Find out about the best exercises and natural remedies to relieve back pain yourself at home, as well as when you need to seek medical advice
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Some 80% of people in the UK have issues with lower back pain. Back pain is also the single largest cause of disability in the UK and referrals for spinal surgery are on the increase.
Millions of people have visited their GP for lower back pain. They have had numerous tests but are still left without a specific diagnosis for their pain and have to self-manage their symptoms with a restricted lifestyle or painkillers.
I had a ruptured disc in my lower back in my twenties. It was never diagnosed properly in the early days before it ruptured and therefore I was unaware that I could have been doing exercises to help it recover. It got so bad it eventually split, trapping the nerves for both of my legs and making it nearly impossible for me to walk, and the pain was excruciating.
I spent three months in bed before I was referred to a specialist who told me that there was no way I could ever walk properly again without an operation, and even then he didn't know if I would walk, but he could take away the pain.
I had a long (about 6 hours) operation and then had to learn to walk all over again. However, this time I did my research and was able to do appropriate exercises and find an Alexander Technique teacher to help my rehabilitation.
My surgeon told me that almost everyone who has a disc removed from their back will have a second one go at some stage as their back has been weakened by the loss of the original disc. I was not prepared to go through that experience again and here I am decades later still strong and flexible and have never had another disc rupture.
Read on to find out how you can help your back pain now and hopefully prevent it from getting to the stage where you need surgical intervention.
Why does my lower back hurt?
The lack of flexibility in our backs creeps up on us slowly over the years. When we were younger we tended to be more active. Sitting for many hours of the day increases the pressure on the spinal discs (little spongy doughnut shaped rings that go down your spine and act as shock absorbers). This means that at the end of the day you are slightly shorter than you were in the morning due to water loss. As you lie in bed overnight the discs suck up water again to regain their bounce.
As we age though, our discs can get harder and less flexible. They can't hold as much protective fluid and become more prone to damage. Sitting all day also means that, unless you are fairly active the rest of the time, your back and tummy muscles get weaker over time too.
From our mid twenties we also start to lose collagen, which can start to show in the form of mild wrinkles and loss of elasticity in our skin and tissues (see my article on The Benefits of Collagen). Collagen also helps lubricate our joints. What starts as just a slight tightness in our late twenties or early thirties can be a full blown locked back in our forties. This is why exercise such as gentle stretching, yoga, pilates, walking and swimming can be so beneficial in keeping our bodies flexible and pain free. Taking a collagen supplement can also help.
When should I see a doctor for back pain?
There are many medical conditions that can cause lower back pain such as kidney infections, endometriosis, gallstones, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and various other conditions. If you are in severe pain or have been suffering for over a few weeks then you should seek professional medical advice.
If you have back pain and any of the symptoms below, you should seek immediate medical assistance:
sudden weakness in either one or both legs
incontinence (bladder or bowel)
inability to pass water or faeces from the bladder or bowel
numbness or pins and needles in your legs and/or buttocks
the pain is accompanied by a high temperature
the pain came on immediately after an accident such as a bad fall or something hitting your back or ribs
Symptoms of lower back pain
You don't feel too bad standing up but if you bend over you don't seem to have the 'power' to pull yourself back up properly. You feel weak and it may hurt.
You find you can't straighten up 100% and walk with a slight hunch or tilted forwards slightly.
You limp slightly because one leg doesn't seem to want to work properly and/or it feels weak. It may cause greater pain if you try and walk properly with both legs.
You get a stabbing pain in the lower back for no reason at all now and again, or your back suddenly just 'gives way'.
You have difficulty getting out of bed or a chair due to the pain in your lower back.
If you try to bend over to pick something up you go over to one side more.
You have a pain in one or both buttocks.
You have a pain in the lower back along with pain in either the groin, side of knee, ankle or toes (or all).
There is a continuous and horrible cramp like pain down your hamstring or calf.
You have a 'locked' back where there is excruciating pain in your back on movement and you find yourself unable to move properly or straighten up.
