, such as a car crash or a fall from a height, or back pain with chest pain. Call emergency services. If the pain started straight after the accident, keep still while you wait.
- Emergency: sudden, severe pain in your lower back or tummy that is not like your usual back pain, if you have been told you have a swelling of the main blood vessel in your tummy (abdominal aortic aneurysm), you are over 60, you smoke or used to smoke, or you have high blood pressure. The same applies if sudden, severe back or tummy pain comes with feeling faint or passing out, pale, sweaty or clammy skin (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), a racing heartbeat or being short of breath. Call emergency services straight away. This can be a sign of an aneurysm bursting, which needs treatment in hospital at once.
- Emergency: new neck or back pain after a fall, a knock or a jolt, even a minor one such as a trip or a sudden stop in a car, if you have a condition that stiffens the spine, such as ankylosing spondylitis. Call emergency services or go to an emergency department straight away, do not drive yourself, and tell the staff about your spine condition, so they keep your neck and back in their usual position. A stiff spine can break after a small injury, and the break is easy to miss at first. If the pain started straight after the injury, or you also have numbness, tingling or weakness in your arms or legs, keep still and call emergency services.
- Emergency: back pain with a fever, or you feel hot, shivery or very unwell, and you also have new weakness, numbness or tingling in one or both legs, or new trouble with your bladder or bowels. Call emergency services or go to an emergency department straight away, and do not drive yourself. This can be an infection pressing on the nerves in the spine (spinal epidural abscess), which needs emergency treatment.
- Emergency: you have had cancer, now or in the past, and your back or neck pain feels like a tight band around your body, or you have new or worsening pain spreading down an arm or leg, weakness, numbness, pins and needles or a loss of feeling in your arms or legs, trouble walking, or trouble controlling your bladder or bowels. Those symptoms count on their own, with or without back or neck pain. Call your cancer team's emergency number straight away, or go to an emergency department if you do not have one or cannot get through, and do not drive yourself. This can be cancer pressing on the spinal cord (metastatic spinal cord compression), which needs treatment straight away.
Get help today
- Same day: a leg or foot that is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop). Get medical advice the same day. If the weakness is getting worse by the hour, go to an emergency department.
- Same day: back pain after a minor fall or strain if you are older, have low bone density (osteoporosis) or have taken steroid tablets for a long time. Get medical advice the same day. Until it has been checked, stop the exercises and keep away from lifting, bending forward and twisting, because those load a bone in the spine that may be broken.
- Same day: back or leg pain with a fever, or you feel hot, cold, shivery or generally unwell. Get medical advice the same day, and go to an emergency department if you feel very unwell.
- Same day: you have back pain and have lost weight without trying. Get medical advice the same day and mention the weight loss.
- Same day: new back pain and you have had cancer, now or in the past. Get medical advice the same day and mention your cancer history. If you are being treated for cancer now, contact your cancer team the same day.
- Same day: pain that is worse at night, or does not ease at all when you rest. If you have had cancer, now or in the past, or you have lost weight without trying, get medical advice the same day.
- Same day: severe pain that comes on suddenly or is getting worse quickly. Get medical advice the same day.
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
Book an appointment
- Within a few days: pain that is worse at night, or does not ease at all when you rest. See your doctor within a few days.
- Within a week or two: back or buttock pain that started before the age of 45, has lasted more than three months, is worse after rest and in the morning, and eases when you move. This is not an emergency, but see your doctor in the next week or two and ask whether it could be inflammatory back pain (axial spondyloarthritis).
- Routine: back pain that comes from the top of your back, between your shoulders, rather than your lower back, and has not been checked, or back pain that is worse when you sneeze, cough or poo, or comes with a lump or swelling, or a back that has changed shape. Book an appointment with your doctor, as the NHS advises, and have it checked before you start this program. If the pain came on suddenly, get medical advice the same day.
Common questions
Why does my back hurt after golf?
Usually because a spine that was already sensitive met four hours of walking, 60 to 120 fast rotations and a few dozen practice balls in one afternoon. The research supports that reading better than it supports a technical fault: the pooled data in a review of 19 studies found golf-related low back pain associated with increasing age and body mass, and the prospective studies in it pointed to a previous history of back pain as the strongest predictor of future episodes (Smith and colleagues, 2018). Reviews put the lower back at roughly a quarter of all golf injuries, with reported rates from 18.2 percent to 54 percent (Lindsay and Vandervoort, 2014). The practical consequence is that the useful changes are usually to the week rather than to the swing. Fewer balls, a trolley instead of a carry bag, and a gap day after a round do more than any single drill.
Can I keep playing golf with back pain?
Most people can, in a reduced form, as long as none of the warning signs on this page apply. The NHS advice for back pain generally is to keep moving and carry on with your normal activities as far as you can, and a round of golf that has been trimmed is closer to that than a fortnight on the sofa. A fair trial looks like nine holes with a trolley instead of eighteen with a carry bag, no practice balls, and putting and chipping instead of a full range session. Judge it by the next morning rather than by how it felt at the time: a back that is stiff for an hour and then settles tells you the dose was about right, and a back that is worse the next day tells you it was not. If you cannot get through nine holes, or the pain is spreading down a leg, book an assessment rather than experimenting for another month.
