Lower Back Pain: Causes, Exercises and Fast Relief

Lower back pain is the single leading cause of disability worldwide, according to the WHO, and most people will have at least one episode in their life. The good news: in most cases it isn't caused by anything serious and gets better within a few weeks.

Common causes

• Muscle or ligament strain from lifting, twisting or a sudden movement
• Long hours of sitting, especially hunched over a laptop or phone
• Weak core and back muscles and low activity levels
• Disc problems: a bulging (herniated or "slipped") disc can press on a nerve and cause sciatica, a shooting pain down one leg
• Age related wear of the spine (spondylosis)
• excess weight, pregnancy, stress and poor sleep

Low vitamin D levels, very common in India, can cause aching bones and muscles.

What helps

1. Keep moving. Gentle walking and normal daily activities, within comfort, help more than lying in bed.
2. Heat. A hot water bag or warm shower relaxes tight muscles.
3. Painkillers. Paracetamol or a short course of an anti inflammatory gel or tablet may help: check with a doctor or pharmacist, especially if you have stomach, kidney or heart problems.
4. Sleep position. Lie on your side with a pillow between your knees, or on your back with a pillow under your knees.
5. Stay positive. Fear of movement can make pain last longer.

Gentle exercises

Do these slowly, 5 to 10 times each, stopping if pain sharply increases:

• Knee to chest: Lying on your back, pull one knee gently toward your chest and hold for 20 seconds.
• Pelvic tilt: Lying on your back with knees bent, flatten your lower back into the floor by tightening your stomach. Hold 5 seconds.
• Cat and cow: On hands and knees, slowly arch and round your back.
• Bridge: Lying on your back with knees bent, lift your hips to make a straight line from knees to shoulders.
• Child's pose (balasana): Kneel, sit back on your heels and stretch your arms forward on the floor.

Yoga, Pilates and a structured physiotherapy programme have good evidence for long term back pain.

Desk worker tips

• Keep your screen at eye level and your feet flat on the floor.
• Use a small cushion or rolled towel to support your lower back.
• Stand up and move every 30 to 45 minutes.
• Don't work from the bed or sofa for long periods.
• Lift with bent knees and keep loads close to your body.

When to see a doctor

See a doctor if pain hasn't improved after 4 to 6 weeks, is getting worse, keeps you awake at night or follows a fall or injury.

Seek emergency care if you have numbness around your genitals, buttocks or inner thighs; new difficulty passing urine or loss of bladder or bowel control; or weakness in both legs. These can signal cauda equina syndrome, which needs urgent surgery.

Also get checked promptly for back pain with fever, unexplained weight loss, a history of cancer, or if you're over 50 with new pain.