How to Relieve Lower Back Pain: The Ultimate Guide (With 10 Best Ways)

It starts off just like any other day: the alarm sounds, you mentally scan through your to-do list, then you go to prop yourself out of bed. That’s when it hits you. A sudden jolt of pain followed by a throbbing soreness that stops you dead in your tracks. “What in the world did I do?” you ask, but nothing comes to mind. For the remainder of the day, no matter what you do, that nagging pain in your lower back with intermittent bursts of agony unrelentingly persists. For the next few days you struggle with sleeping, sitting, and going about your daily activities.

You search for advice on how to relieve lower back pain, but suggestions from friends, family and online searches are equal parts overwhelming and discouraging. “Should I call a doctor? Should I stay in bed?” You barely have the energy and motivation to make it through the day, much less scour the internet for a solution. What are you to do?

You’re in good company. Back pain affects 80 percent of adults at some point in their lives, and is one of the leading causes of disability world-wide (Rubin 2007). The good news is that in most cases you can tackle this demon yourself. In fact, you may not have to do anything at all.

Most cases of lower back pain resolve by themselves in one to two weeks. But you’re smart, and you don’t want to leave it up to chance. You also want to be sure your pain is gone as fast as possible. You’ve come to the right place. We’re going to cover all the most common causes and top solutions to this pervasive condition. So no matter the reason, we’ve got you covered.

Causes of Lower Back Pain

Lower back pain can be broken down into two categories: acute and chronic. “Acute” means it came on recently and abruptly, while “chronic” means it has persisted for the better part of 3 months. Acute pain is usually caused by a strained muscle, and is the most accommodating to treatment. The most common reasons for acute lower back pain are:

• Lifting heavy objects with improper lifting technique
• Unnatural twisting.
• Muscle strain from poor posture, excessive sitting, and sleep position
• Pregnancy

Acute pain can devolve into chronic pain if it persists for more than 3 months, but is most often caused by problems with the discs, joints, or nerve roots. The vast majority of chronic lower back pain is caused by:

• Herniated Discs: also called a “slipped disc”. A spinal disc is the cushion between the vertebrates that has a soft interior and tough exterior. A disc becomes herniated when the tough exterior ruptures allowing the soft interior to be pushed out. Symptoms include back pain; numbness or tingling; muscle weakness; and burning in the shoulders, neck or arms. The vast majority of cases can be treated at home without medical intervention.
• Spinal Stenosis: a narrowing of the spaces in your spine resulting in pressure on the spinal nerves. This may cause pain or numbness in the arms or legs in addition to lower back pain. More severe cases can cause bladder control issues and sexual dysfunction. Relief is usually found through bending forward to decompress the lower spine.
• Sciatica: caused by compression of the sciatic nerve (spinal nerve root) causing severe pain radiating from the lower back to the butt or legs. Can be caused by a herniated disc or spinal stenosis. Like a herniated disc, sciatica typically resolves by itself.
• Osteoporosis: a medical condition where bone tissue weakens and becomes prone to fracture. When the bones in and around the lower back are affected it can cause, or contribute to, back pain. This condition is usually caused by hormonal changes or vitamin d and calcium deficiencies. While medical treatment is advised, it can be managed at home with lifestyle modifications like diet and exercise. There are also medications available.
• Arthritis: a medical condition caused by inflammation and stiffness of the joints. When the joints in and around the lower back are affected it can cause back pain. Arthritis can typically be managed at home with the assistance of lifestyle interventions, but medications are also available.
• Trauma: Spinal injuries like fractures or dislocations can be caused by car accidents, sports injuries, and falls. Any damage to the spine caused by trauma should be medically assessed.

Are You At Risk?

There’s a variety of factors that can put you at greater risk of developing acute or chronic lower back pain. Three of the primary contributers are age, weight, and sex.

Age

The likelihood of developing lower back pain increases with age, and most people experience their first episode of acute pain between the ages of 30 and 50. Muscle tone and bone density decreases with time, predisposing you to the whole host of causes.

