Low Back Pain When Hiking, Backpacking and Trekking

Low back pain is a common issue amongst hikers, backpackers and trekkers.

Long days sitting at the computer with shoulders rounded forward combined with recreational weekend outings with heavy backpacks and long hours on your feet can lead to uncomfortable pack pain.

If you have recurring back pain, it is best to address back pain symptoms with a physical therapist or orthopedic specialist.

And in addition there are a number of things that just about everyone can do to help their pain.

Improve your posture

Poor posture can lead to changes in your spine, pressure on muscles, discs and joints as well as nerve damage that contributes to pain. When you practice optimal posture techniques during the day you are less likely to experience the damage that contributes to pain and more likely to hike with good posture. Here are some exercises you can do to help strengthen the deep neck flexor muscles.

Use trekking poles

Research has shown that using poles can help alleviate pain when walking. “Pole use increases balance and stability, distributes weight through the arms and torso, and decreases loading of the spine and lower limbs.” And, “Trekking poles decrease lower extremity loading and forces.”

If you aren’t sure how to use trekking poles properly, here is some great advice from REI.

If you regularly experience back pain, important features to look for are shock-absorbing poles and foam or cork grip with extended sections of foam that go 4-5 inches down the shaft from the grip so you can easily move your hands to adjust for various terrain.

Wear the right backpack

It is worth taking the time to get fitted to get a back pack that is the perfect for you.
It is imperative that you get one that has a chest strap and a hip belt. The hip belt should ride snuggly around your hips to cover the front of your hips. This takes the weight of the pack off shoulders and spine and transfers it to the hips so that the big muscle groups of the lower body can carry the weight.

Build your core strength

Your core is a complex of muscles that include the muscles in your back, spine, abdomen, glutes and hips. These muscles act to stabilize your spine providing a firm foundation for all the activities you do. When you hike, run, walk, jump, bend over, and turn, these muscles work together. They transfer force through your body and if strong and well trained, help prevent you from having back, hip, knee and even neck pain.
Strengthen the weak muscles and stretch the tight

Sometimes there is a muscle imbalance in the core and this can lead to pain. It is common to see the hip flexors being very tight and the glutes and other core muscles being weak from sitting for many hours of the day. This combination could result in an anterior pelvic tilt which can cause lower back pain as well as knee and hip problems.

When I work with clients, I perform functional movement assessments to identify these imbalances and correct them with stability and strengthening exercise, stretching and myofascial release.

I recommend devoting time every single day to working on your core to ensure the right muscles are activated as you head up a trail.

Here are some exercises you can do to improve your glutes and core.


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Oat, Peanut Butter and Chocolate Energy Balls

Oats, peanut butter, flaxseed meal, protein powder, honey and chocolate chips.

Makes 11 energy balls

My goal in creating these delicious morsels, was to include mostly nutritious food with a little chocolate to make them tempting.

Being that they are calorically dense, these little bites provide compact calories, carbs and a little protein to fuel the long-distance hiker or runner, backpacker, snowshoer, cross-country skier or mountain climber. Eat two of these an hour for the recommended amount of carbohydrate.

Oats contain the soluble fiber beta-glucan, which helps slow digestion, increase satiety, and suppress appetite. Beta glucan is linked to improving cholesterol levels and boosting heart health.

Oats also contain polyphenols that act as antioxidants to reduce the damaging effects of chronic inflammation that is associated with various diseases like cardiovascular disease and diabetes

Flaxseed contains the polyphenol lignan which has several properties including anti-inflammatory, antioxidant and antitumor activities.

½ cup old fashion rolled oats

3 Tbsp flaxseed meal

¼ cup chocolate chips, roughly chopped

2 Tbsp chocolate protein powder

¼ cup crunchy or creamy peanut butter

3 Tbsp honey

Mix the oats, flaxseed meal, chocolate chips and chocolate protein powder together in a medium sized bowl.

In another medium sized bowl, mix the peanut butter and honey together.

Pour the oats mixture into the peanut butter and honey mixture and mix well to combine.

Wash and dry your hands.

Using a 1 Tbsp measure, scoop out a level 1 Tbsp of the mixture and with your clean hands roll into a ball. These will keep well covered and stored in the refrigerator for a week or wrap well and freeze for up to 3 months.

Nutrition Facts
Servings 11.0
Amount Per Serving
calories 119
% Daily Value *
Total Fat 5 g 8 %
Saturated Fat 2 g 8 %
Monounsaturated Fat 0 g
Polyunsaturated Fat 0 g
Trans Fat 0 g
Cholesterol 3 mg 1 %
Sodium 28 mg 1 %
Potassium 18 mg 1 %
Total Carbohydrate 15 g 5 %
Dietary Fiber 2 g 8 %
Sugars 8 g
Protein 4 g 8 %
Vitamin A 0 %
Vitamin C 0 %
Calcium 1 %
Iron 3 %
* The Percent Daily Values are based on a 2,000 calorie diet, so your values may change depending on your calorie needs. The values here may not be 100% accurate because the recipes have not been professionally evaluated nor have they been evaluated by the U.S. FDA.
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What Food Should I Take Mountaineering on Summit Day?

