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5 tips for managing a flare-up of lower back pain


Lower back pain is one of the most prevalent painful conditions worldwide, 50-85% of people will experience it in a lifetime and for around 10-25% of people this pain will re-occur.

If you are someone who experiences lower back pain, you will know that deep sense of dread when a flare-up comes on! But there are lots of simple things that you can do to support yourself and hopefully reduce the impact and longevity of your pain.



Here are my top 5 tips for managing the early stages of a painful flare-up...


1.Try not to panic!


The first thing to understand is that hurt does not equal harm. A flare-up of lower back pain does not necessarily mean that you have injured yourself or that there is something sinister going on. This is particularly true when it comes to chronic or re-occurring lower back pain, often the pain is a result of increased sensitivity and there are many, many factors that can contribute to this.

90-94% of lower back pain is non-specific (no sinister cause) and for 80-90% of people with non-specific lower back pain, they will see a significant reduction in their pain in 6 weeks or less.

Pain is complex, but it is essentially our brain's response to a perceived threat. Feelings of panic, fear, stress and anxiety which may be bought on by a sudden flare-up of pain, only serve to amplify the brain's perception of threat and therefore increase pain. If you notice yourself experiencing these emotions, pause, take some deep, slow breaths, allow the emotions to pass... remind yourself that you are safe and that your pain too will pass.


2. Experiment with pain relievers


In the early stages of pain, it is a great time to pull out all of the tools in the box... ice, heat, painkillers, anti-inflammatories, there is no right or wrong (as long as medications are used in accordance with the instructions of course), it's about finding what works for you!

When is comes to ice and heat, everybody is different and it really is about experimenting and finding what helps to relieve your pain. Some people use one or the other and others will alternate both, applying ice and/or heat for 10-15mins of each hour can be really beneficial in managing pain. If you experience a lot of pain and stiffness in the morning, heat from a hot shower or bath can help to get things moving, which brings me to my next tip...


3. Practice frequent, gentle movement


When we're in pain it is tempting to lay in bed and not move at all, but this really is the worst thing that you can do. Movement is a natural analgesic and staying in one position for too long will only leave you feeling more stiff and painful. Frequent gentle movement and changing position is key, going for a walk, if you can manage it, is a great way to ease lower back pain, being outside in nature can also provide a welcome distraction and reduce stress, which in turn can reduce pain.

These gentle exercises act like a movement massage for your lower back and you can do as many repetitions of each one as feels comfortable to you.

Lay on your back with your knees bent and feet planted on the floor:

  • Slowly tilt your pelvis up towards the sky so that your lower back is flat to the ground, then reverse the movement so that your pelvis is tilted down towards the ground and your lower back lifts slightly away from the ground.

  • Alternately bend one knee up towards the chest then lower it back down, using your hands to guide your leg.

  • Slide one hand down your side towards your foot, as far as feels comfortable, so that you can feel a gentle stretch through your back on the opposite side. Repeat on the other side.

  • Bend both knees up towards your chest slightly, feet off of the ground and gently lower both knees to one side, so that your lower body is rotating, keep both shoulders on the ground. Bring your knees back to the middle and then lower them to the other side. This may only be a small movement to begin with, increase it as your pain allows.


4. Notice your thoughts and beliefs


Our thoughts create our reality, what are you telling yourself when you are in pain?

The mind-body connection is strong and your thoughts and beliefs will have physical effects in the body. This can be used to your advantage or to your detriment. It is understandably very easy to slip into spiraling negative thought patterns when you are in pain; catastrophizing, resisting, self-judgement, blame and this can lead to feelings of frustration, anger, exhaustion and overwhelm. All of this is going to result in... you guessed it more pain!

Be aware of what you are telling yourself and the beliefs that you hold about your pain, are they true? Draw on past experiences of coming through painful flare-ups, what did you learn from those experiences? That your pain can change? That it will come and go? When you notice yourself falling into negative thought patterns, pause, draw your attention back to the present moment, accept where you are at right now and try offering yourself some compassionate reassurance.


5. Support your sleep


Sleep is so important in not only recovering from a painful episode, but in being able to cope with it. When you are in pain, it can be challenging to get a good night's sleep, so you will need to do everything that you can to support the process!

Use your pain relieving tools just before you go to bed, a nice hot bath, painkillers, gentle movement, you could even practice some mindfulness exercises or meditation to bring the body and mind into a more relaxed state.

If you sleep on your side, try using a pillow between your legs to reduce rotation of the spine. If you sleep on your back, try placing a pillow under your knees to alter the angle of the spine.

If you find that you wake up in pain in the night, try changing your position first. If you are still unable to get back to sleep, sometimes it is better to get up for a little while, keep the light low and use some of those pain relieving tools again before you go back to bed.


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