Lower Back Pain Treatment Ultimate Guide: Causes & Exercises

If you want to get rid of your lower back pain, it helps to understand a little bit about lower back pain treatment.

If you’ve already read my story, you know I’ve spent hours researching to bring the most important information into one place.

Don’t worry, I’ll try to keep it from being too boring! If you feel that the guide is too long, use this table of contents below.

1. Lower Back pain Causes and Symptoms

2. Lower Back Pain Treatment (exercises and stretches)

3. For your further help

1. HOW BIG OF A PROBLEM IS LOWER BACK PAIN, ANYWAYS?

You might be shocked by what the research says!

As I started investigating lower back pain, I was amazed to find out how many people are affected by lower back pain and how big of a problem it really is.

Lower Back Pain infographic

• Over 80% of people will suffer through lower back pain at some point in their lifetime.
• Americans spend over $50 billion each year trying to treat or get rid of lower back pain.
• Lower back pain is the 2^nd most common reason for seeing a doctor, the 5^th most common reason for being hospitalized and the 3^rd most common problem behind patients who require surgery.
• Lower back pain is the most common cause of disability claims in Americans younger than 45.
• Lower back pain is the most expensive condition in industrialized countries and accounts for over 19% of all workers’ compensation claims in the United States.
• Every year, about 3 – 4% of the entire US population is temporarily disabled by lower back pain, and 1% of the working-age population is permanently disabled.

1.1 DIFFERENT TYPES OF LOWER BACK PAIN

Lower back pain can be either chronic (ongoing for more than 6 weeks) or acute (lasting less than 6 weeks).

There are generally three different types of back pain:

1 Axial Lower Back Pain: The most common type of back pain, this refers to back pain that doesn’t travel, can be either sharp or dull, is sometimes severe enough to limit movement and often worsens with activity or position.

2 Lumbar Radiculopathy: As the second most common type of back pain, this refers to pain caused by the compressed roots of the sciatic nerve (sciatica), and can often be more severe in the leg than in your lower back. The pain travels, though it can be both deep and steady.

3 Lower Back Pain with Referred Pain: This refers to lower back pain with accompanying pain in the groin, butt, upper thigh and leg – though rarely below the knee. The degree, frequency and severity of pain can vary a lot, but it’s usually dull and achy

You can find a lot more information on the above types of back pain, including the importance of a proper diagnosis, at the Hospital for Special Surgery’s website.

1.2 WHAT CAUSES LOWER BACK PAIN?

You might be worried that your lower back pain means that you’ve got a slipped disc, degenerative disease, or even cancer.

Here’s the good news: As explained by pain expert Dr. Richard Deyo, about 85% of people suffering from lower back pain have idiopathic (unexplained or non-specific) causes for their lower back pain.

Several studies support the idea that most cases of lower back pain come from unspecific causes.

The even better news? Only about 2% of lower back pain cases are caused by metastatic cancer, and just 1% from serious infections such as spinal osteomyelitis and epidural abscesses.

So – what’s going on back there, anyways?

The frustrating truth is that unless you’ve suffered something like a major accident, the exact cause of lower back pain can be hard to identify.

Some of the most common causes include…

• Overuse or strain from activity
• Poor muscle strength in the back (your back muscles help stabilize your body – so if it’s weak, it can be more easily injured!)
• Injuries from accidents or related trauma
• Obesity/being overweight, which adds stress to your spine
• Muscle or ligament tears
• Herniated (slipped) discs or protruding discs
• Degeneration of vertebrae (cause by aging or stress on the muscles and ligaments)
• Fractures (for example, from an accident)
• Diseases like spondylitis (relatively uncommon)
• Abnormal growths, like tumors (don’t panic – again, this is uncommon)
• Infections (also uncommon)

Many of the above relate to disc injuries. Remember, your spine is made up of vertebrae, separated by intervertebral disks.

That’s far from an exhaustive list (the National Institute of Neurological Disorders and Stroke has a fantastic resource as well) – but most of the other causes are far less common.

There can even be psychological factors! For example, studies have shown that those who are dissatisfied with their jobs or stressed may focus more on their pain, causing it to feel worse.

1.3 WHAT ARE THE MOST COMMON LOWER BACK PAIN SYMPTOMS AND THEIR CAUSES?

One very important fact is that the degree of your pain is NOT directly related to the degree of the problem causing your lower back pain. Severe pain can be caused by relatively minor problems, while major issues may cause little to no problem at all!