Dried cranberries, walnuts, chocolate covered espresso beans, dates, Cheetos and dried mango offer a smorgasbord to the high altitude athlete.



What’s the best food to eat on high altitude treks, climbs or expeditions?

Perceived exercise effort is increased at altitude. There is a real decrease in exercise capacity above 5000 feet elevation (1) and exercise just feels harder. To make matters worse, usually sleep is compromised at high altitude as well. Eating enough calories and drinking enough can help you feel better.

On climb day, ascending to high altitude can cause a lack of appetite. So pack whatever food tastes the best to you and will be something you will want to eat regularly. During the climb at altitude the focus is on consuming enough calories, carbohydrates and fluids. As you ascend, eat often, and eat snacks that will maintain your glycogen levels to use as fuel.

During your training the food you eat in your meals and training sessions should be nutritious and antioxidant rich to promote recovery and performance. I recommend real foods.

Experiment During Training

To determine which foods fuel your body best, try different items on various training hikes to see how your body feels after consuming each snack. Also, keep in mind that some foods can cause GI upset. So this is best discovered before climb day.

Just Eat!

Climbing a mountain burns calories. Lots of them! Rising stress hormone levels place a higher demand for fuel on your body. As calorie needs increase, athletes need to add to their caloric intake.

Eat Carbohydrates

Moderately increasing carbohydrate intake is key in replacing glycogen stores in your body when climbing and compensating for the increased caloric demand at altitude.


Altitude makes water loss worse because at altitude you will breathe faster and more deeply. This is because the higher the altitude the lower the air pressure, so you take more breaths for the same amount of oxygen. This extra breathing leads to fluid losses. If you aren’t staying on top of your intake, dehydration may sneak up, and leave you feeling light-headed and nauseated.

When you are over 10,000 feet elevation drink 1 to 1.5 liters of water daily 3 to 5 liters of water plus 200-300 grams of carbohydrate. Monitor your urine color. It should be a light yellow. Sports beverage powder packs easily in a small ziplock bag to add to a water bottle.

Recommended sports beverages:

Gatorade Endurance, carbs

Fluid Performance Natural, carbs

Gatorade Thirst Quencher, carbs

GU Hydration Drink, carbs

Hammer HEED, carbs

Accelerade, carbs and whey protein

Powerbar Recovery, carbs and whey protein

Food Packing Considerations

When packing food for your upcoming climb it’s important to consider a few variables: calorie density, weight, durability, and enjoyment.

Food is important. Plan out your meals and snacks, pack them as well as you can in a way that will make them easy to eat on the upper mountain when you are cold and tired. Some foods come in a convenient packaging and others will need to be repacked in a Ziploc.

For day one, you can bring some fresh foods: meat sandwich, pita and cheese, string cheese, hardboiled eggs, fruit, carrot sticks, orange slices, broccoli, for instance. For perishable food, it is advisable not to keep them above 41F for longer than 2 hours.  Food-borne bacteria can multiply rapidly especially so in over 70F. It is better to be safe than sorry. Having the “runs” in the mountains would be a nightmare.

You can make a disposable ice pack by filling a sandwich size zip lock with water, squeeze the air out then put it in another zip lock bag and freeze.

Below are a few tips to consider:

  • Bring a variety of foods that you like.
  • Bring a mix of sweet, salty and savory.
  • Bring a mix of protein, quick burn and slow burn carbs.
  • Things get beat up in a backpack so consider durability (think bagels vs. bread and thick pretzels vs. thin ones).
  • Bring food you know and like and have experimented with on your training hikes.
  • Remember extra food is far better than not enough, but not too much. Food is heavy! That’s why it takes some careful planning so your pack isn’t too heavy.
  • Think about bringing no more than a pound per day.
  • You can and should eat every time you stop for a break. On a typical 3 day climb of Mt. Rainier, I recommend bringing about sixteen 200-400 calorie snacks (that gives you a little extra).
  • Keep some small snacks like cut up mangos, nuts, protein bars cut into bite-size in your pockets so they are easily accessible when you take a break. Keep bars that freeze in your inner coat pockets to keep them warm.
  • Test the food you are taking when it’s frozen to see if it’s still edible.

Food Suggestion Ideas:

Here are some foods to keep you powered up on your high altitude climb:

  1. Wehrlin JP, Hallén J. Linear decrease in .VO2max and performance with increasing altitude in endurance athletes. Eur J Appl Physiol. 2006 Mar;96(4):404-12. doi: 10.1007/s00421-005-0081-9. Epub 2005 Nov 26. PMID: 16311764.
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