Lower Back: Why It Hurts and What Exercises Relieve It

Unlike in the cervical and thoracic spine, the spinal cord has a minimal presence in the lumbar segment. At the second lumbar vertebra, it separates into a pair of thick nerve bundles that go on to innervate the lower torso and legs. 

The muscles around the lumbar spine stabilize the torso. This requires considerable power and depends on proper posture. Poor standing or seated posture overloads these muscles and the lumbar spine, leading to pain.

Lower Back Pain: From Poor Seated Posture to Disc Herniation

“Doctor, my back hurts!” Doctors and physical therapists hear this day in, day out. Back pain is among the top 10 reasons for seeking medical aid. MUDr. Michal Vilímovský (link in Czech) writes 8 out of 10 adults experience it at some point in their life. The lower back is among the most common localizations.

Pain in the lower back can be caused by any number of problems:

• overloaded lumbar spine (from exertion or poor seated posture)
• lumbar spine blockage
• acute lumbago
• spinal disc herniation

The first two causes can usually be resolved by rehabilitation, while herniated discs sometimes require surgery.

Back pain is the second-most common cause of sick leave in the Czech Republic. Starting in 2023, the government will officially recognize back pain as a professional injury (link in Czech), except when incurred in office work. Yet another reason to invest in a therapeutic chair.

However, the body’s various systems are interrelated, and pain in the lower back can be the result of a problem elsewhere, including muscle overload and conditions affecting certain organs.

If you are suffering from lower back pain, do not hesitate to visit a physician. If you’re facing long waiting times, you may try the exercises discussed below in the meantime.

Recognizing Overload-Generated Pain

How do you tell overloaded muscle pain from herniated disc pain? Let’s look at the differences.

Lower back muscle overload:

• Muscles tire quickly
• Pain usually occurs in static positions (standing or sitting), rather than during activity
• Muscles are stiff in the morning, then loosen up during the day, then pain may return with fatigue
• Pain is not sharp, but is distracting, and you frequently seek relief positions

Lumbar spine blockage:

• Sudden, sharp pain
• Pain resulted from a quick, careless motion (usually some combination of forward lean and sideways twist)
• Can’t straighten up
• Moving around is painful and difficult

Herniated spinal disc:

• Specific motions cause sharp, shooting pain in the legs
• There may be a pins-and-needles sensation or numbness
• Pain appears when sneezing and using the bathroom

Why Do Muscles Overload? Poor Seated Posture Hurts the Lower Back and More

Physical therapist MUDr. Kateřina Klimešová says: 

“Our bodies aren’t built for sitting, but walking. Walking keeps the body fit and muscles toned, including on the front of the torso. Frequent sitting causes muscle imbalances that overload back muscles while abdominal and gluteal muscles weaken. As the imbalance progresses, strain in the lower back increases until the area begins to hurt. 

The pain is the body’s way of signalling a problem, in the hopes you will protect it from further damage.”

We simply aren’t built to spend all day at a computer. What to do?

Learn healthy sitting. Invest in your health and get a therapeutic chair, which allows you to mildly exercise muscles around the spine without overloading them.

All-or-Nothing Sports Don’t Help

Some people take a foxy approach: They lack the time for regular exercise, but once a month, they really let it rip in a tennis match, golf game, etc. This is far from ideal.

When your body isn’t used to strenuous activity, starting it suddenly can hurt you. Muscles need a start-up period before being asked for peak performance, so if you exercise rarely or are older, you should spend more time warming up. Otherwise, you run the risk of a sudden-onset lumbar blockage.

Quick Relief for Lower Back Pain: What to Do When You Can’t Exercise

Your condition has become intolerable. Everyone around you says “You have to exercise”, but you know that any activity will cause excruciating pain. What do you do in this situation? Try relaxing the muscles by breathing:

1. Lie down on your back, legs bent at right angle
2. Put your hands under your navel
3. Close your eyes and focus on your breathing
4. Breathe deeply with the lower abdomen, where your hands are

After some time of this, move your hands up to your lower ribs and try breathing with this region. Then move on towards the sternum.

If your pain is too severe to do anything, it helps even just to visualize exercise. It may sound fishy, but research shows that concentrating on the idea of particular motions does cause some degree of activation in the relevant muscles.