Pain related to disc degeneration (like herniated discs and spinal stenosis) is more prevalent between the ages of 30 and 60, with arthritis and osteoporosis being more common after the age of 60. Age also increases the chance that acute pain will become chronic.

Obesity: Lose Weight to Gain Relief

Obesity has a host of issues that accompanies it, with lower back pain being one of them. Excess weight forces your spine to compensate for the extra load by tilting unnaturally forward. This puts a consistent burden on the joints, muscles, and ligaments of the lower back. This means that if back pain was already present it’s probably going to get worse, and if it wasn’t already present it’s more likely to develop. Making dietary changes and getting more physical activity are essential if being overweight is causing or contributing to your pain.

Back Pain Can Be Sexist

Whether you’re a man or a woman can impact how lower back pain manifests itself. Women are more likely to get lower back pain, but it’s also a common complaint among men. Each sex has their own set of predispositions that can impact the lower back.

Men

Men lack the anatomical vulnerabilities that make women the number one victims of lower back pain. However, there are a handful of conditions men are more likely to develop. As a result, there is still a significant number of male sufferers. One study found that between 1997 and 2014 23 percent of men in the US suffered from lower back pain (Elflein 2019). Conditions more common in men are:

• Disc rupture: Men are more likely to have physically strenuous work that increases their risk of a ruptured disc. Taking adequate preventative measures (like stretching) before engaging in physical labor is crucial if you have a physical job.
• Abdominal Aortic Aneurysm: a condition where the largest artery in the body (aorta) becomes enlarged. Back pain is the primary symptom of this condition and is more common in men. Lifestyle improvements (diet and exercise) can help prevent this condition. Treatment consists of surgical repair.

Lifestyle factors like smoking and drinking also play into the high rate of back pain among men. Men smoke 5 times more often than women do (Hitchman & Fong 2011), and 23 percent of smokers compared to 15 percent of non-smokers experience back pain (Agbi & Fahad 2009). Furthermore, tobacco use is the primary risk factor for developing an abdominal aortic aneurysm.

Along with smoking, men are also more likely to drink excessively. This can dehydrate the kidneys and cause gastrointestinal disruptions, resulting in lower back pain. Man or woman, reducing or eliminating these substances should be a high priority — but especially for men.

Women

Several studies have demonstrated that women suffer from back pain more often than men, and one study found that lower back pain in women was more likely to turn into a chronic condition ( Karppinen & Samartzis 2017). Reason being that there are several conditions affecting the lower back that women are more prone to. These are:

• Coccydynia: Pain in the coccyx (or tailbone) affects women 5 times more often than men (Lirette, Chaiban, Tolba, & Eissa 2014) because the tailbone is less protected in female anatomy. This condition is usually caused by an injury to the tailbone from childbirth. The coccyx provides weight bearing support while sitting, so symptoms present themselves when sitting down, sitting on hard surfaces, and leaning backward while sitting. These symptoms are usually relieved as soon as you stand up.
• Sacroiliac Joint Dysfunction: The sacroiliac (or “SI”) joint connects the pelvis to the bottom of the spine. Women have smaller SI joints, making it more vulnerable. Other anatomical variations (such as a wider sacrum, less curved backs, etc.) sets up the SI joint for problems. Sacroiliac joint dysfunction causes sciatica-like symptoms including lower back pain, dull pain in the buttocks, and shooting pain in the thighs. Sitting for extended periods of time, climbing stairs, and lying down on the site of pain can worsen symptoms.
• Degenerative spondylolisthesis: This condition is created when a spinal vertebra slips over the one below it because of spinal degeneration. Women are three times more likely than men to get this condition, and post-menopausal women are at greatest risk. It’s caused by low estrogen levels that causes the discs of the vertebrae to degrade and the ligaments to loosen. In addition to lower back pain, degenerative spondylolisthesis can cause radiating pain in your legs while walking. Pain relief is usually found by bending forward for a time.
• Piriformis syndrome: a spasming of the piriformis muscle, located in the buttocks. This can irritate or depress the sciatic nerve, mimicking sciatica pain. It also causes chronic pain in the buttocks, shooting pain in the back of the thigh, and makes you unable to sit down for long periods of time. Women are 6 times more likely to have piriformis spasms than men because they’re usually caused by pelvic shifts from child-birth (Shah 2019). Lying on your back eases piriformis pain.
• Pregnancy: There’s a lot to be said in relation to pregnancy and lower back pain. Therefore, we’ll begin our examination of pain relief strategies here.

