From the Guidelines
There is no direct evidence linking Attention Deficit Hyperactivity Disorder (ADHD) and lower back pain, but individuals with ADHD may experience more back pain due to restlessness, fidgeting, and poor posture. The relationship between ADHD and lower back pain is complex and involves several interconnected factors. People with ADHD may experience more back pain due to:
- Restlessness and fidgeting that creates muscle tension and poor posture over time
- ADHD-related executive function difficulties that lead to inconsistent physical activity patterns—either too much or too little exercise—both potentially causing back strain
- Sensory processing differences that may lower pain thresholds or increase pain sensitivity
- Psychological components, such as anxiety and depression, which can amplify pain perception and create a cycle where pain worsens mental health symptoms and vice versa Some ADHD medications like stimulants may contribute to muscle tension, though this varies by individual 1. Management approaches should address both conditions simultaneously, including:
- Proper ergonomics
- Regular movement breaks
- Consistent exercise routines
- Potentially physical therapy For those experiencing significant back pain with ADHD, consulting healthcare providers about medication adjustments or complementary treatments like muscle relaxants might be beneficial, while also exploring behavioral strategies to improve posture and body awareness 1.
From the Research
Relationship Between ADHD and Lower Back Pain
- There is evidence to suggest a relationship between Attention Deficit Hyperactivity Disorder (ADHD) and lower back pain, particularly in patients with persistent chronic nonspecific low back pain (CNLBP) 2.
- A study found that patients with persistent CNLBP had high scores on the Conners' Adult ADHD Rating Scales (CAARS) self-report and observer-rated questionnaires, indicating a possible association between ADHD and CNLBP 2.
- The study also found that the ADHD indices, which comprised subscales of the CAARS estimating the necessity of treatment for ADHD, were significantly higher in patients with persistent CNLBP than in the Japanese standardized sample 2.
- Additionally, the study found that CAARS-S hyperactivity/restlessness, CAARS-O hyperactivity/restlessness, and the Diagnostic and Statistical Manual of Mental Disorders, fourth edition hyperactive-impulsive symptom subscale scores correlated with pain intensity 2.
Management of Lower Back Pain
- The management of lower back pain is complex and depends on various factors, including the duration of symptoms and the presence of red flags 3.
- A study found that recognizing red flags early in the evaluation is crucial to expedite appropriate treatment, and routine imaging should be avoided in the absence of red flags 3.
- Another study discussed the conservative management of low back pain, including patient education, therapeutic exercises, and bracing 4.
- However, these studies do not provide direct evidence on the relationship between ADHD and lower back pain, except for the study that found an association between ADHD and CNLBP 2.
ADHD Treatment and Lower Back Pain
- There is no direct evidence on the relationship between ADHD treatment and lower back pain, except for a study that suggested that administering ADHD medications can substantially relieve persistent CNLBP 2.
- Other studies discussed the treatment of ADHD, including combination pharmacotherapy 5 and the effects of drug treatments on cognitive performance 6, but did not provide evidence on the relationship between ADHD treatment and lower back pain.