If you’ve been experiencing back pain but you’re stumped as to what might have caused it, you may need to broaden your scope. Check your posture, consider whether you have pulled a muscle by heavy lifting. Look for all the low hanging fruit of back pain causes, of course. But don’t stop there!

Here are some questions to ask yourself when the normal reasons have been exhausted:

How long have you had your shoes?

Even some of the most seemingly comfortable shoes could actually be doing more harm than good. Even though high heels are known for causing back pain, the trust is that regular shoes can impact the health of your back as well. This is especially true if the bottom of the shoe is damaged. That inadequate support can cause both pain in your foot and back.

How heavy is your purse or shoulder bag?

If you have a purse with a shoulder strap, be mindful of how much weight is pulling on your shoulder at any time. Carrying that burden each and every day can take a toll on your back and shoulders. Be sure to only carry what you really need to have with you each day, and take advantage of opportunities to lighten the load.

Do you fly a lot?

After a long flight, take a few moments to stretch or move around a bit before carrying your bags to your next destination. After sitting in a space filled with pressurized air, the discs in your back can become irritated and might be a little more susceptible to bulging.

Are you a smoker?

When people think about the health hazards of smoking, the focus is usually on the lungs. However smoking causes damage in other parts of the body as well – including the back. How? Cigarettes limit the amount of oxygen that the body takes in with each breath. When your cells become deprived of oxygen, it can hinger the range of motion you have in your back. Smokers possess a very high risk of back pain.

Do you find yourself stressed out a lot?

Mental stress and anxiety doesn’t just hang out in your head. The effects stream into other parts of your body as well. You’ll feel it in the forms of tension, discomfort, and sometimes pain.

How do you use your cell phone or tablet?

We live in a world that’s full of smartphones and tablets. When you see other people using these devices, many of them have their heads tilted downward. Maybe they’re using their head, neck, or shoulder to keep the phones against their ear. When you think about how many times phones and other devices are used each week, you know that’s going to take a toll on your neck and back. Be aware of your positioning when using yours.