Possible Causes of Lower Back Tightness

A tight lower back can be frustrating as it can begin to affect daily movements, such as walking or bending forward.

Everyday movements such as sitting for prolonged periods of time can cause tightness in the lower back.[1] Tightness may also occur with tense muscles, stiffness, or cramping. It is not unusual to experience some tightness or soreness after certain activities, but this often returns to normal within a short period of time. Listening to the signals from the body is an important step in helping the symptoms. There are a number of exercises available that may help alleviate a tight lower back.[2]

If the pain is persistent or severe, it could indicate an underlying medical condition which needs to be assessed by a doctor before any treatment or exercises are commenced.

What are the symptoms of a tight lower back?

Common symptoms of a tight lower back include:

• Sharp lower back pain

• Right side lower back pain

• Left side lower back pain

• Tightness in the lower back

• A dull ache

• Tense muscles

• Muscle cramping

• Reduced ease of movement

What causes a tight lower back?

There are several contributing factors to a tight lower back, including:

• Muscle strains

• Sedentary lifestyle

• Sitting for long periods of time

• Stiffness

• Muscle imbalance

• Muscle tightness, especially the hamstrings or hip flexors

• Poor posture

A tight lower back may also be caused by an underlying medical issue, such as the following.

• Disc herniation

• Sporting injuries

• Age-related spinal changes

• Arthritis

• Muscle dysfunction

• Obesity

• Nerve irritation

• Stress

• Organ problems

As there are multiple different causes of tightness in the lower back, it is important to consult a medical professional if there are any concerns before a treatment plan is commenced. They will take a detailed history and perform a physical examination to determine the cause and rule out any serious underlying medical conditions.

How is a tight lower back treated?

The treatment for a tight lower back will depend on the cause and severity of the symptoms. In most cases, a tight lower back can resolve on its own. However, there are several treatment options that a doctor may recommend, including:

• Oral or topical pain relief

• Corticosteroids

• Acupuncture or dry needling

• Ice or heat packs

• Other prescription medication.

Physiotherapy for a tight lower back

A physiotherapist can help alleviate symptoms of a tight lower back and restore movement. Depending on the cause, possible treatments may include exercise, postural correction, or massage.

A physiotherapist will also likely discuss other strategies that may help, such as a walking program or yoga. Consistency is the key to achieving better posture and alleviating symptoms. Some people may respond well to movement, where it may worsen the pain for others. A physiotherapist can distinguish between the different causes of the lower back pain and prescribe the appropriate exercises based on the symptoms.

Some common exercises from a physiotherapist may include:

1. Standing hip circles

Standing hip circles is a gentle exercise that can help improve mobility and relieve tension by relaxing tense muscles in the lower back and surrounding areas.

Muscles involved:

• Erector spinae muscles

• Abdominals

• Gluteal muscles

• Hip flexors.

Exercise method:

• Starting position - Standing with the feet positioned slightly wider than the hips

• The hands can be placed on the hips or in a relaxed position

• The hips are rotated in small circles in one direction

• The hips can be slowly rotated in the other direction.

2. Gentle knee rocking

Gentle knee rocking is an exercise that can help relieve tension and reduce stiffness in the lower back.

Muscles involved:

• Hip flexors

• Quadriceps

• Abdominal obliques

• Erector spinae.

Exercise method:

• Starting position - In supine (lying, facing upwards) with knees bent and feet on the floor

• Feet should be approximately hip width

• The arms can rest on the floor and help support the lower body

• To start, the knees are gently rocked to one side whilst the feet remain on the floor

• Then the knees are gently rocked to the other side

• This can be repeated, alternating from side to side.

3. Knees to chest

‘Knees to chest’ is a gentle exercise that can help stretch out the lower back and relieve symptoms of tightness.

Muscles involved:

• Spinal extensors

• Gluteals

• Hamstring

• Hip rotators.

Exercise method:

• Starting position: Supine with both legs straight

• One knee is drawn towards the chest, whilst keeping the other leg straight

• This is then repeated on the other side

• Both knees can also be drawn into the chest at the same time

The physiotherapist may recommend starting with small movements only to reduce the intensity of the exercise.

4. Supine hamstring stretch

A supine hamstring stretch can be helpful to stretch the hamstrings and leg to relieve tightness in the leg and the lower back.

