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Ho Ho… Oh My Back! Does Santa Have Low Back Pain?

As Christmas is fast approaching, I suspect that Santa is gearing up for yet another busy night of delivering gifts to boys and girls all around the world. As a chiropractor, I am worried about Santa’s back when I see him carrying around his large present sack each year.

December 8, 2023
Santa with back pain against a red background

Santa Can't Miss Any Work Days!

Globally, low back pain causes more disability, activity limitation, and missed work days than any other condition1,6. If Santa has to miss work because of his low back pain, millions of children won’t get the presents they wished for! So, what are some of the risk factors for low back pain that Santa should be aware of?
  • Being overweight or obese. Santa has that belly that shakes like a bowl full of jelly — maybe from all those cookies! Most studies show that individuals who are overweight and obese are more likely to experience low back pain2,3. But luckily being overweight or obese is not the most significant risk factor for low back pain. So, although it may be a good idea for Santa to try to cut down on the cookies, there are many other things Santa can do to decrease his chances of experiencing low back pain. (And if I were Santa’s chiropractor, I’d be asking him if he noticed any pattern between his weight gain and his low back pain onset – because finding pain patterns are helpful when addressing the pain presentation!)
  • Smoking. Santa used to be pictured smoking a pipe, but it seems he may have quit since he has not been seen with a pipe in quite a while now. Good for him! After all, smoking is known to increase the risk of back pain4, among other health conditions. Former smokers have less of a chance of developing disabling low back pain than current smokers, but people who never begin smoking have the lowest chance of experiencing low back pain4.
  • Physical Activity. It is a mystery what Santa does during the rest of the year when it isn’t Christmas time. I’d guess he likely spends his time reading lists and checking them twice, and that is a sedentary task. If he increased his physical activity by taking up something active in his ‘off’ season, such as walking, running, dancing, gardening, swimming, or weightlifting, he could reduce his chances of low back pain. Leisure time physical activity can reduce the risk of chronic low back pain by 11%-16%5.
  • Psychological Factors. Some of the strongest predictors of low back pain are psychological factors such as depression, catastrophizing (assuming the worst will happen), fear avoidance beliefs (avoiding activity due to fear of pain), and low job satisfaction1. It is hard to imagine Santa disliking his job (after all, he’sSanta!), so I suspect he protects himself from having a disabling episode of low back pain given how holly and jolly he is!

And finally, just being alive is a risk factor for low back pain! Santa is alive, how else do the cookies and milk get eaten each Christmas Eve? However, because low back pain is so common, it’s likely you’ll experience it at some point in your life. Approximately 80 percent of adults (aged 16 years or older) will experience an episode of low back pain at least once in their life1,6. The good news is evidence shows that 90% of low back pain is not caused by serious underlying injury or disease and typically does not require MRIs, CT scans, medication, surgical referrals, or opioid prescriptions6! Although most episodes of low back pain will improve within 6 weeks1, approximately 2 out of 3 individuals will continue to experience low back pain at 3 months and 12 months7. Although back pain can be very uncomfortable and disruptive to your life, by recognizing that pain does not mean something is seriously wrong, you can help reduce the worry and fear that may actually exacerbate your pain! Developing coping strategies to go about your daily life and work, as well as remaining physically active, despite the discomfort, can significantly reduce your chances of developing disabling low back pain!

Keeping these risk factors in mind, and addressing them in your life, will also help YOU to prevent low back pain during the holidays. But, even if you do experience low back pain, your Christmas isn’t a lost clause! Reach out to me so I can help you get back to your merry ways! Chiropractic treatment, and the GLA:D Back Program, are excellent options for pain management and learning how to self-manage your low back pain!

Interested in learning more? Book your complimentary consultation call here today!

Disclaimer: The information provided in this blog is for informational purposes only. It is meant to augment and not replace consultation with a licensed healthcare provider. Consultation with a licensed healthcare provider is recommended for anyone suffering from a health problem. 


1 Hartvigsen Jan, Buchbinder Rachelle, et al. 2018. What is low back pain and what to do about it.The Lancet, 391(10137):2356 – 2367.

2 Rahman Shiri, Jaro Karppinen, Päivi Leino-Arjas, Svetlana Solovieva, Eira Viikari-Juntura. 2010. The Association Between Obesity and Low Back Pain: A Meta-Analysis,American Journal of Epidemiology, 171(2): 135–154.

3 Zhang, Ting-Ting MB; Liu, Zhen MB; Liu, Ying-Li MD; Zhao, Jing-Jing MM; Liu, Dian-Wu MD; Tian, Qing-Bao MD. 2018. Obesity as a Risk Factor for Low Back Pain.Clinical Spine Surgery, 31(1):22-27.

4 Shiri, Rahman et al. The Association between Smoking and Low Back Pain: A Meta-analysis. 2009.The American Journal of Medicine, 123(1) 87.e7 – 87.e35.

5 Shiri R, Falah-Hassani K. 2017. Does leisure time physical activity protect against low back pain? Systematic review and meta-analysis of 36 prospective cohort studies.Br J Sports, 51(19):1410-1418.

6 Health Quality Ontario. (2019). Low back pain: care for adults with acute low back pain (Quality Standard & Patient Guide). Retrieved from: https://www.hqontario.ca/evidence-to-improve-care/quality-standards/view-all-quality-standards/low-back-pain.

7 Gianola, S., Bargeri, S., Del Castillo, G., Corbetta, D., Turolla, A., Andreano, A., … & Castellini, G. (2022). Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis. British journal of sports medicine, 56(1), 41-50.