Lower Back Pain

Which kind of back pain is it

Stand up for a second and try to touch your toes, knees straight. Where did you stop, and where did you feel the pull?

If the pull hit the backs of your thighs long before your fingers got anywhere near the floor, your hamstrings are tight, and in my experience that is one of the most common things behind a sore lower back. A dull ache across the low back that is worse after sitting and better once you move around is the most common kind of back pain there is, muscular and mechanical. A sharp pain that shoots down the back of one leg, past the knee, sometimes with tingling, is sciatica, a nerve being pressed or irritated. And stiffness first thing in the morning that takes a long time to ease is worth mentioning to a doctor.

If you have numbness between your legs, trouble controlling your bladder or bowels, or new weakness in a leg, stop and read the doctor section at the bottom right now.

What happened to me

I will tell you where I am coming from, because I did not learn this from a textbook.

As a teenager I pretty much broke my lower back, between snowboarding and BMX. I lived with what that left behind for a long time. What rebuilt it was not one fix. It was paying attention to how I sit and stand, stretching my hamstrings, building the muscles that hold my spine up with lifts like deadlifts and rows, and good bodywork, with Rolfing at the top of that list.

Some of that has strong science behind it and some of it is my experience. I will tell you which is which, because I am not going to hand you a claim I cannot stand behind.

My mains

If you only change a few things, change these.

Stretch your hamstrings. This is my number one. In my experience, super tight hamstrings are behind a huge share of lower back pain, because they pull on the pelvis and hand the strain to your back. A meta-analysis of 14 randomized trials found hamstring stretching lowered pain and improved function in people with low back pain. I will be straight with you, research has not settled whether tight hamstrings cause back pain in the first place, but stretching them helps, and it has helped me. You can do it sitting in a normal chair, any time, which I cover below.

Build the muscles that hold you up. Weak back and core muscles leave your spine doing work it was never meant to do alone. A Cochrane review of 249 trials found exercise therapy reduced chronic low back pain by about 15 points on a 100 point scale compared with no treatment or usual care, a difference patients actually feel. Deadlifts, bent over rows and planks are my core three. In a randomized trial of people with back pain, a program built around the deadlift worked as well as gentle motor control exercises, and between half and four fifths of people in both groups reported less pain and disability, holding over two years.

Stack your spine and keep changing position. Become aware of how you sit. Ears over shoulders, shoulders over hips, the natural curves of your back in place instead of slumped into a C. Then do not stay there. In a meta-analysis of observational studies, prolonged sitting was linked with about 42 percent higher odds of low back pain, and long hours of driving with about double. The research on posture itself is mixed, so the stacking is my experience, but moving often is something everyone can agree on.

Rolfing. A deep, structured bodywork that works through the fascia over a series of sessions. For me, it is amazing for any back problem. I have not found a trial of Rolfing for back pain that I would stake a number on, so this one is my experience, and a strong one.

Free, starting today

You start at the bottom. You do what you can, where you are, and you only climb if you need to.

Keep moving, do not take to bed. A Cochrane review found that for acute low back pain, advice to stay active gave slightly better pain relief and function than advice to rest in bed. Gentle walking beats lying still.

Hamstring stretch in your chair. Sit near the front edge of a chair, straighten one leg out in front with the heel on the floor and toes up, keep your back long, and hinge forward from the hips until you feel the stretch behind the thigh. Hold thirty seconds, breathe, switch legs. Do it a few times a day. You do not need a gym for this one.

Change chairs, change positions. I use all kinds of seats. I eat sitting on the floor on a meditation cushion. For work I have a kneeling stool I can sit or kneel on, and an adjustable office chair, and even in that chair I keep shifting, sometimes cross-legged, sometimes with my feet up on something. No single position is perfect for eight hours. The best position is the next one.

Get up every half hour. Stand, walk to the kitchen, reach for the ceiling. A timer helps.

Planks. Start with twenty seconds, forearms and toes, body in one straight line, and build from there. A plank trains your trunk to hold your spine still, which is the same job motor control exercise targets, and a Cochrane review found motor control exercise reduced chronic low back pain compared with minimal intervention.

Your weight and your plate

Carry less around the middle. In the same meta-analysis that looked at sitting, excess weight was linked with about 35 percent higher odds of low back pain. Extra weight in front pulls the lower spine forward all day.