Muscles involved:

• Hamstring muscles

• Gluteal muscles

• Calf muscles

• Erector spinae.

Exercise method:

• Starting position: Supine with the knees bent and feet on the floor

• One leg is lifted until a stretch is felt behind the thigh and/or leg

• The arms (or alternatively a towel or strap) can help support the leg behind the thigh

• This can be repeated on the other side.

5. Pelvic tilting

Pelvic tilting is an exercise that can help teach pelvic control and mobility. It is a very gentle exercise that requires good technique.

Muscles involved:

• Hip flexors

• Abdominals

• Gluteal muscles

• Spinal extensors.

Exercise method:

• Starting position - Supine with knees bent

• The pelvis begins tilting backwards, so the lower back presses into the floor

• The direction is reversed so the pelvis begins tilting forwards to create a slight curve at the base of the spine

• This is repeated slowly.

The physiotherapist may suggest incorporating breath strategies to help control the movements for each direction.

6. Cat-Cow Pose

Cat-cow is a yoga exercise that is used to help improve the mobility in the lower back and help stretch key muscles in the hips.

Muscles involved:

• Erector spinae

• Abdominal muscles

• Hamstrings

• Gluteals.

Exercise method:

• Starting position - Four-point kneel with weight evenly balanced (both hands and knees in contact with the floor, and feet resting for support)

• The arms and knees stay in the same position throughout the exercise

• Firstly, the lower back arches upwards, reaching towards the direction of the ceiling

• Then, in the reverse direction, the belly lowers in the direction of the floor

• This can be repeated, alternating directions.

7. Child’s Pose

Child’s pose is an exercise that originates from yoga, and is designed to be a movement for rest and relaxation.

Muscles involved:

• Posterior chain muscles

• Gluteal muscles

• Spinal extensors

• Quadriceps.

Exercise method:

• Starting position - Kneeling with the hands on the floor (the knees can be resting together or slightly apart)

• The arms extend forwards as the upper body lowers towards the floor

• The neck, shoulder, and other parts of the body should be relaxed.

The physiotherapist can suggest modifications such as using a bolster or pillow under the body for extra support.

8. Legs on the wall pose

Legs on the wall is also an exercise that originates from yoga, and helps to relieve tension in the back and pelvis.

Muscles involved:

• Hamstrings

• Quadriceps

• Hip flexors

• Spinal muscles.

Exercise method:

• Starting position - Supine with the feet elevated resting on the wall

• The arms can be relaxed in a T-shape or beside the thighs

• This exercise does not require movement, rather resting in this position

9. Savasana

Also known as supine relaxation or corpse pose, lying in supine to relax can help reduce stress and tension, and alleviate the symptoms of a tight lower back.

Muscles involved:

• Anterior chain muscles

• Posterior chain muscles

• Lateral chain muscles

• Spinal muscles.

Exercise method:

• Starting position Lying in supine with the legs straight

• The arms can rest beside the body with palms facing up or down

• There is no movement in this exercise, just relaxing in this position

• The breath should remain even and relaxed.

It is important to cease any exercises if there is excessive pain or unwanted symptoms. A physiotherapist can recommend modifications to reduce or increase the intensity, depending on the situation.

When to see a doctor

A tight lower back can also indicate an underlying medical condition. Consult a doctor if:

• The pain is severe or persistent

• The pain does not improve

• If the exercises cause pain.

If there is any leg weakness or numbness, severe pain, loss of bladder or bowel control, unexplained symptoms, or if the tightness is from an injury or accident, a doctor should be seen immediately.

Preventing a tight lower back

Lifestyle modifications can help prevent the risk of developing a tight lower back.

Some strategies might include:

• Eating healthy foods

• Maintaining a healthy weight

• Staying active and exercising regularly

• Completing a warm-up and cool-down for exercise

• Moving regularly throughout the day

• Avoiding prolonged periods of sitting

• Setting up an ergonomic workstation

• Lifting items with the correct technique.

It may be beneficial to implement multiple strategies in combination to help prevent the risk of developing a tight lower back.

Key messages

A tight lower back is common, and often resolves after a short period of time. A physiotherapist may recommend certain exercises to alleviate the symptoms and restore function, depending on the cause of the tightness. There are strategies that can be implemented to help prevent a tight lower back.

If the pain continues to persist, a visit to the doctor may be helpful to review the symptoms and discuss other treatment options.