Spine-Health.com has a TON of information on different symptoms and their causes (hat tip to them!), and I’ve summarized the key points here to save you a lot of reading:

These clues should point you in the right direction – but please, don’t try to diagnose yourself.

I’m happy to offer recommendations for exercises, products and services that might help your lower back pain, but when it comes to a diagnosis, let’s let the pros do their job!

1.4 WHEN IS LOWER BACK PAIN AN EMERGENCY?

While lower back pain isn’t usually cause for immediate alarm, there are a few situations where you should go to a hospital or see your doctor immediately:

• You’re suddenly experiencing incontinence (losing control of your bladder)
• You’re experiencing numbness (not just tingling, but a loss of sensation to touch) around your “saddle area” (the groin, buttocks and basically anything that would touch a saddle)
• You’ve been in an accident that could have fractured your spine

These symptoms could mean that you’ve suffered a spinal cord injury. If any of the above are happening to you, don’t wait to see if your condition improves – act NOW.

(I must give credit to Paul Ingraham at PainScience.com for sharing these symptoms; his work is worth reading for anyone experiencing back pain.)

There are a few other symptoms that should prompt you to see a doctor:

• Unexplained weight loss (sometimes rapidly)
• Chronic lower back pain accompanied by a sustained fever and chills
• Weakness in your legs
• Severe pain in your abdomen
• If the pain is bad enough that it wakes you up from sleep

If you’re at all worried, see a pro. It’s important that you get the right diagnosis – not only to help get rid of your lower back pain, but to give you peace of mind.

2. YOU’VE GOT A LOT TO GAIN BY GETTING RID OF LOWER BACK PAIN

I probably don’t need to tell you this, but back pain can take you away from the things you love in life – whether that’s spending time with your kids or grandkids, playing sports – or just going to work and making a living.

There’s a lot of stress that can come with chronic back pain, and just getting out of bed or lifting things can become an excruciating experience.

And of course, everyone wants to avoid having to have surgery.

In the next section, I’ll share some common lower back treatment possibilities, as well as some exercises and stretches you can use (with a doctor’s permission) to help improve or even eliminate your lower back pain.

So you’ve learned some quick facts, symptoms and causes of lower back pain – now comes the best part – getting rid of it!

As part of my own recovery (you can read my quick story here), I researched, tested and compiled some of the most effective exercises, stretches, treatments and techniques for lower back pain.

I’m sharing these to help YOU make some smart decisions about how you can get rid of your own pain.

Before we get too far into this section, I want to say a couple quick but VERY important things:

• Not everything I share here will work for every person – and that’s OK!
  Everyone’s pain is a little bit different. It’s important to know your own pain and only continue with lower back pain treatment that are safe for your pain/diagnosis and that you feel comfortable with.

• Consistency is KEY! If you’re hoping for miracle cures, I don’t have any to share. The key to relief using any of these lower back pain treatments is to stick with it over time. While some of these treatments do offer immediate help in alleviating pain, anyone who promises an instant cure is lying.

• It should be obvious, but if even one lower back pain treatment makes your problem worse,
  Please, friends – don’t mess with your lower back. If you start feeling more pain or you’re simply unsure about one of these treatments, ask a pro.

• I’m NOT going to talk about any drugs, medications, steroid injections or surgeries – ask your doctor. Look – for as much as I’ve researched, I’m the first one to tell you that I’m not a medical professional. I wouldn’t DREAM of recommending any kind of drugs or surgeries (plus, I try to avoid them myself!), so if you have questions about these, ask your doctor.

• Probably you know that the US government does not provide health benefits to citizens or visitors. Health insurance provides important financial protection in case you have a serious accident or sickness. People without health coverage are exposed to these costs. This can sometimes lead people without coverage into deep debt or even into bankruptcy. To get health insurance, you need to make regular payments (called “premiums”) to a health insurance company. In exchange, the company agrees to pay some, or all, of your medical bills. Learn more about health insurance.

Got all that? Good! Let’s hop into talking about the stuff that helps make lower back pain easier to manage – or gets rid of it entirely.

2.1 THE #1 BEST, MOST PROVEN LOWER BACK PAIN TREATMENT: Exercises and Stretches

While the last thing you might feel like doing when you have back pain is work out, the number one most prescribed (and most effective) lower back pain treatment is stretching and back strengthening exercises.

9 Best Back Strengthening Exercises and Stretches for Lower Back Pain infographic

Exercising helps to reduce weakness, get rid of stiffness, minimize how often back pain will recur and reduces the severity and duration of possible future episodes of back pain (according to Spine-Health.com).

