What to do when your low back hurts so badly you can’t stand up straight

No 1– Don’t panic!  Our nervous system is really smart and when you panic, it makes everything way worse.  Trust me on this one.  I have been there many times.

No 2-Get into a position of comfort.  It may be sitting, lying down or any position that makes you feel good.  I had very bad back pain some years ago that I had to squat every block in NYC where I live, just to get to the bus stop.  Forget the subway, that was way too far!!  Trust your body on this one.

No 3-Know that the acute symptoms will calm down.  You will be left with lingering symptoms, which will need addressing from a good physical therapist.  The key here is:  knowing what NOT to do.  What positions to avoid rather than what exercises to do.  Knowledge is power and knowing what positions to avoid can be the difference in getting a good nights sleep or staying up all night due to your pain.

No 4-Ice, ice and ice.  I get a ton of questions about whether to use heat or ice.  I would use ice with any type of acute pain.  If you have a hot and swollen knee or ankle, then ice is your friend.  If your back hurts, I prefer ice.  But many of my patients say heat helps.  If there is an acute muscle spasm, I believe ice really works.  At the end of the day, use what makes you feel better!! There is no hard or fast rule, outside of swelling, which requires ice.

No 5-Stretching your back out by bending over, or stretching your hamstrings may not be wise choices if your back hurts when you sit or lean forward.  Hamstring stretching early on can aggravate a nerve and potentially flare you up again.   On the other hand, lying on your stomach and propping yourself on your elbows, the so-called “McKenzie Extension” may not be a good thing if you can’t stand up straight or have a problem bending backwards.   This varies from individual to individual and depends on what motion aggravates you.   Obviously this is for the acute stage and can change once the symptoms ease.

No 6-If you experience back pain with many different movements, like walking, sitting, getting up from a chair and just plain standing, then a lumbar support (belt) may help in the short term.



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