Causes of lower back pain
Most causes of back pain are what are called 'non specific' in that there appears to be no apparent reason for them, despite the pain. Many cases of lower back pain can be caused by the following:
Injury or accident such as a fall or heavy activities such as gardening or lifting furniture (that you are not really used to)
Sitting for long periods of time
Abnormal postures such as decorating or lifting something in a hard to hold or difficult position
Being pregnant or overweight (where more weight is carried at the front the lower back over arches to try and balance out the weight)
Weak 'core' tummy muscles
Weak back muscles and lack of movement
A new form of exercise where you may have over-done it slightly
Sleeping on an old, worn or broken mattress (or sitting on a non supportive sofa or chair) where your back is not fully supported
Wearing badly made shoes that have an unsupportive sole
How to relieve back pain
As I mentioned at the beginning of this article, I was unfortunate enough to have a ruptured spinal disc which required surgery. Trust me, surgery is not an option you want to go for, partly because there is no guarantee that it will work and it can end up making matters worse. With care and exercise I have managed my back for decades now and have, for the most part, been perfectly normal. I walk, run and cycle with no problems. That doesn't mean I don't sometimes get lower back pain so here are the things that I do to get fully functioning again.
In most instances lower back pain should relieve itself within a week or two with some self-care at home. It is important to try and keep mobile, even if it is only a little, so that you don't cease up. Treat yourself with care and follow what you back is telling you, and if in any doubt at all, consult a medical professional at the earliest opportunity. If you are pregnant or think you may be pregnant, do not attempt any of the exercises or treatments below without consulting your GP.
If the pain is particularly bad take painkillers as necessary. When there is no pain your muscles relax helping you get more mobile. You can also ask your doctor for some non steroid anti-inflammatories or some muscle relaxants as well if the pain is severe or you can't sleep.
Exercises for lower back pain
Knees to Chest
Lie on your back on a soft surface (a yoga mat if you have one is ideal) and gently lift your knees up and as close to your chest as comfortable. Clasp your arms around your legs to hold them to your chest. You will feel the bottom of your back open up slightly as the muscles stretch and gently release. Do this carefully and slacken the grip on your legs if you feel any pain. Very gently roll to the left and right if possible. This is an extremely small movement, just enough to gently massage your lower back. If you are able to, roll the small of your back around in a small circle - make sure you are holding your tummy muscles in when you do this.
Relaxing Leg Lift
Lie on your back on a soft surface. Place a small, flat cushion under your head and lift your legs onto a chair or over the side of a chair. This will take the pressure off your lower back and help the muscles relax. This position can be very good for relieving lower back pain and muscle spasms, in fact it is my go to exercise at the first sign of a twinge.
The Bridge
This is a yoga exercise. Lie on the floor with your legs outstretched and your arms by your side. Bend your knees upwards keeping your feet flat on the floor. Holding your tummy in slightly, gently start to lift your bottom off the floor, curling your back as you go. Lift as high as is comfortably possible (even a little is good) whilst keeping your shoulders on the floor. Your neck, face and shoulders should remain relaxed. Hold for 10 seconds and then gently lower your bottom back down again by curling your back and coming back down to the floor in a controlled manner. Don't let your knees flop outwards, keep them in line with your hips. Repeat this exercise 3 - 6 times if you can and try and get to holding for about 10 - 20 seconds. In between lifting you can hold your knees to your chest (see above) to relax your back. You will probably find that you can lift a tiny bit higher at the end of the session as your back muscles relax more.
Bottom Lifts
Start in the position for the Bridge above but this time lift your bottom up and down very slowly. Start gently and try do this five times, remembering to hold in your tummy muscles. If you can manage this try and do 5 more next time and build up as time goes on. This is a great exercise for switching off back spasms and strengthening the back and leg muscles.
Sitting Stretch
Sit on the floor upright with your knees bent. Move your legs apart and your feet further away from you. Put your chin towards your chest, lean forwards and put your arms down the inside of your legs and hold on to your ankles or feet. Try to relax into this stretch and hold for as long as comfortable. This stretch helps keep your lower back flexible and helps relieve and muscle tightness or spasms.
What remedies help back pain?
Ice Pack
Use an ice-pack on the area of your back that is painful. Use a special gel ice pack if you can but a bag of frozen peas works well too. Just wrap the ice pack in a thin towel to stop it damaging your skin and place it on the painful area for about 10 minutes. Take it off and wait for about 10 minutes and then do it again. Do this 3 - 4 times a day for the first day of pain and always if you have pain after doing something like lifting or twisting where you know it was this action that brought the pain on. This will help greatly with any inflammation. An ice pack is only really beneficial within the first 24 hours of pain starting as it can calm swelling and any inflammation.
Hot Water Bottle
A hot water bottle can be very useful for helping to ease tight muscles and assisting with blood flow to the congested muscles. Make sure that you wrap the hot water bottle in a towel so that you don't burn yourself and don't keep the hot water bottle in place for long. Try doing 5 minutes on and 10 minutes off.