Not all exercise is suitable for everyone, so I’ve broken it down into two key categories, with some quick recommendations for each:

• Stretching Exercises
• Low-impact aerobic exercise

While there are fantastic weight training programs for building your lower back (through deadlifts, rowing movements and pull-ups, for example), I want to focus on activities that could be easily done even when experiencing lower back pain while putting you at minimal risk of injury.

2.2  5 GREAT STRETCHES FOR LOWER BACK PAIN

There are dozens (if not hundreds) of stretches you can do for lower back pain – but these are a few of my favourites that have actually worked:

1 SPHINX (Lumbar Extension)

Lie flat on your stomach, propping yourself up with your forearms. Make sure your elbows are directly under your shoulders. Gently but firmly press through the palms of your hands and the tops of your feet while pressing your pubic bone forward.

Hold this for 1 – 3 minutes, or as long as you can without serious discomfort.

2 HAMSTRING FLOOR STRETCH

Start by lying on your back, with your hips level and your lower back on the floor. Then, keeping one leg extended, bend the other one toward your chest.

Slowly extend your raised knee, lifting the sole of your foot toward the ceiling. Use your hands to gently pull your leg towards you, to the point of “mild discomfort”. You can use an elastic to help pull your leg higher if need be!

Breathe deeply and hold for 10 – 30 seconds, before repeating with the other leg.

3 SINGLE/DOUBLE KNEE TO CHEST

This one’s simple! Lie on your back with both legs extended on the floor. Then, keeping one leg extended, bring a knee up into your chest and hold for 15 – 30 seconds. You can use your hands to help pull the leg closer to your chest, if it’s comfortable. You should feel this in your lower back and buttocks.

You can do the same thing with your both knees on the same time. Bring one knee up, then the other, pulling both to your chest. Bring your forehead to your knees and hold for five 5 seconds.

4 BRIDGE

Lie on your back as shown above, with knees bend and your feet placed a hip distance apart. Then, take a deep breath, and as you let it out, lift your hips up off of the floor until your knees, shoulders and hips are in a straight line. Breathe in and lower your hips back to the floor. Repeat this 8 – 12 times.

5 KNEE ROLLS/SPINE STRETCH

Lie on your back with a slight cushion under your head. Stretch your arms out to the sides, and place your legs in front of you, with your knees bent and together. With your upper body relaxed, breathe deeply, and as you breathe, roll both of your knees to one side, followed by your pelvis, while keeping your upper body and shoulders flat on the ground. Breathe deeply and return to the starting position before rolling your knees to the opposite side. Repeat 6 – 8 times.

2.3 4 LOW-IMPACT AEROBIC EXERCISES FOR LOWER BACK PAIN

Lower back pain’s worst enemy is low-impact aerobic exercise.

Not only does it get your heart pumping and deliver more blood to the area for healing and nutrients, low-impact aerobic exercise also helps reduce the number of episodes of lower back pain, assists in weight control (taking pressure off your spine) and releases endorphins that combat pain.

1 WALKING

Easy on your back but great for every part of you, walking a few miles 2 – 3 times per week on a treadmill or outdoors is an easy way to stay active and help your lower back at the same time.

Treadmill

For an even better level of exercise (with even less impact), consider a stair machine or elliptical trainer. These will add some resistance to the movements (though you can control it) and will really get you sweating, in the best way possible!

Elliptical trainer

Bonus: While walking, you’re away from the couch or office, where sitting improperly can accomplish the opposite.

2 ROWING

Called the “Best-Kept Secret at the Gym” by Weight Watchers, rowing can help strengthen your back muscles while using smooth, low-impact movements that are easy to handle.

Rowing machine

During my own recovery, I found rowing so enjoyable and helpful that I actually purchased a machine for my home – convenient, too, since it takes up less space than some other bulky equipment.

3 EXERCISE BIKES

Stationary exercise bikes are perfect for getting your heart rate up and improving blood flow while allowing you to remain seated.

Whether it’s the intensity of a spin class or a leisurely pace that’s easier for you to handle, climbing on an exercise bike is a great way to help get through back pain and stay active.

This piece of equipment is particularly good for those who are overweight/obese, as it allows you to ramp up your intensity without putting your joints at risk.

4 SWIMMING/WATER THERAPY

Water-based exercise is a fantastic option for those in so much pain that normal aerobic exercise is too painful. The buoyancy of being in the water minimizes the stress on your back, while still giving you the chance to get in a great, back-strengthening workout.