Eat to calm inflammation. Clean organic meat and fish, a pile of vegetables and olive oil, less sugar and processed food. That is my reasoning rather than a back pain trial, and it is the same way of eating behind The Anti-Candida Kitchen.

A few dollars, in the moment

Heat. A stick-on heat wrap or a heating pad on the sore spot. In a randomized trial of acute low back pain, continuous low-level heat wrap therapy gave more pain relief than either ibuprofen or acetaminophen, and people could bend further and do more by day four.

A foam roller. Roll the backs of your thighs, your glutes and your mid back, and go easy on the lower back itself. A vibrating foam roller is the one I use. That is my experience rather than a back pain trial.

A yoga mat on the floor. Somewhere comfortable to stretch and plank every day. An extra thick yoga mat makes it easy to start.

About $30 to $300: gear for strength at home

You do not need a gym to build a back that holds you up. Start with what fits your space and your budget.

A kettlebell. A single kettlebell covers deadlifts, rows and swings. Learn the hinge first, hips back and spine long, before you go heavy.

Resistance bands. Bands with handles and a door anchor give you rows and pull aparts for the upper back for very little money.

Adjustable dumbbells. Adjustable dumbbells let you progress rows and deadlifts for years.

A massage gun. For the tight spots in your glutes and hamstrings after training. A massage gun is quick, and I use one often.

Electrical stimulation. A TENS unit can take the edge off pain for some people. A 2026 meta-analysis found it only helped when the intensity was strong enough to feel clearly and was turned up during the session, and the overall evidence is low certainty. Think of it as pain relief, not repair.

Want the starter kit in one click? Add the mat, foam roller and kettlebell to your cart.

Learn to lift it right

Deadlifts and bent over rows are two of the best things I know for a back, and two of the worst if your form is off. Learn them properly.

The Strength Upgrade teaches every lift, cue by cue, deadlifts and rows included, and the eight week program in The Anti-Candida Kitchen app runs your training for you, building your weights from your own max and climbing them each session. Get the course and the app together.

Bodywork and practitioner care

Rolfing. My top pick, my experience, usually a series of ten sessions at roughly $150 to $250 each.

Massage. A Cochrane review found massage beat inactive controls for pain and function in the short term for chronic back pain, and beat other active treatments for pain, though the evidence quality was low. Usually about $80 to $130 an hour.

Acupuncture. For the pain. A Cochrane review found it relieved chronic back pain a little more than sham acupuncture in the first week, about 9 points on a 100 point scale, which is real but short of what counts as clinically important. Usually about $75 to $150 a session.

Spinal manipulation. A meta-analysis in JAMA found chiropractic or other spinal manipulation gave modest improvements in pain and function for acute back pain over six weeks, with temporary soreness common afterward.

Yoga and tai chi. In a randomized trial, twelve weeks of yoga improved function and pain more than a self-care book, and matched conventional stretching classes. A ten week tai chi program reduced pain and disability in another randomized trial.

Mindfulness. In a randomized trial in JAMA, eight weeks of mindfulness-based stress reduction gave 60.5 percent of people a meaningful improvement in function, against 44.1 percent with usual care, and the benefit held at a year. Pain and stress feed each other. I teach the practices I use in The Anxiety Upgrade.

None of this has to happen this week. But today you can stretch your hamstrings in your chair, get up every half hour, and hold a plank for twenty seconds.

When it belongs with a doctor

I am not a doctor and I am not diagnosing anyone. Numbness in the groin or between your legs, new trouble controlling your bladder or bowels, or weakness that is spreading in your legs can mean a compressed nerve bundle at the base of the spine, and that is an emergency. Go now. See a doctor soon if back pain comes with fever, follows a fall or accident, comes with a history of cancer or unexplained weight loss, wakes you at night and does not ease with rest or movement, starts for the first time after age 50, or has not improved after about six weeks.

Your body is not broken

Your body is not broken. It is blocked. And for so many people with a sore lower back, the block is not a damaged spine. It is tight hamstrings, muscles that were never asked to hold anything, and eight hours a day frozen in one chair.

I rebuilt a back I broke as a teenager. Stretch it, strengthen it, and keep it moving, and let yours do the same.

Stand tall, my friend.