How to Relieve Lower Back Pain During Pregnancy

Anywhere between 50 and 70 percent of women experience back pain during pregnancy (Perkins, Hammer, & Loubert 1998). As the baby grows your center of gravity progressively shifts forward, forcing you to lean backwards to compensate. This puts a lot of stress on your lower back. Maintaining good posture and wearing appropriate footwear can combat this tendency.

Having the right pair of shoes has many advantages. They can help with posture and provide ankle support resulting in less swelling of the feet, ankles, and calves.

Consider buying a pair half a size larger than you currently wear. This allows for room to fill in the coming months when swelling and weight gain is at its peak. Also consider a slip-on variety. Your growing bump in the latter stages of pregnancy makes bending forward to put on and take off your shoes more difficult.

High heels are a no-no. No woman struggling with lower back pain should be wearing high heels, but this is especially true for pregnant women. They shift your center of gravity even further forward, compounding the pre-existing problem. High heels also place excess pressure on the balls of your feet and tighten your calf muscles. Again, things you’re probably dealing with enough as it is.

A maternity belt is another valuable item. These support the abdomen and hips which reduces the strain on your lower back. There are various types of maternity belts available, including:

• Belly Bands: flexible tubes worn around the belly helpling to extend the life of clothing while providing mild compression to ease lower back strain. They’re usually worn under clothes.
• Belly Belts: In contrast to belly bands, belly belts are more rigid providing greater support to the back and hips. These are usually worn over clothing, but can also be worn under clothing.
• Maternity or Prenatal Cradles: combines a belly belt with an upper strap that wraps over the top of the abdomen — forming a cradle. These provide the greatest amount of structural support.

The type you choose depends on how much compression and support is comfortable for you, and whether or not you want to wear something under or over your clothing.

Finally, sleeping on your side promotes proper spinal alignment. Doing so is generally recommended for any type of back pain, but there are some additional suggestions for pregnant women.

Some experts suggest sleeping on the left side to optimize blood flow to the baby, uterus, and kidneys. Maternity support pillows can be helpful, as they support your bump, promote staying on your side throughout the night, and keep separation between your knees to further assist spinal alignment.

How to Relieve Lower Back Pain — 10 Methods for Everyone

Now that the specifics are out of the way, we can shift our focus to the ten most effective pain relief strategies that work regardless of the cause. Try to utilize as many of these strategies as you can. While the last two items require professional assistance, the remainder can be conducted from the comfort of your home with minimal expense, so you can get started right away.

1. Use Hot and Cold

You probably learned from your mom that every time you stub your toe or bump your head you can grab a bag of frozen peas to ease the pain. This time-tested trick also happens to be one of the most efficacious ways to relieve lower back pain. Thanks mom.

Heat is also incredibly effective and works synergistically with the cold, but only if used at the right time. You should start with ice for the first 24 to 48 hours after the onset of pain, then you can switch to heat.

The cold helps by constricting blood vessels which reduces inflammation, and it reduces the nerves’ ability to conduct pain signals. Heat then helps mobilize blood flow and oxygen back to the site of pain (facilitating healing and repair), and helps relax stressed muscles. Applying heat prematurely can promote the very inflammation that’s causing the pain, which is why you start with ice.

You can use a pack of peas, a cold gel pack, or a bag full of ice. Whatever you choose, make sure to wrap it in some type of cloth to minimize skin irritation. Only use it for 10–20 minutes at a time with 10–20 minute breaks in between applications.

For heat, you can take a warm shower, a hot bath, or use a heating pad. If using a heating pad apply the same principles as the cold pack by wrapping it in a cloth and only using it for a predetermined amount of time.

