People blame all sorts of things for back pain. Maybe it started when you were lugging suitcases from the car or hauling boxes from the garage. These may seem like obvious culprits, but most cases of back pain are caused by things that you would never suspect, including…

A Big Wallet

I’m sure that some men prefer streamlined billfolds, but in my experience, most men have wallets that are bulging with stuff—and they sit on those luggage-size lumps day after day.

What happens: When you sit on your wallet, one buttock is slightly higher than the other. Over time, this can cause pelvic misalignment and spinal twisting that can lead to chronic back pain and even sciatica.

My advice: Move your wallet to a front pocket. Even a thin wallet will cause problems if you sit on it long enough.

Oversized Bags

When you carry a heavy bag—a gym duffel, a purse, a computer bag—the working shoulder elevates and puts the spine out of alignment.

Another danger: “Bag jerk” occurs when a heavy bag abruptly falls off the shoulder, causing a jerk to the body. The resulting neck, shoulder and back strain can be comparable to a sports injury.

The best evidence that women’s handbags have gotten too big comes from the American Chiropractic Association. It now advises women to limit the weight of their handbags to 10% of their body weight. But should a 150-pound woman be carrying even 15 pounds over her shoulder? That’s a lot of weight!

My advice: Put your bag on a diet—take out whatever you really don’t need. When you’re walking, shift the bag from shoulder to shoulder now and then. You also might consider a backpack.

Flip-Flops

These casual slip-ons give almost no support. The thin soles are a common cause of heel and arch problems. The lack of heel support forces people to take shorter steps and to scrunch up their toes to keep the shoes on, both of which can lead to pain in the knees, hips and lower back. Walking in flip-flops is worse for you than walking barefoot.

My advice: Wear flip-flops only in the venues for which they were designed—at swimming pools, in locker rooms, at the beach, etc.

Too Much Sitting

Sitting has been called the “new smoking” because it has been linked to type 2 diabetes, cancer and heart disease. It’s also hard on the back because it exerts more pressure on the spine than standing. People who slouch when they sit—or hunch forward when watching TV or working on the computer—experience even more pressure.

My advice: Don’t just sit when you’re sitting. Shift your weight every few minutes. Arch your back. Lean back when you notice that you have been hunching forward. At least twice an hour, get up and walk around for a few minutes.

Also helpful: A reclining chair. Recliners lengthen the spine and cause less pressure than upright chairs.

Chewing Gum

Too much jaw action stresses the temporomandibular (jaw) joint, which stresses the muscles throughout your back, leading to tension and pain.

Jaw-related problems may be accompanied by tightness all along the back and spine. Possible signs of jaw problems: You can’t open your mouth very wide…your jaw occasionally clicks or “sticks”…and you grind your teeth or clench your jaw a lot.

My advice: Give up chewing gum altogether. It’s also helpful to stretch the jaw muscles. Place your hand under your jaw. Push with just a little resistance while you open/close your mouth. Repeat the stretch 10 times, three times a day.

Also helpful: Wearing a mouth guard when sleeping reduces pressure on the jaw from ­clenching. If an over-the-counter mouth guard doesn’t fit properly, ask your dentist for a customized one.

Constipation

Believe it or not, constipation is a common cause of back pain. A lack of regular bowel movements causes buildups of inflammatory wastes that irritate the large intestine, which in turn irritates muscles in the back.

My advice: When you notice that “things aren’t moving,” drink a big glass of cold water. It will stimulate the urge to have a bowel movement. Also important: Regular exercise and plenty of beans, fruits, vegetables and other high-fiber foods.

Caution: Don’t depend on high-powered “digestive cleanses”—colonics, supplements, extreme fasts, etc.—for regular bowel movements. They can trigger irritation that is just as hard on the back as constipation.

Stress Breathing

Taking rapid, shallow breaths is part of the body’s fight-or-flight response. People with stressful lives breathe this way often or even all the time, and they aren’t really aware of it. Rapid breathing can’t deliver all the oxygen your body needs. Muscles that are deprived of oxygen get tight and sore…and the stress that causes rapid breathing makes muscle tension even worse. Back pain can result.

Self-test: Turn your head all the way to the right or left—and see how far it goes. Then, take slow, deep breaths for about 30 seconds. Turn your head again. Did it go farther this time? If it did, you need to relax and get more oxygen.

My advice: Every day—particularly when you’re stressed—take a few moments to breathe deeply. Inhale all the way for about four seconds, then exhale just as slowly. Do it for a few minutes, several times a day.