Magnesium supplements
Take magnesium supplements which can often help hugely with muscle problems, especially bad backs. Magnesium is a full subject in itself as it can have a host of other benefits if you are deficient (which you probably are, 70% - 80% of the population have low magnesium levels), so read about the benefits of an ionic magnesium supplement for further information.
Magnesium bath
Soak in a magnesium bath to help your muscles relax. You need to stay in the bath at least 20 minutes to absorb the magnesium but this is an extremely effective way to get magnesium into the body to relax your muscles. It will also help you sleep better. Try Epsom Salts, or BetterYou Magnesium Flakes (available from chemists and Holland and Barret), but never submerge broken skin in a magnesium bath.
Magnesium spray
Use a magnesium spray on any painful areas and rub in. I use BetterYou Magnesium Original Spray which is the strongest in the range and I find it very effective at helping reduce pain and relieving muscle spasms and tightness. It is also really good for putting on after vigorous exercise or a heavy gardening session as a preventative. Apply after a warm bath or shower, it may feel slightly tingly or you might experience a mild stinging sensation, but this is normal.
Essential oils
If you prefer essential oils, try Tisserand's Muscle Ease with ginger, lemongrass and rosemary. Apply this after a warm bath or shower for maximum effectiveness.
Dealing with a bad back on a daily basis
Getting out of bed with a bad back
Don't try and get out of bed by sitting straight up. Protect your back by rolling on to your side and then swinging your legs to the floor and pushing yourself up sideways.
Working at a desk with a bad back
If you are sitting a lot during the day make sure you get up every 30 - 40 minutes or so. You don't have to do a lot just change your position from sitting, just something that will break the sitting position. If the chair that you sit in a lot is quite deep try a lumbar cushion to take the strain off the lower back. You could also try a foot rest under the desk, just make sure you get one that has multiple height settings. I also have one of these and find my sitting position at my desk much improved. You'll be surprised how making a few adjustments to your sitting position can help improve your lower back pain. If you spend a lot of time each day sitting down and it makes your back pain worse then these options are definitely worth trying.
Sitting with a bad back
If you have a sofa that is unsupportive or you spend a lot of time in the car driving and find that either of these give you lower back pain, then try an ergonomic back support. I have had one of these for years and find it really beneficial.
Sleeping with a bad back
Use a pillow to help your sleeping position at night. If you sleep on your back put the pillow underneath the back of your knees to take the pressure off your lower back. If you sleep on your side place the pillow between your knees to stop the top knee dropping over the bottom one and pulling your lower back over.
Exercises to strengthen the lower back
Back strength exercises at home
As your back gets stronger and less painful try the following exercises, which you can do at home, to help build up your back and muscle strength:
The Supported Squat
Find some form of solid fixed support, such as the bottom of a bannister or a door frame. Stand upright with your legs about 18 - 24 inches apart and feet turned out just slightly. Hold the support and start to bend your legs in to a squat (see photo above) with your knees going outwards. Move your hands down the support as you go down. The aim is to get down into a squat and then let your bottom drop as far as it will go towards the floor. If this is no problem for you and there is no pain then you can gently move your head towards your chest to increase the stretch slightly. Sit in the squat for a few minutes - this exercise stretches the back out beautifully, especially if you have been sitting for a long time. As you get stronger hold the support more lightly and use your muscles to help stabilize you. It doesn't matter if you get down and hold the position and then have to roll over to get up again - you still got the stretch and your leg muscles will get stronger.
Back Roll for a Flexible Back
I also love to do back rolls! These help make the spine more flexible and also help relax muscles. Make sure you do this on a soft surface such as a carpet, or preferably use a yoga mat too. Sit on the floor upright with your knees bent. Put your hands under your knees and hold the wrist or hand of one hand with the other. Slightly tip your chin towards your chest. Gently lean forwards just slightly and curve our back. Tighten your tummy muscles then roll backwards, making sure to keep your back curved and your chin towards your chest, and back into an upright position again. Don't attempt this exercise if you can't curve your back as you will just fall backwards and not roll! Don't worry too much if you go back but can't get back up again to start with as long as your back is curved and you roll. Your back is still getting a bit of a roll and you will get stronger as time goes on and not thrash about like a stranded beetle (as I did when I started). This roll helps keep the back joints lose and flexible and it very effective.