2. Anti-Inflammatories

Sometimes, the anti-inflammatory relief derived from an ice pack just isn’t enough. In that case you can use a non-steroidal anti-inflammatory (NSAID) such as naproxen sodium (Aleve) or ibuprofen (Advil and Motrin). These have been shown to be more effective than acetaminophen (tylenol) which doesn’t directly combat inflammation.

If you go this route, be aware that extensive use of these drugs can lead to gastrointestinal issues, and may be contraindicated if certain other medical conditions or medications are present. This makes anti-inflammatories better suited to acute cases, since you’ll only be needing them for a short time.

3. Eat to Beat the Heat

Pills aren’t the only thing you can ingest to combat inflammation- you can also use food.

Certain foods have key nutrients that minimize inflammation and provide the building blocks for proper bone and joint health. These are especially important if you have a condition like arthritis or osteoporosis.

Moreover, if being overweight is causing your pain, making dietary modifications can help shed the pounds. Many of the foods that contain the key nutrients vital for symptom relief double as healthy options that can assist in your weight loss goals.

Some good anti-inflammatory foods you should regularly incorporate are:

• Omega-3 fatty acids: You can find these in supplement form or derive them from certain foods like fish, nuts, and seeds. Try to consume 1,000mg worth of these fats every day.
• Antioxidants: compounds that destroy free radicals and can reduce inflammation. Key antioxidants are Vitamin A, C, E, and Selenium. You can also obtain these in supplement form or from food. Good dietary sources are fruits and vegetables, nuts, and tea.
• Spices: Spices such as turmeric (curcumin), ginger, and chili peppers (Capsaicin) have been shown to drastically reduce inflammation.

Nutrients crucial for bone health include:

• Calcium: We’ve all seen the milk advertisements telling us that calcium builds strong bones, and it’s true. Dairy products (such as milk, cheese, and yogurt) are excellent sources of calcium, but they’re not the only ones. Certain vegetables like broccoli, kale, and collard greens are other great sources.
• Vitamin D: Vitamin D plays so many crucial roles in the body, many of which have a direct impact on lower back pain. It facilitates the absorption and utilization of calcium, and low levels of vitamin D are associated with weight gain and depression — both potential contributing factors to lower back pain. The ideal way to boost your levels of vitamin D is to spend at least 15 minutes a day in the sun, at least three times per week. If this isn’t possible, dietary sources include dairy products (milk, cheese, yogurt, buttermilk, butter), soymilk, eggs, dried shiitake mushroom, and fish oil.
• Phosphorus: an essential element for bone health. Sources include dairy products, beans, oysters, and sardines. Needs to be consumed along with calcium in order to be effective for bolstering bone health.

4. Fix the Way You Stand, Sit, Lift, and Sleep

Improper posture can place a significant burden on your spine and back muscles. The way you stand, sit, lift, and sleep can all contribute to, or even cause, lower back pain.

Standing Posture:

• Stand with straight shoulders, head up, chest forward, and hips tucked.
• Balance weight evenly on both feet.
• Keep your chin tucked to keep your head level.
• Ensure your ears, shoulder, hips, knees, and ankles are aligned vertically.
• Look straight ahead with your head up when walking.

Sitting Posture

• Align your back with the back of your seat.
• The height of your chair should make it so your feet rest flat on the floor, with your knees level with your hips.
• If using a computer, it should be about an arm’s length from the chair with the top of the screen at about eye level.
• Keep frequently used objects (such as your phone, pens, notepads, etc.) within arm’s reach to prevent repeated twisting and straining of your lower back.
• Consider an ergonomically designed chair or a lumbar support pillow.
• Stand up and stretch at regular intervals — at least a couple of times per hour.

Lifting Technique

• Bend at the knees, not the waist.
• Ensure you have firm footing.
• Use your leg and core muscles while lifting instead of your lower back.
• Keep the object you’re carrying close to your chest.

Sleeping Posture

• Sleep on your side.
• Assume the fetal position by drawing your legs up towards your chest.
• Place a pillow or two between your knees.

