Low Back Pain in Golfers: Why It Happens and How We Treat It in Fort Worth
Low back pain is one of the most common musculoskeletal complaints among golfers, affecting recreational players, competitive amateurs, and professionals alike. Despite golf’s reputation as a low-impact sport, the repetitive rotational forces of the swing place significant mechanical stress on the lumbar spine.
At Aspen Chiropractic & Wellness in Fort Worth, we treat golfers with low back pain using an evidence-based, active care–focused approach designed to reduce pain, restore function, and keep golfers playing long term.
How Common Is Low Back Pain in Golfers?
Low back pain is consistently reported as the most frequent injury location in golfers, accounting for approximately 20–25% of all golf-related injuries (McHardy et al., 2006; Smith et al., 2018). Competitive golfers experience higher prevalence rates due to increased swing volume and cumulative spinal loading (Smith et al., 2018).
A previous history of low back pain is one of the strongest predictors of future episodes, emphasizing the importance of proper rehabilitation rather than symptom management alone (Smith et al., 2018).
Why Golfers Develop Low Back Pain
1. Repetitive Rotational and Shear Forces
The golf swing produces high rotational velocity and shear forces across the lumbar spine, particularly during the downswing and follow-through. Repeated exposure to these forces can overload spinal joints, intervertebral discs, and surrounding soft tissues (Lindsay & Horton, 2002).
Over time, this may contribute to:
Lumbar facet irritation
Disc-related pain
Myofascial overload
Connective tissue stress
2. Load Exceeding Tissue Capacity
Current evidence suggests that low back pain is best understood as a load management issue, not simply a mechanical fault. When the physical demands of golf exceed the adaptive capacity of spinal tissues, pain and dysfunction are more likely to develop (Hodges & Smeets, 2015).
This is commonly seen in:
Golfers returning after time away
Players increasing practice or play frequency
Active adults with incomplete recovery from prior injuries
3. Altered Muscle Activation Patterns
Golfers with low back pain often demonstrate altered trunk muscle activation, including delayed or reduced activation of deep stabilizing muscles and increased reliance on superficial musculature (Cole et al., 2008). These inefficient patterns increase spinal loading and may contribute to symptom persistence and recurrence.
The Most Important Part of Treatment: Rehab & Active Care
At Aspen Chiropractic & Wellness, rehabilitation and active care form the foundation of treatment for golf-related low back pain.
High-quality research consistently shows that exercise-based rehabilitation is the most effective long-term intervention for reducing pain, improving function, and preventing recurrence in low back pain populations (Hayden et al., 2005; Qaseem et al., 2017).
Our golf-specific rehab programs focus on:
Improving spinal and pelvic stability
Increasing load tolerance of lumbar tissues
Enhancing coordination between the hips, trunk, and core
Reducing recurrence during golf activities
For golfers, this means progressive loading strategies that prepare the body to tolerate the rotational and compressive demands of the swing—not just short-term symptom relief.
How Shockwave Therapy Supports Rehab in Golfers
We use extracorporeal shockwave therapy (radial and focused) as an adjunct to active care, not a standalone treatment.
Shockwave therapy has been shown to:
Improve local circulation
Promote tissue remodeling
Reduce chronic myofascial pain
Decrease pain sensitivity that limits exercise tolerance (Speed, 2014; Mani-Babu et al., 2015)
In golfers with persistent low back pain, shockwave therapy helps reduce pain barriers, allowing patients to participate more fully and earlier in their rehabilitation program—an essential factor for long-term outcomes.
How Dry Needling Complements Active Care
Dry needling is another evidence-supported intervention we use to address neuromuscular dysfunction associated with low back pain.
Systematic reviews suggest dry needling can:
Reduce muscle tone and guarding
Improve range of motion
Decrease pain intensity
Improve functional outcomes when combined with exercise (Gattie et al., 2017)
For golfers, dry needling is commonly applied to lumbar paraspinals, quadratus lumborum, and hip stabilizers that influence force transfer during the golf swing.
As with shockwave therapy, dry needling is used to support active rehabilitation, not replace it.
Why This Approach Works for Golfers
The evidence supports a multimodal, active care–driven approach:
Exercise and rehab drive long-term adaptation
Passive modalities reduce pain to facilitate movement
Improving tissue capacity reduces recurrence risk (Hodges & Smeets, 2015)
By combining structured rehabilitation, shockwave therapy, and dry needling, we help golfers return to play with confidence and resilience.
Golf Low Back Pain Treatment in Fort Worth, TX
Whether you play near TCU, Colonial, Clearfork, Ridglea Country Club, or elsewhere in Fort Worth, low back pain doesn’t have to limit your game.
At Aspen Chiropractic & Wellness, we specialize in treating golfers and active adults using evidence-based rehab and advanced therapies—so you can keep playing, not just managing pain.
Author: Nathan Ballmann, D.C.
This article was written by Dr. Nathan Ballmann, Doctor of Chiropractic and owner of Aspen Chiropractic & Wellness in Fort Worth, Texas. Dr. Ballmann specializes in evidence-based treatment for active adults and athletes, with a clinical focus on rehabilitation, load management, and return-to-sport care.
The treatment strategies discussed in this article reflect current best evidence from peer-reviewed sports medicine and rehabilitation research, as well as real-world clinical experience treating golfers with low back pain. Care at Aspen Chiropractic & Wellness emphasizes active rehabilitation as the foundation of recovery, with adjunctive therapies such as shockwave therapy and dry needling used to support tissue healing and improve tolerance to exercise.
All recommendations are individualized based on patient presentation, functional limitations, and response to care.
References
Cole, M. H., Grimshaw, P. N., & McNair, P. J. (2008). Trunk muscle onset and cessation in golfers with and without low back pain. Journal of Biomechanics, 41(13), 2829–2836.
Gattie, E., Cleland, J. A., & Snodgrass, S. (2017). The effectiveness of trigger point dry needling for musculoskeletal conditions: A systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 47(3), 133–149.
Hayden, J. A., van Tulder, M. W., Malmivaara, A., & Koes, B. W. (2005). Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews, (3).
Hodges, P. W., & Smeets, R. J. (2015). Interaction between pain, movement, and physical activity: Short-term benefits, long-term consequences. Pain, 156(Suppl 1), S97–S109.
Lindsay, D. M., & Horton, J. F. (2002). Trunk rotation strength and endurance in healthy normals and elite male golfers with low back pain. Sports Medicine, 32(12), 831–840.
Mani-Babu, S., Morrissey, D., Waugh, C., Screen, H., & Barton, C. (2015). The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: A systematic review. The American Journal of Sports Medicine, 43(3), 752–761.
McHardy, A., Pollard, H., & Luo, K. (2006). Golf injuries: A review of the literature. Sports Medicine, 36(2), 171–187.
Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain. Annals of Internal Medicine, 166(7), 514–530.
Speed, C. (2014). A systematic review of shockwave therapies in soft tissue conditions. British Medical Bulletin, 110(1), 161–172.
Smith, M. F., et al. (2018). Risk factors for low back pain in golfers: A systematic review. British Journal of Sports Medicine, 52(11), 713–720.