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When Golf-Related Back Pain Is More Than a Muscle Strain

Written by Ifije Ohiorhenuan, MD, PhD — Board-Certified Spine Surgeon. Last updated 2026-06-20.

Not all golf back pain is the same

Many golfers describe any back pain after a round as a “strain.” Sometimes that is accurate. Muscle strains and mechanical back pain are common. But golf-related low back pain can also involve discs, facet joints, endplates, transitional anatomy, or fractures in vulnerable patients.[1, 2, 3]

The point is not to alarm golfers. Most back pain improves without surgery. But persistent, severe, recurrent, or unusual symptoms deserve a proper evaluation.

Disc-related pain

The golf swing creates compression and rotation. In some golfers, especially those with pre-existing disc degeneration, this may irritate a lumbar disc. Disc-related pain may stay in the back, but it can also radiate into the buttock or leg if a nerve root is irritated.

Symptoms that may suggest nerve involvement include leg pain, numbness, tingling, weakness, or pain that travels below the knee. These symptoms should not be ignored.

Facet-related pain

The facet joints are small joints in the back of the spine. They can become painful with extension, rotation, and side-bending. Some golfers feel facet-type pain during the finish position, especially if the swing ends in an exaggerated arched or reverse-C posture.

Facet pain is often localized to the low back, but it can refer into the buttock or thigh. It may be worse with extension or rotation.

Modic changes and endplate irritation

The source synthesis includes a small series of golfers with Modic Type 1 changes, which are MRI findings associated with inflammatory changes near the vertebral endplates.[4] These are not diagnosed by symptoms alone. They require imaging and clinical correlation.

For patients, the practical message is that persistent golf-related back pain sometimes has a specific structural correlate. But imaging findings must be interpreted carefully because many people have MRI abnormalities that are not the main pain generator.

Compression fractures and osteoporosis

The source synthesis includes cases of postmenopausal women who sustained vertebral compression fractures during the golf swing, associated with osteoporosis.[5] This is uncommon, but clinically important.

A golfer with known osteoporosis, sudden severe back pain, pain after a twisting event, or pain that does not behave like a typical muscle strain should seek medical evaluation. Compression fractures are managed differently from routine muscular soreness.

Transitional anatomy and Bertolotti syndrome

Some people have a lumbosacral transitional vertebra, sometimes associated with Bertolotti syndrome. In selected cases, this can contribute to low back pain. The source synthesis includes a case where targeted injections and radiofrequency treatment helped a golfer with this condition.[6]

This is not something a golfer can self-diagnose. It is a reminder that persistent back pain sometimes requires a careful spine evaluation rather than generic advice.

When should a golfer seek care?

Golfers should consider medical evaluation when back pain:

  • Persists despite rest and reasonable activity modification.

  • Repeatedly returns when golfing resumes.

  • Radiates into the leg.

  • Causes numbness, tingling, or weakness.

  • Is severe or sudden in onset.

  • Occurs in the setting of osteoporosis or cancer history.

  • Limits walking, sleep, work, or normal daily activity.

Urgent evaluation is appropriate for new neurologic deficits, bowel or bladder dysfunction, fever with severe back pain, or major trauma.

Bottom line

Most golf-related low back pain is mechanical and can improve with activity modification, rehabilitation, conditioning, and swing changes. But not all back pain is a simple strain.

Persistent or concerning symptoms should be evaluated so the golfer can identify the pain generator and choose the right treatment path.

References

This guide draws on the following studies and reviews. Much of this literature is observational or abstract-level, so findings are described here as associations rather than proof. The numbered markers in the text show which sources support each point.

  1. Hosea TM, Gatt CJ Jr. Back pain in golf. Clin Sports Med. 1996;15(1):37-53.
  2. Carnovale BJ, Lavadi RS, Choudhary A, et al. Accounts of Spine and Paraspinal Injury While Playing Golf. World Neurosurg. 2025;194:123343.
  3. Menzer H, Gill GK, Paterson A. Thoracic spine sports-related injuries. Curr Sports Med Rep. 2015;14(1):34-40.
  4. Mefford J, Sairyo K, Sakai T, et al. Modic type I changes of the lumbar spine in golfers. Skeletal Radiol. 2011;40(4):467-73.
  5. Ekin JA, Sinaki M. Vertebral compression fractures sustained during golfing: report of three cases. Mayo Clin Proc. 1993;68(6):566-70.
  6. Back JD, Wyss JF, Lutz GE. Bertolotti syndrome as a potential cause of low back pain in golfers. PM R. 2011;3(8):771-5.

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This article is educational and does not replace individualized medical advice. If your back pain is severe, persistent, radiates into the leg, or comes with numbness, weakness, or bowel or bladder changes, seek evaluation from a qualified clinician.