Tips to Relieve Your Lower Back Pain

If you’ve experienced back pain, you’re not alone. 

“Virtually everybody will have low back pain at some point throughout their life,” says Harold J. Pikus, MD, a neurosurgeon at Alice Peck Day Memorial Hospital, a member of Dartmouth Health.

Back pain doesn’t have just one cause. It can come from things like overuse, injury, genetics, aging, tobacco use, and obesity. People are also living longer and spending more time sitting, which means less movement to keep the spine healthy.

“Roughly a third of us are chronically plagued by it to some degree,” Pikus explains.

Your spine links your nervous system with your body’s structure and movement. With two exceptions, each bone of the spine has six joints, adding up to about nearly 150 joints that allow you to move and stay stable.

“The spine is complex,” says orthopaedist Adam M. Pearson, MD, of Dartmouth Hitchcock Medical Center (DHMC), a member of Dartmouth Health. “And those joints can wear out over time.”

As we get older, natural wear and tear on the spine increases, and conditions like arthritis and degenerative disc disease become more common.

“For about 90% of patients with back pain, we’re just dealing with what we would call non-specific back pain,” says chiropractor Logan Benjamin, DC, of the Family Medicine Practice at Dartmouth Hitchcock Clinics Heater Road.“That’s a good thing because it means that we’re not looking at any sort of serious structural issue.”

What are the causes of wear and tear on your spine?

Injuries
Strains and sprains are the most common causes of back pain. Daily movements like bending, lifting, and twisting add up over years and can strain your muscles and joints. More serious injuries like spinal fractures can happen from a fall or car accident.

Aging
As you age, the discs between your vertebrae lose water and flexibility, and joints can develop arthritis.

Sedentary lifestyle
Sitting for long periods weakens core muscles and puts sustained pressure on the lower back.

Poor posture
Slouching or improper alignment increases stress on the spine over time.

Excess weight
Extra body weight, especially around the midsection, adds strain to the lower back.

Incorrect exercise or lifting techniques
Even healthy activity can contribute if done with poor form.

Tobacco 
Using tobacco can be a major contributor to chronic back pain.

Should you rest or keep moving?

“The main advice we give is to stay active, even though it might seem odd because it can sometimes cause discomfort,” Benjamin says.

Research shows that being active helps recovery, and resting too much can make lower back pain worse. It can also make people think the pain is serious and prevent them from moving.

But most lower back pain resolves on its own, often within a matter of weeks, says Rebecca J. Gallant, APRN, of the Pain and Spine Clinic at Dartmouth Hitchcock Clinics Manchester.

“In the majority of patients with acute low back pain, it actually will go away by itself within six weeks without any sort of medical intervention,” Gallant says.

You should still use caution. Staying active with back pain doesn’t mean you should push through strong pain or start tough workouts. Gallant says simple things like walking, gentle stretching, and easy home exercises are typically most helpful.

Do you need surgery for back pain?

Even though back pain is common, experts say aggressive treatment or surgery are rarely necessary.

“Surgery for back pain in general is a losing proposition,” Pikus explains. “We don’t operate on people for back pain, except in some very specific circumstances.”

Surgery is usually only needed for clear structural problems, such as nerve compression causing leg pain or numbness, fractures, tumors, or major instability in the spine.

“Although there are a few exceptions, most people have mechanical back pain, and that’s going to resolve with treatment, not surgery,” Pikus says.

Do I need to worry?

 For most people, back pain is annoying but not dangerous, unless you are exhibiting one or more of the “red flag” symptoms. In general, those include changes to bowel or bladder function, fever, something that predisposes you to risk of fracture (for instance, osteoporosis), history of cancer, or inflammatory diseases.

If you are worried, seek medical consultation. Pain, numbness, or weakness into the legs should also direct you toward medical evaluation.

What helps back pain?

Physical therapy, managing your weight, chiropractic care including spinal manipulation, and anti-inflammatory medicine like ibuprofen can help treat lower back pain. Targeted exercises to strengthen your core and improve movement also help.

“Even if your back has arthritis, if your core is strong and you stay as limber as possible and active, it probably will hurt less,” Pearson says. “And while you can’t ward off aging and arthritis, you can limit the negative effects of those changes.”

It’s also important to change how you think about pain and not see it as a sign of harm.

“Hurt doesn’t always equal harm,” Benjamin explains. “Taking a walk or doing some stretches and feeling discomfort doesn’t mean you’re making things worse.”

For most people, staying active, building strength, and maintaining healthy habits help with easing or preventing lower back pain.

“The bottom line is that movement is going to help you and your spine in the long run,” Benjamin says.

Stretches and exercises you can do to reduce lower back pain

Stretching can help reduce back pain and lower the risk of recurrence. Stretches for “healthy” backs are different than for backs that are injured, Pikus explains.

Our experts suggest the following movements, which are designed to stretch and strengthen your back and the muscles that support it. If your back is injured already, you should avoid hyperflexion (when the spine is twisted forward too far), hyperextension (twisting of the back in a backward motion), and twisting of the spine when possible.

Straight leg lifts

• Lie on your back with legs out straight on the floor.  
• Tighten your core and lift one leg straight up in the air as high as you can to 90 degrees.
• Hold for 3 to 5 seconds and gradually lower the leg.  
• Start with 5 reps on each side and gradually increase to 3 sets of 10 on each side.

Bird dog 

• On your hands and knees, keep your back flat and core engaged.
• Then lift one arm straight out in front of you at the shoulder while you lift the opposite leg straight out behind you at the hip. Hold outstretched while keeping back flat and core engaged for 5 seconds. 
• Start with 5 reps on each side and gradually increase to 3 sets of 10 on each side.

 Lower back flexibility exercise

• Lie on your back with knees bent and feet flat.
• Gently tighten your core so your lower back lifts slightly off the floor. Hold for 5 seconds.
• Then reverse it by pressing your lower back into the floor. Hold again.
• Repeat 5 times to start, gradually working up to 30.

Shoulder blade squeeze

• Sit or stand up straight.
• Pull your shoulder blades back and together.
• Hold for 5 seconds, then relax.
• Repeat 3-5 times, twice a day.

Cat stretch

• Start on your hands and knees.
• Slowly round your back upward (like a stretching cat), tucking your chin.
• Then gently let your belly drop and lift your head.
• Move slowly between the two positions. Repeat 3–5 times, twice a day.

*Avoid this exercise if your back is already injured.

Seated twist stretch

• Sit upright in a chair.
• Cross one leg over the other, then gently twist your upper body toward the crossed leg, using your opposite arm for support.
• Hold for about 10 seconds, then switch sides.
• Repeat 3-5 times per side, twice a day.

*Avoid this exercise if your back is already injured.

Lower back rotation stretch

• Lie on your back with your knees bent and feet on the floor.
• Keeping your shoulders down, gently drop both knees to one side.
• Hold for 5–10 seconds, then bring them back to center and switch sides.
• Repeat 2–3 times on each side, ideally morning and evening.

*Avoid this exercise if your back is already injured.

Resources + Related Stories

Department of Orthopaedics at DHMC

Pain and Spine Clinic

Why You Need Functional Fitness for Strength and Balance

Injured? Hold the Ice and Start Moving