Downward Roll
When you are a bit stronger also try this exercise to help stretch out the back and strengthen the muscles. Stand up straight, feet just slightly apart. Drop you chin towards your chest and put your hands flat on your tights. Gently bend the knees, but only slightly. Hold your tummy muscles in and curve your back, then gently start to slide your hands towards your knees. Once past the knees let your hands hang free so you are basically hanging over but make sure you keep the tummy pulled in and breathe freely. Feel the stretch in the lower back. Hold for about 20 seconds and then take a deep breath in and slowly start to uncurl your back as you unfold yourself back into an upright position, one joint at a time slowly. You can use your hands on your legs if you need to.
ADVANCED: If you can manage this OK then when you are curled over gently allow your arms to swing in circles (like a sideways figure 8 and then reverse the arms so they are swinging the other way. This helps release the shoulders beautifully. Just remember to keep your tummy pulled in at all times.
Pose of a Child
This position is great for stretching out both the lower back, the shoulders and the ankles. Keep your knees apart if you can to increase the stretch but if this is too much keep your knees together and your toes curled under (so your feet are not flat on the floor). This will give you a nice stretch if you are not quite as flexible and protects the ankles if they are a bit stiff. As you lie in this position you can 'crawl' your fingertips forwards to gently stretch further as your muscles relax. As you get more flexible you can move your arms around to the left to provide a stretch down the right side of the body, and then gently crawl the hands and arms around to the right to repeat the stretch on the left hand side of the body. This is one of my favourite exercises.
The main thing to remember is to try and keep mobile. If you really get into trouble and have been to your doctor and tried exercising to release and strengthen the back and are still having issues then I would recommend finding a really good chiropractor.
Chiropractors for back pain
A good chiropractor can transform your life. However, just as with any profession there are good ones and bad ones out there. A good chiropractor should give you a full consultation before attempting any treatment. They should also ask you to do some tests, perhaps grip tests for strength, bending, turning or twisting gently to see how your mobility is, and should take a detailed health history.
A good chiropractor will tell you that you won't get cured on your first visit, in fact they won't promise they can fix you at all. They should say that they think they can help you if they feel your condition is treatable. Most plans are for 6 weeks to 3 months and then you should have a review against your first set of tests so you can see what progress you have made.
Totally avoid chiropractors who you know are giving you a big sell or trying to get you to sign up for a course of treatments. I know of one chiropractor that won't treat people if they don't sign up for a hugely expensive course. That does not give me confidence in the chiropractor. They would argue that you need a course of treatments to see any benefits, but if they are any good you will want to keep going back. Naturally, the benefits come from more than one treatment, as with most things, but a good chiropractor should be confident in their abilities and treatments and should let you attend just a session at a time.
Chiropractic treatment also has a host of other benefits that you have probably never even considered such as more energy, better mood, relief of headaches, insomnia, digestive issues and ear ache as well as pain relief and that is just scratching the surface on benefits!
Alexander technique for back pain
After my back operation I found myself an Alexander Technique teacher to help me with my rehabilitation. The Alexander Technique revolves around teaching you how to improve your posture and movement which will help you avoid issues in the future.
One example when I started was my teacher asked me to stand sideways to a full length mirror. She told me to stand up straight, not tall and stiff but just relaxed and straight. She then asked me to look left at the mirror. I was leaning forward at an alarming angle although I felt I was completely upright! She gently pushed me in to an upright position but kept a hand gently on the back of my shoulders. When I looked in the mirror I was completely upright but when she took her hand away I felt like I was going to tip over backwards. That is how out of sync my body perception had become.
Alexander Technique teachers use various methods to help you re-posture yourself so that you ditch a lifetime of bad postural habits and start to use your body as it should be used. An Alexander Technique teacher can be extremely helpful in getting to the root of why you have a bad back.
Best Book for back pain
If you like researching and are interested in finding out more about your back, how it works, what causes it to lock up or give you pain, then the best self-help book that I can recommend for you is The Back Sufferer's Bible by Sarah Key.
With a foreword by HRH King Charles III (or HRH Prince of Wales as he then was), Sarah Key explains just how a back starts to break down, starting with the odd niggle or twinge, right through until the fully blown locked back. There are plenty of diagrams, pictures and case histories to help explain and it is not a heavy read, just very informative.
She gives a full list of exercises and treatments that you can do at home and they are incredibly effective in helping you manage your own back issues. Thoroughly recommended and available from Amazon in paperback and on Kindle.
If you find you are getting pain underneath your foot or in your heel, then you may have plantar fasciitis. Check out the article on how you can help relieve the pain and heal plantar fasciitis naturally at home too.
You may also find that a calming pillow sleep spray can help you relax at night too - read the review of Neal's Yard Goodnight Pillow Mist Spray.
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