Here’s what we’re going to cover in this article:
- Should I rest my back or stretch it?
- Should you stretch a “thrown out,” back?
- Is stretching for lower back pain or strengthening, better?
- How to choose the right stretches and exercises for your lower back pain
- How do I know the stretching is working?
- Should I stretch even if it hurts? Can stretching make lower back pain worse?
- What exercises to avoid if I have lower back pain?
Disclaimer: When should you seek more medical assistance for your lower back pain?
If you are having worsening numbness, tingling, weakness, or bowel and bladder changes, this could be due to cauda equina syndrome, and you should make an appointment with your doctor ASAP.
If you have fallen recently and landed on your back and are experiencing sharp pain, or have a history of osteoporosis, you should also get in contact with your doctor as this could be a possible fracture.
If your symptoms continue to get worse and worse you need to either change what you’re doing in terms of exercises and stretches, or, you need to speak with a qualified professional, either a physical therapist, physician, or chiropractor.
Now that all that is out of the way, let’s get into it!
Should you do stretching for lower back pain or stretch it?
Resting is okay for a few days, but getting back to normal activity as soon as possible is highly recommended. This is a best practice and people who get moving sooner rather than later tend to improve much faster. If your symptoms are highly irritable with normal activities, finding different stretches and exercises to do may be helpful.
For example, bending backward might be really painful. If that is the case, sometimes bending forwards seems to relieve symptoms.
For other folks, both of those are aggravating.
After this section, I’m going to go through a step-by-step method of how to choose stretches or exercises that might be best for you. Remember, if you are consistently making the pain worse, you will want to alter the movements that you are doing as continuing to flare things up is not the goal.
Here’s another article I wrote about whether or not it’s okay to stretch a strained lower back.
How to Choose the Best Stretches for Lower Back Pain – A step by step method
IMPORTANT: If symptoms are significantly worse 1 hour, and 24 hours later after stretching you will want to modify how many reps and sets of the stretches you are performing. You will also potentially want to switch with exercises or stretches you are doing to see if there are others that would be more effective.
Many people think stretches or exercises won’t work for them, but they did not try enough OR they did not modify the movements enough in a way that works for them. It is very rare that I cannot find specific stretches or exercises that will help someone’s lower back pain feel a bit better.
It’s also important to note that most people (not everyone), if they stay moving and avoid certain exercises that provoke high levels of pain, usually get better within 2-6 weeks.
Step 1:
Start in a seated position with a chair at a height of about 17-20”. Spread your feet about shoulder-width apart and allow yourself to bend forward and try to touch the floor if you can.
Hold it at the bottom for one second and then come back up to the starting position. Do this 10 times and ask yourself. “Are my symptoms the same, better or worse?”
If the symptoms are better, wonderful, you’ve found your first stretch.
A few other movements that might feel good for the lower back if this one feels good are child’s pose, and standing forward flexion with slightly bent knees.
If symptoms are worse after this step or are unchanged, go on to the next step.
Step 2:
If forward bending does not feel good, move onto this step.
In a standing position, put your hands on your hips and slowly bend backward, keeping your knees straight. Only go back as far as you can comfortably. Repeat this 10 times and then ask yourself; “are my symptoms the same, better or worse?”
https://www.youtube.com/watch?v=Tl5lZXFpCRE&ab_channel=KadalystPerformanceSystem – start the video at 1:36.
If the symptoms are better, wonderful, you’ve found a good exercise to start with.
Another low back stretch that might feel good is prone on elbows, cobra, cat-cow, or bird dog.
If symptoms are worse after this step or are unchanged, go onto the next step.
Step 3:
If neither forward bending or bending backwards feel good, you can try rotation.
This can be done in standing or sitting. With your arms outstretched, rotate your entire body from left to right, slowly.
Complete this 5 times on each side and then ask yourself; “are my symptoms the same better, or worse?”
If the symptoms are better, another few stretches/exercises that would be of benefit are thread the needle, open book, and bent knee lower back and hip rotation.
Step 4:
Check in with yourself one hour after trying these movements and then 24 hours after these movements. Ask yourself, “are my symptoms the same, better, or worse?”
Particularly after 24 hours, if symptoms are better or worse, this will help to instruct you of which movements to do, and which ones to avoid for now.
Step 5:
Exact prescription of how many sets and reps of a specific stretch will depend on how your body responds to the stretch. A good starting point for most people is starting with 3 sets of 5 to 10 reps, 2x/day.
Once that feels okay, increasing the number of repetitions to 15 to 20 is a good next step. Additionally, if symptoms permit, you should also start increasing your number of steps per day while walking. For example, if your step average is 3,000 steps per day, work on increasing that to 3,500 per day.
Remember, the caveat here is that if your symptoms get worse, you will want to either decrease your number of repetitions of the stretches, or the number of steps you are walking in a day.
Should you stretch a “thrown out” low back?
Yes, this is fine as long as the stretches that you are performing are not making symptoms worse.
Worse is defined as symptoms that are significantly worse 1 hour and 24 hours after performing the stretch or exercise.
Is stretching or strengthening better for low back pain?
This depends on what makes your symptoms better. For my patients, I put them through the step-by-step process that I demonstrated above. Once we’ve found a movement or a couple of movements that work for them I will usually also include some lower back strengthening exercises as well.
To-date the research suggests that there is no inherent benefit over stretching, strengthening, or even a basic walking program.
Ultimately, you need to find what works best for you, ideally through a systematic approach as suggested in my above process. This helps you find what works and ignore everything else.
There are so many different things that you could do, but really honing in and focusing on one thing at a time makes it so you aren’t spinning your wheels for months and months trying to find what works best for you.
How do I know the stretching is working?
If your symptoms are less and you are able to resume more normal activities then it is quite clear that the stretching is doing its job (helping you stay moving.) The most important thing when it comes to recovering from a bout of lower back pain is to stay moving without making symptoms worse while giving the body time to calm down.
Like I alluded to before, most people, as long as they stay moving, will improve.
Should I stretch even if it hurts? Can stretching make lower back pain worse?
Yes and no. Yes it’s okay to stretch if the pain level is tolerable, and, if after 24 hours, your symptoms are not worse.
If your symptoms are worse after stretching I would recommend making modifications to how many sets and reps you are doing, in addition to potentially changing the stretches you are performing.
What exercises to avoid if I have lower back pain?
You are free to do any exercises that you want to, as long as the symptoms are not significantly worse after 24 hours.
There is no “bad,” exercise, only the stretch or exercise that you are not prepared to do.
I hope this was helpful for you, please leave a comment below if you have any questions!