You can do bicep curls, arm circles, treading water, hip abduction lifts and more exercises that strengthen then back, shoulders, arms and neck, reducing pain.

3. GET A PROPER MATTRESS

We spend hours every night laying down at rest to rejuvenate our bodies.

But if those hours are spent on a bad mattress or in a position that hurts our bodies instead of helping them recover, back pain will continue (or get worse)!

Studies prove your mattress matters…

• A 2010 study at Oklahoma State University found that chronic lower back pain sufferers saw significant pain relief when they switched to medium-firm foam-surfaced mattresses tailored to their personal sleeping positions.
• A 2009 study from Oklahoma State also found that new bedding systems increase sleep quality while reducing back discomfort.
• A 2003 controlled-blind study saw that chronic, non-specific lower back pain patients with medium-firm mattresses had better outcomes for pain in bed, pain on rising and disability than those with VERY firm mattresses.
• 95% of orthopedic surgeonsin one survey said they believed a mattress plays a role in lower back pain

You probably need a new mattress if…

• Yours is dented, sagging, worn out or has big grooves in it
• You haven’t replaced your mattress in 8 years (the materials in your mattress can and do break down)
• Your current mattress is uncomfortable to sleep on (obviously!)
• Your existing mattress offers little in the way of firmness or support

I’ve gone into much more depth on what makes a good mattress and how to buy the best one for you on my “Lower Back Pain Relief Products” page – it could help you save tons of wasted time and money while getting you relief more quickly!

For now, some quick mattress-buying tips:

• Firmer does not always mean better. There’s a popular lie out there that the firmer your bed, the better for your spine. Yes, firmer beds CAN help support the spine better, and a super-plush bed with terrible support will likely leave you in pain – but only to a point. Remember, it was medium-firm beds that did best in the studies I shared earlier.What’s most important is what feels comfortable to YOU.
• Brand names don’t mean much. Yes, there are some trusted names in mattresses, but don’t write off a brand just because you haven’t heard of it before. Your back doesn’t care if it’s a Serta – It’s all about how that mattress FEELS.
• Test everything – but test the most expensive beds first, No, this doesn’t’ mean you need to BUY the most expensive option – but it helps as a comparison point to know what the priciest beds feel like on your back compared to cheap ones.Sometimes, you don’t know comfort until you’ve tested a premium bed – but other times, you’ll find that a cheaper bed is actually superior (and you won’t be curious anymore!)

To read more about choosing a mattress and to see some of my most-recommended companies (based on my own research and the feedback from my readers), check out my Lower Back Pain Products page.

3.1 MASSAGE & MASSAGE CHAIRS

I’ve never met a single person who didn’t love a good massage.

Better yet, a study by the Annals of Internal Medicine found that those suffering from chronic lower back pain reported less pain after just 10 weeks if they got a massage than those who didn’t.

As Spine-Health.com reports, there are 3 big reasons why massage works for healing lower back pain:

• Manipulating your lower back muscles increases blood flow, which allows more nutrients to circulate and be absorbed by those muscles and tissues.
• Massage therapy loosens up tight muscles, allowing them to relax and improving your flexibility.
• Massage makes you feel (scientifically) better! Massage therapy increases your endorphin levels – the chemicals that help you feel good. While reducing your pain, reducing anxiety and shortening your recovery time.

Of course, making time to get a massage isn’t always easy (even if you love it), and some people just aren’t comfortable seeing a massage therapist regularly.

The good news is that new massage chair technologies are increasingly effective for helping to alleviate lower back pain.

“Is a massage chair right for me?”

Yes, this is a bit of a luxury item – but I can tell you personally (and you might relate) – finding that relief is worth every penny. And as the tech gets more common, the prices are coming down a bit, too!

After testing out a couple chairs in shops, reading reviews and hearing back from a few readers, one of the chairs I most recommend is the Inada Dreamwave Chair.

You can customize your own massage based on your pressure points (the chair automatically scans and determines this – it’s pretty amazing) and get a massage across all areas of your body (not just your back, but your hips, thighs, calves and even your feet!).

But seriously, as soon as you sit in this thing, you’ll realize… it’s A-MA-ZING.

Of course, it’s not your only option. Read more about massage chairs and other back pain relief products!

3.2 LOWER BACK PAINT TREATMENT WITH HEAT & ICE PACKS

We’re all familiar with ice pack and heat methods.

Most doctors say it’s okay to alternate between heat and ice, though Paul Ingraham of PainScience.com makes a good argument that ice is almost never the best option.