You can try this exercise:

1. Lie down on your back
2. Bend your legs and plant your feet on the mat, hip width apart
3. Imagine a wall clock lying on your pelvis
4. Try moving the pelvis first between the 12 o’clock and 6 o’clock positions, then between 3 and 9 
5. Try moving the pelvis clockwise in circles

Direct applications of moderate heat to the sore area also help. You can use a warm towel or a heated blanket. Avoid hot baths – these warm the whole body equally, whereas you need the heat to be local.

Heat also helps for lumbar blockage. Experts from the FYZIOklinika physical therapy center in Prague recommend (link in Czech):

Lie down on your belly and ask someone to put their palms on your lower back, chest, etc., applying moderate pressure while moving the skin and muscle around the spine. Use the whole palm and all fingers; don’t use point pressure. The level of pressure should feel pleasant, not painful. Press with about the weight of the arm.

Lower Back Exercises: Focus On Breathing

Any doctor will recommend exercise; it’s a great tool to both prevent and treat lower back pain. MUDr. Michal Vilímovský (link in Czech) cautions the exercise should be regular and include proper breathing. “You should exercise for at least 10 minutes twice a day, but more is better. It’s important to make all motions slow and gradual, not jerky.”

Dr. Vilímovský also recommends a morning stretch, which helps remove stiffness in the lower back. Stay in bed for a while and stretch one arm and the opposite leg at the same time, then switch. Hold the stretch for 5 seconds; do 3 to 5 repetitions on each side.

If pain arrives while you’re in the office, you can try this exercise: “Stand next to your desk, bend forward slightly, and put your hands on the desktop. Holding your buttocks and abdomen firm, smoothly alternate between bending the lower back forward and backward. It is important to keep the motion restricted to the lumbar area; do not bend in the chest.”

You can find more exercises on this website. Keep in mind, however, that lower back pain can have a variety of causes, which generally need different treatments. If your lower back hurts, don’t hesitate to see a doctor.

Prevention Is King: Take Care of Your Lower Back Before It Starts to Hurt 

The various kinds of spinal pain tend to have the common feature of being caused by lifelong low-level strain. Long-term overexertion or poor standing or seated posture can eventually cause disc herniation later in life.

The good news is, you now know what’s bad for your spine and how to change it while there’s time:

• Stay active. Walking is best. Aim for at least 3 km (2 mi) every day.
• Sit less. Alternate between sitting and standing at work, which can be done with an elevating table (link in Czech).
• Sit healthy. Regular office chairs only allow a passive seated posture, which is unhealthy in the long-term. Get a therapeutic chair for active sitting instead.
• Exercise regularly. Even if nothing hurts.

Further Reading

• Bolesti bederní páteře: příčiny, projevy, prevence a cvičení (“Lower Back Pain: Causes, Symptoms, Prevention, and Exercises”) – detailed article by MUDr. Michal Vílímovský (in Czech)
• Bederní páteř: Cvičení proti bolesti (“Lumbar Spine: Exercises for Pain”) – video with doc. MUDr. Zdeňek Kalvach (in Czech)
• Lower Back Pain – experts from the Fyzioterra physical therapy center review most common problems and treatment options (in Czech)
• Lumbar and Sacral Pain – experts from the Levitas physical therapy center review causes (in Czech)
• Degenerativní onemocnění bederní a hrudní páteře (“Degenerative Conditions of the Lumbar and Thoracic Spine”) – staff article on disc herniation and other problems, Na Homolce Hospital, Prague (in Czech)
• Jak si pomoci při akutní blokádě bederní páteře (“Self-Help for Acute Lumbar Blockage”) – exercise guide by experts from the FYZIOklinika physical therapy center (in Czech)
• Lumbar Blockage and Acute Back Pain – detailed article by experts from the FYZIOklinika physical therapy center (in Czech)
• Lower back primer at Zdraweb, the Masaryk University healthcare portal (in Czech)
• Lower back relief exercises from the Mojžíšová Technique – video guide (in Czech)
• Lumbar vertebrae on the English Wikipedia
• Low back pain infographic at the Mayo Clinic