Back pain and knee pain are more connected than you think. If you feel both, it’s not a coincidence.
The Overlap No One Talks About
Over 60% of Indian software professionals report chronic lower back pain. That figure is hardly surprising, given the long hours spent seated on suboptimal ergonomic setups coupled with a general lack of movement during the workday.
What’s more striking is that nearly 1 in 3 of these professionals also report experiencing chronic knee pain. This is often dismissed as an unrelated issue, which is reflected in how people seek isolated care for knee and back pain relief.
But mounting evidence and clinical experience suggest these two complaints are more closely linked than most people realise.
A Familiar Story
Ravi is a 36 y/o software developer based in Bengaluru. His routine: 10-hour desk days with minimal breaks, and the occasional weekend game of badminton.
A few months ago, he began to notice a dull ache in his lower back. Assuming it was just stiffness from poor posture, he stretched a bit more and carried on. Then came the knee pain: first while climbing stairs, then while standing for prolonged periods. He purchased a knee support sleeve online, but the pain persisted. He eventually gave up and reasoned that the source of the pain is “ageing”. What Ravi didn’t realise was that these two symptoms weren’t separate; they were part of the same biomechanical story.
The Body Works as a Chain
The spine, hips, knees and ankles operate as an interconnected musculoskeletal chain. When one joint is under stress or injured, the rest of the system often compensates, sometimes in subtle ways, sometimes dramatically.
Knee pain, for example, can lead to altered walking patterns or postural shifts that increase the load on the lower back. Conversely, issues in the lumbar spine, such as a slipped disc or sciatica, can radiate pain into the leg, often presenting as knee discomfort.
Moreover, weak gluteal muscles (commonly referred to as the glutes), tight hip flexors, and reduced core stability, a condition commonly found among people with sedentary lifestyles, can contribute to joint instability. This instability affects both spinal health and knee alignment, leading to long-term issues with movement, balance, and lower back and knee pain.
These muscle imbalances can remain undetected for years, gradually creating wear and tear that eventually manifests as pain in multiple joints.
What the Research Tells Us
Studies have shown that people with knee osteoarthritis are significantly more likely to experience lower back pain, highlighting the need to approach chronic joint conditions as interconnected rather than isolated. Others have found that poor mobility or dysfunction in the hip or ankle can lead to abnormal loading of both the knees and spine. These dysfunctions can cascade through the biomechanical system, increasing strain and triggering both knee and back pain.
In practical terms, this means that if you are dealing with both types of pain, treating them independently may not provide lasting relief. Long-term treatment of chronic back pain should include a comprehensive assessment that considers hip-knee-spine alignment and muscle compensation patterns.
Taking a Smarter Approach: The Body Is a Complex Biomechanical System. Treat It Accordingly.
Addressing pain in isolation often leads to temporary fixes. Instead, a more effective approach is to view the body as a system and treat it accordingly. This begins with a posture assessment, strengthening of the core and hips, and possibly making ergonomic adjustments to your workstation, especially if you lead a sedentary lifestyle, which can contribute to joint stress.
In addition to physical interventions, adopting anti-inflammatory lifestyle habits, such as regular movement, improved sleep, and stress reduction, can support long-term relief for both back and knee pain. Regular movement and low-impact strength training can help restore joint stability and reduce discomfort. For example, exercises that support spinal mobility, glute strength, and flexibility help reduce both lower back and knee pain.
In addition, specific orthotic aids can provide relief while these underlying issues are being addressed:
- Knee sleeves offer gentle compression and reduce instability around the joint, especially during walking or standing. They help improve proprioception, enhance blood flow, and reduce stress on the knee during daily activities.
- Lumbar support belts provide both compression and structural support to the lower spine. They can be invaluable during long hours of sitting and also offer mild stabilisation during light physical activity or rehabilitation exercises.
- Orthotic insoles absorb shock at key pressure points, namely the heel and ball of the foot, reducing the impact that travels up to the knees and lower back. They also offer arch support, which helps correct foot pronation and promote better alignment throughout the kinetic chain. Footwear also matters—supportive shoes and well-designed insoles not only reduce mechanical shock but also improve alignment and reduce strain across the ankle, knee, and lower back.
These tools offer support during both active and passive recovery phases, helping to mitigate the effects of poor posture, muscle tightness, and pain, which are common among tech and desk-bound workers.
When to Pay Attention
If you are experiencing persistent knee and back pain, especially as a working professional in your 30s or 40s, it may be time to consider that these symptoms are related. While they may seem manageable now, delaying a comprehensive evaluation could lead to more serious joint degeneration later in life. Recurring joint pain makes it crucial to track factors like bone density to prevent long-term complications.
Pain can often be a pattern. If you or someone you know is quietly dealing with both knee and back discomfort, this could be a sign to reassess how your body moves, compensates, and adapts.
Whether it's due to posture, inactivity, or underlying biomechanical issues, recognising the connection between these joints is the first step toward long-term joint pain relief.
Share this article with someone who might benefit from connecting the dots. Sometimes, the first step to meaningful recovery is seeing the whole picture.
References
- Muraki, S. et al. (2022). Association between low back pain and knee osteoarthritis: The ROAD study. BMC Musculoskeletal Disorders, 23(1).
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-022-05684-4 - Shakoor, N. et al. (2010). Spinal loading patterns in patients with knee osteoarthritis. Journal of Orthopaedic Research, 28(8), 1043–1050. https://doi.org/10.1002/jor.21019
- Riegger-Krugh, C. & Keysor, J. (2019). Gait mechanics and postural compensations in joint disease. Gait & Posture, 74, 66–72. https://www.sciencedirect.com/science/article/abs/pii/S0966636219301620
This article is reviewed by Dr. Anurag Gupta, a gold medalist in MPT-Sports Physiotherapy. He has worked with elite international and national athletes across football, tennis, and badminton. His clientele includes Srikanth Kidambi (#1 Men’s Badminton Player, Arjuna Awardee, Padma Shri) and Hendra Setiawan (Olympic Gold Medalist, 4x World #1 in Men’s Badminton).
Beyond athletes, Dr. Gupta is the preferred physiotherapist for top founders, including Vivek Gupta (Licious), Rishabh Telang (Cult.fit), and Arjun Chaudhary (former MFine), helping them recover from musculoskeletal issues efficiently.
