Ask A PT


Q: What are the best solutions for lower back pain (without surgery!)?

I have had increasing lower back pain over the past year or so. I am pretty active, I take yoga / Pilates classes at least 3 times a week, however I have a desk job and unfortunately have to sit for most of the day. Any solutions to battle back pain other than surgery and / or medication are much appreciated!

  • lower back pain


  • 0
    Physical Therapist Back / Leg / Vertigo Topic Expert

    Aloha Jeanette,

    Some easy tips that help for general low back pain would be to set up your seat and work station as ergonomically as possible. Pay attention also to your sleeping position: if sidelying put a pillow between your knees or if lying or your back put several pillows under your knees to decrease stress on your low back. Here in Hawaii I work closely with several nutritionists, and perhaps seeing one in Texas might provide you with some drug free alternatives.

    As far as surgery goes, unless there are major stability issues with the spine - surgery would not be indicated. Most studies now show that surgery doesn't necessarily decrease back pain. surgery should be reserved for those with intense radiating leg pain, bowel - bladder problems, and progressive leg weakness.

    Also, if need a great PT, Jeff Freeman in Austin is a friend of mine and very good with patients.

  • 0
    Physical Therapist Hip Topic Expert

    Sitting can be aggravating for many people with back pain. Getting the proper chair and/or a standing desk can really help. A proper ergonomic set up is important. Try to minimize static sitting to 20 minutes or less, and stand up briefly to decompress the spine.

    Pilates and yoga can be great for the spine, but many positions can also be quite aggravating. Have you tried physical therapy? A good physical therapist can evaluate your alignment, asses dysfunctional movement patterns and strength imbalances. If alignment is a problem, there are manual techniques to help restore proper balance. Through physical therapy, you can teach spinal stabilization techniques that you can apply to Pilates and Yoga to hopefully reduce potential aggravation to the spine.


  • 0
    Exercise & Fitness Topic Expert

    In addition to setting up your work station as ergonomically as possible, you may want to try to perform back strengthening exercises. Pilates is a good choice because the motions focus on lengthening the muscles (as opposing to twisting and turning movements). An example of an exercise is "Supermans" in which you lay on your stomach (prone position). Keeping your hips in contact with the floor mat, lift your right arm and left leg followed by left arm and right leg. Raise each leg just enough to lift your thigh off of mat, and try to raise each arm to the height level with your ears. Depress your shoulders and squeeze your shoulder blades together during the movement pattern. Perform 8 repetitions on each side with a 1-2 second hold on each lift.

  • 0
    Physical Therapist Neurology Topic Expert

    Jeanette, sorry to hear of your current condition.

    There are many potential solutions for back pain and I would encourage you to visit a Physical Therapist for further evaluation to assist you in finding a solution. They should be using some functional outcome measurement tools to assess your current baseline status. Then they will be examining your activity limitations and participation restrictions through the use of performance based measurements that will be assessed over the course of your treatment. Interventions should include some form of exercise (which will be dependent on their evaluation of you specifically) and some additional use of manual therapy if warranted. Also a good explanation of your condition based on therapeutic neuroscience education should be included in your care.

    Without the specifics of your condition I would not want to offer much specific advice as you will be best served with an in-person evaluation by a physical therapist.

  • 0
    Physical Therapist

    The way that I treat my patients is to find the movements or positions that would increase or cause your pain and try to avoid them as much as possible. And with that being said, whatever movement or position that makes you feel better, you should try to replicate that throughout the day, especially if you know that makes you feel better.
    For the most part, I say to try to avoid sitting as much as possible because sitting is actually really bad for you regardless of how ergonomic your set up is. Would it be too much to ask for a standing desk? This will actually put you in a better position as well as improve productivity.
    Robin Mckenzie has written a couple great books about self treating back pain, if you are not currently seeking care from a physical therapist. Just make sure that you listen to your symptoms and find what makes you better or worse. That will already set you up for success.

    Non medical treatment in addition to physical therapy would include massage, acupuncture, reiki. I am learning a little more about eastern medicine and learning that it is more effective than my impressions.

    I agree with Brett about how surgery is not always the best answer.

  • 0
    Physical Therapist

    You should first determine the cause of your back pain. That will help guide treatment. The good news is PT's have been shown to help LBP in a better and more cost effective manner than surgery. Look for a PT in your area that has advanced credentials such as an OCS (orthopedic clinical specialty) or manual therapy certification. Then make a few appointments to get some exercises and advice. It may be that your activities are harming your back.
    See a good PT. It is virtually impossible to give you sound advice on back pain without first evaluating you. I would estimate 3 or 4 visits would be all you need!

  • 0
    Physical Therapist

    I highly recommend that you get evaluated by a physical therapist who can evaluate your movement, and strength. Many times the cause of pain, especially low back pain, is not at the site of pain.

    Here are some tips I give my low back patients:
    1) Stand up as often as you can, sometimes adjust your monitor so you can work for a couple of minutes standing up.
    2) while sitting try squeezing your butt 10x every hour or so, also do it when you stand up. Activating your glutes may help relieve some low back pain.
    3) do some chest stretches in a doorway, or just bring your shoulder blades together.
    4) when you're in yoga or pilates and doing a shoulder bridge try to squeeze your glutes.

    Hope some of these are helpful to you. Get to a PT ASAP :)

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