Self Help Series: Low Back Pain

Self Help Series: Low Back Pain

Self Help Series:  Low Back Pain

Anna Staehli Wiser, DPT, FAAOMPT

Low back pain (LBP) is a prevalent and complex health issue that affects a significant proportion of the global population. As one of the leading causes of disability worldwide, LBP poses not only a substantial burden on individuals but also on healthcare systems and economies. 

LBP is a widespread condition, with an estimated 80% of people experiencing it at some point in their lives. It can affect individuals of all ages, but the likelihood increases with age, particularly in adults between 30 and 60 years old. The impact of LBP extends beyond the personal realm, contributing significantly to the global burden of disease. The economic implications are substantial, encompassing healthcare costs, lost productivity, and disability-related expenses1.

Low back pain can arise from various sources, including muscle or ligament strain, disc herniation, spinal stenosis, and other structural issues. Occupational factors, such as heavy lifting, prolonged sitting, and repetitive movements, can increase the risk of developing LBP. Lifestyle factors like obesity, poor physical fitness, and smoking are also associated with a higher likelihood of experiencing LBP. Additionally, psychosocial factors such as stress, anxiety, and depression can contribute to the development and persistence of LBP2.

So, what can you do if you are experiencing LBP?  It is very common for LBP to radiate down into the legs.  However, if you have symptoms of numbness in the limbs or saddle area or loss of ability to feel the urge to go to the bathroom, then an urgent phone call to your doctor is warranted3.  If not, then many times this condition can be treated successfully at home with a few exercises and posture adjustments.  

One of the most common causes and contributors to LBP is poor sitting posture.  Prolonged sitting, especially with poor posture creates a long duration load on the lumbar discs which can cause them to become dehydrated and lose volume, which leads to pain and may also create a scenario of compression on the spinal nerves.  If you have a job that involves a lot of sitting, it is important to get up and move around frequently to rehydrate the lumbar discs.  Also when sitting, it is crucial that you use a lumbar support (a small pillow behind the lower back to stop you from slouching).  The lumbar support keeps you in an optimal resting position while at the same time allowing your back muscles to relax.   

Sleeping position can also play a role in lower back pain.  When in bed, the goal should be to keep your lower back in a neutral position.  A pillow between the knees when in side lying is helpful for this.  Sometimes a small folded towel under the waist may be helpful as well when in side lying or supine to maintain a neutral position of the lumbar spine. 

A regular exercise routine that includes mobility and strengthening exercises for the torso, hips, and legs is highly recommended for prevention and maintenance of a healthy lower back.  However, if you are experiencing an acute episode of LBP, it can be difficult to know what exercises are useful and which ones to stay away from when all movement seems to hurt. Generally speaking, most types of LBP can be placed into one of two categories - those people who have more pain with lumbar flexion, and those who have pain more related to lumbar extension.  People who have more pain with lumbar flexion tend to have difficulty with sitting or bending activities.  People who have more pain with lumbar extension tend to have difficulty with standing and walking. 

If you find that sitting and bending seem to trigger your lower back pain the most, then you will want to include primarily extension-based exercises in your routine and avoid flexion as much as possible until your pain is under control4.  If standing and walking triggers your pain, then you will want to include mostly flexion-based exercises in your routine and avoid extension5.  Also, if you have low back pain with standing and walking you likely have some movement restriction in the hips and will want to do some hip stretching and possibly strengthening too. 

Watch this video to learn more about what extension-based and flexion-based exercises might look like.

Sometimes, despite all the best exercises and proper posture, people find that they cannot fully overcome their nagging lower back pain on their own.  This is when osteopractic physical therapy may be needed.  Dr. Anna Staehli Wiser will perform a comprehensive evaluation that includes analysis of posture and movement.  An individualized treatment will be designed, however, most people with lower back pain respond very readily to a combination of spinal manipulation, soft tissue massage, and dry needling6.  Although spinal manipulation is usually thought to be synonymous with chiropractic care, osteopractic physical therapists and osteopathic doctors are trained in spinal manipulation as well.  Soft tissue massage is usually thought to be exclusively performed by massage therapists, but this is a technique that the osteopractic physical therapist is also well trained in.  Lastly, dry needling is very similar to acupuncture in that both techniques employ the insertion of acupuncture needles and share the goal of promoting healing and reducing pain.   

With osteopractic physical therapy, the patient gets a session that includes all the best treatments in one visit.  So, if you are struggling with chronic lower back pain, fear not - Dr. Wiser is here to help!


1. Urits I, Burshtein A, Sharma M, et al. Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Curr Pain Headache Rep. 2019;23(3):23.

2. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769-781.

3. Lavy C, Marks P, Dangas K, Todd N. Cauda equina syndrome-a practical guide to definition and classification. Int Orthop. 2022;46(2):165-169.

4. Mann SJ, Lam JC, Singh P. McKenzie Back Exercises. In: StatPearls. StatPearls Publishing; 2023.

5. Dydyk AM, Sapra A. Williams Back Exercises. In: StatPearls. StatPearls Publishing; 2023.


6. George SZ, Fritz JM, Silfies SP, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1-CPG60.