Managing Low Back Pain

About Lower Back Pain

Eighty percent of adults will experience significant low back pain sometime during their lifetime. Low back pain usually involves muscle spasm of the supportive muscles along the spine. Also, pain numbness and tingling in the buttocks or lower extremity can be related to the back. There are multiple causes of low back pain (see below). Prevention of low back pain, as well as knowing self-care options for acute low back pain, are important, as symptoms can recur on more than one occasion.

Common causes of lower back pain

  • Muscle strain. The muscles of the low back provide the strength and mobility for all activities of daily living. Strains occur when a muscle is overworked or weak.
  • Ligament sprain. Ligaments connect the spiral vertebra and provide stability for the low back. They can be injured with a sudden, forceful movement or prolonged stress.
  • Poor posture. Poor postural alignment (such as slouching in front of the TV or sitting hunched over a desk) creates muscular fatigue, joint compression, and stressed the discs that cushion your vertebrae. Years of abuse can cause muscular imbalances such as tightness and weakness, which also cause pain.
  • Age."Wear and tear" and inherited factors may cause degenerative changes in the discs (called degenerative joint disease). Normal aging causes decreased bone density, strength, and elasticity of muscles and ligaments. These effects can be minimized by regular exercise, proper lifting and moving techniques, proper nutrition and body composition, and avoidance of smoking.
  • Disc buldge. Also known as herniation, can cause pressure on a nerve, which can radiate pain down the leg. This generally responds well to a strengthening and stretching program and rarely requires surgery.
  • Other causes of low back pain include bladder/kidney infection, endometriosis, cancer, or ovarian problems.

Self-care treatment

  • Rest. Rest from any aggravating activity. Avoid prolonged sitting, driving, bending, heavy lifting and twisting.
  • Ice. Ice applied to the low back for 15 minutes every 1-2 hours is helpful in reducing pain and spasm. Avoid using heat for the first 48 hours of an acute injury.
  • NSAIDs. Your doctor may prescribe anti-inflammatory medication such as aspirin, advil, aleve, ibuprofen or naproxen sodium.
  • Early exercise. Gentle exercise for mobility and stretching (especially the muscles of the legs and back) can help decrease the severity, duration and recurrence of low back pain. Try the suggested exercises below. Do not perform exercises that increase your pain.
  • Positioning. Modifying your sleeping position can help ease strain to your low back. Make sure your bed is firm enough to give you adequate support, and use a small pillow for your head. If you sleep on your back, try putting a pillow under your knees. Or if you prefer to sleep sidelying, put a pillow between your knees and a folded towel under your waistline.
  • When to seek professional help. See your health care provider if you have the following: significant pain that persists beyond a week, unexplained fever, unexplained weight loss, redness or swelling on the back or spine, pain/numbness/tingling that travels down the leg(s) below the knee, leg weakness, bowel or bladder problems, or back pain due to a severe blow or fall.

Prevention of lower back pain

  • Once the severity of pain has decreased, a rehabilitation program to strengthen your hip, abdominal and back muscles can help prevent future occurences. Perform the exercise below daily.
  • Posture! Posture! Posture! The goal is neutral spine, not slumped or over-arched.
  • Learn proper-lifting and body mechanics.

Basic exercises for the lower back


Lying on floor, pull thigh towards your chest to about 90 degrees. Straighten your knee until a stretch is felt in back of thigh. Hold 1 minute. Repeat with opposite leg.

Hip Flexors

Lying on your back, pull one knee to the chest to keep the back flat. Allow the opposite thigh to drop over the edge of the bed. Do not allow the thigh to move away from the midline or rotate. Hold 30 seconds. Repeat 2 times each leg.

Simple Knee to Chest

Pull knee to chest until a comfortable stretch is felt in hip and lower back. Hold 15 seconds. Repeat with opposite leg. Repeat 5-10 times each leg.

Prop Up on Elbows

On firm surface, lying on your stomach, prop up on your elbows. Keep pelvis, hips and legs relaxed. If propping on elbows is painful, try only lying on stomach or with a pillow under your abdomen. Hold 30 seconds. Repeat 3-5 times.

Pelvic Tilt

Flatten back by tightening stomach and buttock muscles. Hold 10 seconds. Repeat 10 times.

Tail Wag

On all fours with back maintained in neutral position, gently move hips toward rib cage to side bend trunk. Hold briefly, then alternate and do other side. Repeat 10-15 times.

Cat and Camel

On all fours, assume a "hump" back position by arching the back up. Hold briefly and then slowly lower the back into a sagging position. Repeat 10-15 times.

Lumbar Position

Slowly rock knees from side to side in a pain free range of motion. Allow back to rotate slightly. Repeat 10-15 times.

Stretching illustrations used with permission from Visual Health Information (VHI). Copyright, VHI, 1999 / 1-800-356-0709.