5. Get a New Mattress (Or Flip Your Old One)

Chronic pain is one of the leading causes of insomnia, and in turn insomnia can make chronic pain worse. Sleep posture is undoubtedly important for ensuring you get a good night’s sleep despite pain, but it won’t matter if you’re doing so on a sub-par mattress. Back pain or not, having a comfortable mattress that you’ll be happy spending a third of your life in is one of the best investments you can make.

Mattresses only have a lifespan of about ten years. It’s possible that your mattress used to provide the perfect amount of support, but their quality deteriorates over time. After around the 6 year mark is when a replacement should be considered, but even if it’s younger than that it should be replaced if it’s sagging considerably.

Most people find that a medium-firmness (neither too soft or too firm) provides the greatest spinal support and symptom relief. Conventional wisdom would have you believe the firmer the the better, but this doesn’t seem to be the case for most. At the end of the day it’s a matter of what works best for your individual needs.

Sometimes, buying a new mattress just isn’t feasible. In such cases, rotating and/or flipping your current mattress can help extend it’s life. This works by spreading out the daily pressure you exert on it. It should be noted that many mattresses are “one sided” and can’t be flipped, but can still be rotated. If you plan on doing this you should get someone to help you. It would be a shame to injure your back while performing a prevention procedure.

6. Lower Back Pain Exercises

It may be tempting to crash on your couch (or newly flipped and rotated mattress) for the duration of your back pain episode, but staying as active as you can will help reduce stiffness and increase mobility. Simple things like taking your dog on a walk, making your bed, and continuing to go to work can do the trick. If you work at a desk-job, standing up to stretch at least once an hour will help tremendously.

Exercise has the added benefit of releasing endorphins (your inner pain-killers), so if you’re up for it, light aerobic activity like swimming, bicycling, and brisk walks can work wonders. Just be sure not to overdo it.

Once you’re feeling better you can perform exercises to increase your core and back strength to prevent future episodes of acute pain. Again, overdoing it will do more harm than good. Stop if you experience any pain (that is more than mild) that lasts for more than 15 minutes.

Great exercises to strengthen the back and core include:

• Back Bridges
• Planks
• Front
• Side
• Simply sitting on an exercise ball for 30+ minutes

If formulating an exercise routine on your own seems too overwhelming you can work with a personal trainer or physical therapist to help design a personalized routine tailored to your individual needs. No matter which route you take, be sure to stretch before-hand.

7. Stretch

Stretching, either as part of a structured routine or merely standing up from your desk a couple of times per hour, helps stabilize your spine and reduces muscle strain. Yoga in particular has been shown to bring short term relief to lower back pain, and has the added benefit of lowering stress that can be an aggravating factor (Tilbrook, et al. 2011).

Here are some of the most recommended yoga poses:

• Cat-Cow
• Child’s pose
• Downward facing dog
• Pidgeon’s Pose
• Happy Baby
• Thread the Needle

There are several yoga routines freely available on youtube that are geared specifically toward lower back pain management, such as the following:

Video: Double-Click to View

8. Master Your Mind

The way your mind interacts with your pain can make it better or worse. There’s a substantial overlap between the neurological circuits responsible for processing pain and emotions.

Depression, anxiety, and other negative states can make your pain even worse. This can devolve into a feedback loop of pain contributing to negativity in turn creating more pain. Fortunately, there are techniques and practices that help manage both pain and negative emotional states, thereby interrupting the cycle.

CBT

Cognitive-Behavioral Therapy (CBT) is a therapeutic modality designed to change cognitive distortion, improve emotional regulation, and develop effective personal coping strategies. Originally designed to treat depression, CBT has expanded to incorporate the treatment of many other conditions, including chronic pain. While typically employed with the help of a therapist, many of the techniques can be learned on your own through books and websites.

Meditation

One of the most effective means of exercising mind over matter is mindfulness practice.

The popularity of meditation has exploded over the last several years, and for good reason.

Among the multitude of benefits is a dramatic ability to reduce pain. In fact, some studies have shown mindfulness practice to be more effective than narcotics (Chen 2016).

