Low Back Pain Self-Management Guide
This resource page provides guidance on how to self-manage low back pain. It is based on medical research and clinical observation of common presentations of low back pain, and treatment standard practices. It is only for guidance and is not to be interpreted as a formal diagnosis of your condition, or seen as a medical directive. It is best to consult with a doctor, when available.
That being said, the vast majority of typical/common cases of low back pain can be managed conservatively using ice, heat and other safe physiotherapies along with stretches, exercises and certain lifestyle modifications. Less than 2% of cases of low back pain are “red flag” situations that require a doctor’s visit. This includes spinal fractures, disc rupture, nerve root or cord compression, tumors, cancer, infection or any other serious condition capable of producing back pain.
STEP 1: Answer a few questions about your low back pain:
STEP 2: Click your diagnosis result below:
(instructional videos coming soon, please check back later.)
Recommended Therapy
to Self-Manage and Cure Low Back Pain
Frequently Asked Questions about Low Back Pain
What is the fastest way to relieve low back pain?
+For general low back pain, ice, rest, NSAIDs like Tylenol, and avoiding strenuous activity for 2 days works for most cases. But if you cannot afford to wait, you can accelerate pain relief with things like red light therapy, laser and pulsed electromagnetic field. If pain persists, consider getting checked by a chiropractor. Low back pain is best avoided by keeping fit, maintaining a strong core (abdominal and spinal muscles) and practicing good posture and movements.
What are some of the best lower back pain treatments?
+The best treatments for lower back pain include cold therapy (cryotherapy), infrared heat lamps, pulsed EMF, red light therapy, laser, and TENS. Traction may help relieve pressure to your discs and can be accomplished using an inversion table. Exercises to strengthen the back muscles and abdominals, as well as posture correction exercises help prevent future episodes of lower back pain. Also, if you are overweight, getting to a healthy weight will help reduce lower back pain.
Should I use ice or heat for low back pain?
+Use ice for the first 24-48 hours after onset of low back pain to numb pain and reduce swelling, then shift to heat to increase blood flow, hence oxygen and nutrients to the injury. Ideally, visit a cryotherapy center to get dry freezing air, or go inside the cryotherapy chamber for 3-4 minutes. Infrared heat is better than a hot pack because it penetrates deeper.
How to treat low back pain from pregnancy?
+As your pregnancy enters the 3rd term you will gain the most weight. This will put your lower back into a sharper arc when standing, which compresses the discs and facet joints of the lumbar spine. So a good exercise is pelvic tilts: lie on your back, knees bent with feet on the floor, and contract your abdominals so as to flatten your low back against the floor and curl your lower back into flexion. Push off just a little with your feet for leverage. Hold the flexed lumbar position for 3 seconds then relax, and repeat. Do about 12 repetitions three times a day. This decompresses your discs and facet joints.
Why does my low back pain keep returning?
+Chronic, non-specific low back pain is the most common type. People who engaged in a heavy labor job, sports, or prolonged sitting in their job are at the highest risk. Obesity is also a risk factor. But some people with none of these factors can get this type of back pain. The causes are not well known but are most likely due to abnormal core/ postural muscle coordination and strength, poorly healed soft tissues, and even sensory nerve dysfunction in the spinal cord and/or brain. A smart remedy for this type of low back pain is increasing one's fitness and muscle coordination using functional exercises. Check with an athletic trainer experienced in improving muscle coordination and response time.
How do I know if I have a pinched disc?
+A "pinched disc or nerve" is the layman's term for disc herniation. The term suggests the disc material or spinal nerve root being pinched by the vertebrae above and below it, causing pain. A disc herniation is the bulging outwards of the disc center called the nucleus, which can happen from an injury or from gradual weakening of the disc annulus, the bulk of the disc arranged in concentric rings. A disc typically herniates posteriorly and to the left or right. If it's big enough, it can "pinch" the exiting spinal nerve root and cause leg pain and numbness on that side, sometimes down to the foot but mostly to the calf. There's a good chance you have a pinched nerve from a disc herniation if your pain occurred from trauma (fall, sports injury, lifting something heavy); it feels deep and sharp/focal; it makes you stand crooked to one side, and you have leg symptoms.
I'm thin and don't lift heavy things or do sports. Why does my back hurt often?
+Low back pain can be ergonomic related. This means how you sit, stand, walk, and move in your environment. If your work station is arranged such that it requires you to bend excessively, it can strain your spine and cause pain. It can also cause imbalances in your abdominal, spinal and gluteal muscles which can cause things like an anterior or posterior tilted pelvis, which can cause low back pain. If you have a sedentary job, you may lose muscle group coordination which is needed to properly move your spine during everyday movements such as picking something up from the floor. This can make you prone to a back injury.