I tested out Paul’s theory, and I agree: Try heat packs first. If you’re feeling relief, stick with heat. Ice is both messier to deal with, and as Paul points out, doesn’t really seem to offer the same relief.

3.3 LOWER BACK PAIN TREATMENT WITH INVERSION THERAPY

Some of my readers SWEAR by inversion therapy, while others have told me it wasn’t right for them.

Studies that suggest that even 25 degrees of inversion for a couple of minutes every day can have very positive effects – from lowering your back pain, to reducing headaches, improving your circulation and even assisting with neck pain.

Another study by physiotherapist L.J. Nosse found that muscle tension was reduced by 35% within 10 seconds of inversion!

That said, there are definitely situations you shouldn’t give this a go: As noted by the Mayo Clinic, if you’ve got high blood pressure, heart disease or glaucoma, inversion therapy is a treatment to steer clear of.

And in general, inversion therapy is best for people with acute – not chronic – pain.

Inversion therapy can also be a great alternative to more invasive forms of treatment (like surgery or mechanical traction).

Before you start messing around with Inversion table, have a look at this quick video below:

How to Use an Inversion Table Properly:
PLEASE, don’t just climb on and invert all the way!

• First, adjust the table so it fits your body. Don’t let your head hang over the edge; it should be resting on the bed of the table. Also, consider putting on some gym shoes – it’s not advised to use the table in bare feet.
• Depending on your table, you may have a body strap, foot “stirrups”, an ankle bar (pretty common) or something else – just do what it takes to be sure you’re securely in there.
• Use the inversion table for short periods (1 – 2 minutes at first) only, working up to about 5 minutes at a time. You can do this once or twice a day. Do NOT try to sleep on this thing – not advised!
• Choose the degree you want to be inverted. If you’re just starting out, it’s best to start with a small inversion, like 25 degrees, before increasing to 45.
• Be very slow and gentle as you invert; never EVER jerk or swing erratically.
• If it’s comfortable, try raising your hands above your head. This will help elongate the spine and create a better environment for spinal traction.

Over time, you can work your way up to about 60 or 90 degrees as you get more used to the table; you can also work up to using the table 3 times a day – or whenever your back pain strikes.

What’s a good inversion table?

There are inversion tables out there with all kinds of bells and whistles, but for an affordable but effective solution, I recommend Ironman Gravity 4000 Inversion Table – a very reputable company whose tables are the industry standard.

I truly like their tables in particular because they are easily adjustable (my father started using one, and he’s a good 1.5 feet shorter than me, we needed to be able to adjust quickly! It’s also super-comfortable and built with pre-rotation control (for avoiding dangerous over-inversion).

3.4 CHIROPRACTIC TREATMENT

When it comes to the spine, chiropractors know all about bringing muscles, tendons and ligaments back into alignment while taking the stress off of areas that are injured or ailing. Chiropractic has been shown to contribute to lower back pain recovery – and can also be used as a preventative measure (along with strengthening your lower back muscles).

3.5 TALK THERAPY

Yup, this one is a weird one – but there’s at least some evidence that shows that cognitive behavioral therapy is good for not only your mental health, but your physical health, too!

A 2010 study showed that patients participating in a group cognitive behavior therapy for three months saw twice(!!!) the improvement in chronic low back pain as those who didn’t.

So while it might seem weird to “talk out” your back pain, it’s well worth a try.

Even if it doesn’t help, everyone can benefit from the release and freedom that comes with tackling your stress and anxieties head-on in therapy. It doesn’t need to be a dirty word!

3.6 ACUPUNCTURE

I’ve got to admit – the thought of someone poking me with needles to FIX my lower back pain was a bit off-putting at first, but once I tried it – I was hooked.

Sure, it feels a bit strange to think about – but the experience was, to my surprise, quite soothing.

It’s not all just ancient wisdom, either: a 2007 study showed acupuncture to be more effective than other conventional lower back pain treatments, reducing both the intensity of the pain, and leading to improvements in disabilities that can result.

There’s a low risk of any side-effects, and it can be used to help with both acute and chronic back pain.

3.7 REST

I’ve put this one last for a reason. Yes, injured muscles, tissues and nerve roots can all benefit from a few days of ceased activity – but the vast majority of the time, you need some activity in your life to help reduce and eliminate lower back pain.

Too much rest will weaken the muscles in your back, making it harder for them to support your spine over the long-term. You need to be exercising and stretching to build strength and flexibility.