Meditation shouldn’t be an intimidating venture, and you don’t have to be the Dalai Lama to reap the rewards. Apps like “Insight” and “Headspace” are geared towards all experience levels, and offer several guided meditations for pain management.

9. Acupuncture

Moving on from the methods to reduce pain at home, there are also certain alternative (or “complementary”) therapies like acupuncture that have been proven effective in managing lower back pain. In fact, one study found that acupuncture was more effective than painkillers (Lee, et al. 2013).

We may know that acupuncture works, but we’re not exactly sure how. Researchers speculate that it works by releasing pain killing endorphins and the “feel good” neurotransmitter serotonin. Quite similar to the benefits of exercise, but without the physical activity which might not be possible depending on the severity of your pain.

It may not sound appealing to have a bunch of needles stuck into your skin while you’re in the midst of pain, but the potential upside should make you strongly consider this option.

10. Massage

Massage is increasingly being recognized for its pain-relief benefits. There aren’t any studies definitively showing its long-term benefit on back pain, but there are some demonstrating that it brings substantial short-term relief. Similar to acupuncture, one of the reasons massage is thought to be useful is because it releases endorphins.

Another likely mechanism is that it increases blood-flow to the tense muscles causing pain. There are several different types of massage, and some are more effective than others.

Neuromuscular Therapy (also known as “Trigger Point Myotherapy”) is considered the most effective. This type of massage concentrates on breaking up muscular “knots” by cycling periods of varying pressure at the areas causing pain. Swedish Massage and Deep Tissue Massage have also been shown to be helpful.

Massage may not be the most researched modality, but the volume of testimonials from other back pain sufferers should warrant scheduling yourself a “rub-down”.

When Should You Call a Doctor?

There are times when calling a doctor or going to the E.R. should be the first thing you do. These are:

• Fever
• Recent, unexplained weight loss
• Pain so intense it wakes you up at night
• Causes bowel or bladder control issues
• Numbness in tingling in your legs
• Pain spreads down your legs
• Pain occurred immediately following a physical trauma (car crash, sports injury, etc.)
• Pain persists after 4 to 6 weeks of self-care

You can expect your doctor to implement additional testing, prescribe certain medications, and/or refer you to a pain specialist. The testing will likely consist of a physical evaluation, symptom survey, and potentially imaging tests like an X-ray or MRI.

Some of the medications your doctor may prescribe are:

• Epidural steroid injections (cortisone shots): a short-term, but potent anti- inflammatory used for treating sciatica and lower back pain caused by inflammation.
• Counter-irritants: topical creams or sprays that stimulate the nerves in the skin to give a warm or cold sensation to decrease the sensation of pain. Other topical analgesics boost blood flow and reduce inflammation.
• Muscle Relaxants: act on the central nervous system to relax muscles. Used to manage pain, muscle spasms, and hyperreflexia.

Do you Need Surgery?

Many struggling with chronic pain consider surgery in the hope that it will provide a quick fix, but this usually isn’t the case. In fact, surgery comes with it’s own list of possible complications, and most people don’t realize it takes several, often painful, months to fully recover.

Additionally, there is little evidence showing which surgery works best for their corresponding indications. Unless there’s a pinched nerve caused by a herniated disc or something similar, most cases can be managed independently of medical supervision, with physical therapy, or just with the passing of time.

Surely, surgery should only be considered as a last resort when all other avenues have been exhausted, and at the recommendation of a pain specialist.

What is the Best Treatment for Lower Back Pain?

Having lower back pain is no fun. It zaps your energy and can be a source of endless frustration. In that state, it can be hard to muster up the motivation to try anything new and seemingly intimidating. However, if lasting relief is what you seek you need to take action.

Start small; but start.

There’s no perfect strategy that will work for everybody, so you need to discover what works best for you.

If your pain just began, perhaps try starting with alternating cold and hot packs along with taking an NSAID. If that proves insufficient after a few days consider scheduling a massage or acupuncture appointment.

At the end of the day, the important thing is to just get the ball rolling. Doing something every day that brings symptom relief will begin chipping away at your pain and discouragement. If you persist, before you know it you’ll have your life back — pain-free.