Is the golf swing bad for your back?
It loads a lumbar spine hard, which is a different claim from the specific swing faults being proven causes. Two studies measured the crunch factor, the combination of side bending and rotation at the top of the follow through, and neither found a significant difference between golfers with and without low back pain. Two more measured the X-factor, the separation between shoulders and hips, and they conflicted with each other. Pooled trunk extension range of movement gave a standardized mean difference of 3.2 with a confidence interval running from 2.6 below zero up to 9.0, and an I squared of 98 percent, which is a non-result built on studies that disagreed almost completely (Smith and colleagues, 2018). None of that means your swing is irrelevant to how your back feels, only that nobody has shown that changing it prevents or fixes the pain, which is why it does not belong at the top of the list.
Why does my back hurt on one side?
Because golf is asymmetrical, and your spine knows which way you turn. The 2020 international consensus statement says golf's injury patterns are non-symmetrical and recommends recording both the side and the golfer's handedness, with the lead side being the left in a right-handed golfer (Murray and colleagues, 2020). Most golfers with one-sided pain describe it on the trail side at the top of the backswing or at the end of the follow through. What it does not tell you is the cause, and one-sided back pain has a wide range of explanations that have nothing to do with golf, which is why lower back pain on one side exists as a separate page. Tell whoever assesses you which hand you play with, since left-handed golfers are routinely assessed as though they were right-handed.
Does my swing need changing?
Possibly, for your golf. Not as a treatment, because no trial has shown that a swing change prevents or resolves back pain. One review proposed a swing that keeps the spine more stable through the shot as a way of reducing load, and presented it as reasoning from the mechanism rather than as a tested treatment (Lindsay and Vandervoort, 2014). A coach can make your swing better and more repeatable, which has value on its own and may well make a sore back feel better. Just do not spend six months on a swing rebuild while leaving your playing volume, your sleep and your strength work untouched, because those are the levers with evidence behind them.
How many rounds a week is too many for a back?
No study gives a number for a back specifically. The nearest thing is a meta-analysis of 20 studies and 9,221 golfers, in which two of the included studies reported greater injury risk in amateurs playing more than three and more than four rounds a week, and which also found professionals significantly more likely than amateurs to report a lower back injury, with a relative risk of 3.05 (Williamson and colleagues, 2024). Read that as volume mattering, not as a limit. What tends to flare a back is the jump: two rounds a week for a year is usually fine, and going from one to four in April is usually where the trouble starts.
References
- Smith JA, Hawkins A, Grant-Beuttler M, Beuttler R, Lee SP. Risk factors associated with low back pain in golfers: a systematic review and meta-analysis. Sports Health. 2018;10(6):538-546. https://doi.org/10.1177/1941738118795425
- Lindsay DM, Vandervoort AA. Golf-related low back pain: a review of causative factors and prevention strategies. Asian Journal of Sports Medicine. 2014;5(4):e24289. https://doi.org/10.5812/asjsm.24289
- Williams A, Murray A, Sorbie GG. Epidemiology of injuries in UK based golfers: a retrospective study. The Physician and Sportsmedicine. 2025;53(2):152-158. https://doi.org/10.1080/00913847.2024.2432859
- Williamson TR, Kay RS, Robinson PG, Murray AD, Clement ND. Epidemiology of musculoskeletal injury in professional and amateur golfers: a systematic review and meta-analysis. British Journal of Sports Medicine. 2024;58(11):606-614. https://doi.org/10.1136/bjsports-2023-107324
- Murray A, Junge A, Robinson PG, Bizzini M, et al. International consensus statement: methods for recording and reporting of epidemiological data on injuries and illnesses in golf. British Journal of Sports Medicine. 2020;54(19):1136-1141. https://doi.org/10.1136/bjsports-2020-102380
- Kim SB, You JS, Kwon OY, Yi CH. Lumbopelvic kinematic characteristics of golfers with limited hip rotation. American Journal of Sports Medicine. 2015;43(1):113-120. https://doi.org/10.1177/0363546514555698
- Gosheger G, Liem D, Ludwig K, Greshake O, Winkelmann W. Injuries and overuse syndromes in golf. American Journal of Sports Medicine. 2003;31(3):438-443. https://doi.org/10.1177/03635465030310031901
- NHS. Back pain. Page last reviewed 5 March 2026. https://www.nhs.uk/conditions/back-pain/
- NHS. Sciatica. Page last reviewed 03 December 2024. https://www.nhs.uk/conditions/sciatica/
- NHS. Slipped disc. Last reviewed 24 April 2024. https://www.nhs.uk/conditions/slipped-disc/
- NHS. Chest pain. Page last reviewed 8 August 2023. https://www.nhs.uk/symptoms/chest-pain/
- NHS. DVT (deep vein thrombosis). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
Written and checked by the PocketPhysio editorial team. Last updated 2026-11-06.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.