What is the best stretch for low back pain?
+A good stretch for low back pain is the cat-camel: Get on the floor on your hands and knees, look straight ahead. Relax your back muscles so that your low back sinks/ stomach falls downwards, and arch your neck back (camel posture). If your back is too stiff to sink on its own, force it into an arc by contracting your low back muscles. Hold for 5 seconds, then round your back by contracting your abs and pushing down on your hands (cat posture) and let your head drop downwards. Repeat 10x, 3 times a day.
Why isn't my low back pain going away?
+If you have low back pain for over two or three weeks that seems to have gradually appeared on its own (no injury event involved) and have been resting, using ice and heat and taking NSAIDs to no effect, then you should see your doctor. This could be a sign of metastatic bone cancer, infection or other pathology capable of producing low back pain.
Is chiropractic safe and effective for low back pain?
+Chiropractic is statistically a comparatively safe therapy. Chiropractors complete a course of study similar to medical doctors, are licensed by the state and are required to take continuing education to keep their license active. Chiropractic adjustments may be able to lessen your down time from low back pain. Although most cases of low back pain resolve on their own with rest, avoiding strenuous activity for a few days; ice, heat, and NSAIDs chiropractic adjustments can be helpful in reducing pain level, down time, and preventing recurrence. A chiropractor can determine if you have deficiencies in your skeletal alignment that may be making you prone to injuring your back, and can correct them using manual techniques.
Low Back Pain Terminology
Vertebra (plural = vertebrae): the name of the bones that comprise the spinal column. There are seven cervical (neck) vertebrae, twelve thoracic (torso) vertebrae, and five lumbar (lower back) vertebrae. Each type has structural features specially suited for its function. Cervical vertebrae are relatively smaller and are designed to rotate in a wide arc; thoracic vertebrae have long side extensions that support ribs; and lumbar vertebrae have larger bodies, limited rotation and are designed to support the weight of the upper body.
Intervertebral disc: a very tough ligament that tightly holds spinal vertebrae together. Its structure consists of concentric rings of fibrocartilage called the annulus which gives it tensile strength, pliability and the ability to absorb forces to the spine. It has a jelly-like center called the nucleus pulposus that binds water and absorbs most of the axial forces to the spine. Excessive pressure to the disc can cause the nucleus to gravitate away from the center and cause the annulus to bulge out. This is called a disc herniation, or bulging disc.
Disc bulge, Disc herniation: layman’s term for when part of the circumference of a spinal disc moves radially outwards. Most disc bulges on MRI do not cause symptoms/pain and are considered normal. In fact the disc is designed to bulge outwards when weight is placed on it, like pressing down on an inflatable ball. If the disc bulge is due to tissue damage, where the outer rings break, pain is usually present. If the disc bulge/herniation is large enough it can compress a spinal nerve root or the spinal cord and cause numbness and muscle weakness in the extremities, depending on its location.
Disc rupture or prolapse: severe injury to a disc where the outer annulus breaks, allowing the nucleus material to exit the disc. This typically leads to the eventual death of the disc and loss of its shock absorbing and stabilizing ability. Over time the disc thins, disappears and the vertebrae above and below it make contact and eventually fuse together, resulting in lost motion of that joint and reduced low back range of motion in all directions. In some cases, ruptured discs are surgically scraped off and replaced with an artificial disc, or material that allows the vertebrae to fuse together.
Pinched disc, pinched nerve: layman’s term to describe compression of a disc and or spinal nerve root by the “pinching action” of the vertebrae above and below the disc/nerve root. It is a somewhat accurate description, as such “pinching” can happen. The correct term is disc/nerve root/ cord compression. Signs that you may have a pinched nerve or disc include a recent injury to your back or neck; a deep, focal, sharp pain on one side of your neck or back, and numbness, tingling and weakness in the same side leg or arm.
Sciatica: a condition involving shooting pain, numbness and tingling originating in the buttock and traveling down the lower extremity, usually felt in the back of the leg and sometimes down to the foot. It may affect one or both (bilateral) legs. Sciatica refers to these symptoms, not the cause. Anything that can compress the neurons or nerve roots that form the Sciatic nerve, the largest nerve in the body that controls the legs, is capable of causing sciatica. This includes a bulging lumbar disc, scissoring of the nerve by the Piriformis muscle in the gluteal region; spinal stenosis –narrowing of the spinal canal due to degenerative changes that irritate spinal nerve roots to the sciatic nerve, and in rare cases, a tumor in the brain or spinal cord that compresses the upper neurons that form the sciatic nerve.