Pain Management For Low Back Injuries
Dr. Molly Pierson, PT, DPT • March 21, 2025
Why you should keep moving when you have low back pain!
Managing low back pain can be challenging, but there are several strategies to help alleviate discomfort and improve mobility. Previous beliefs suggest resting, and while that may be helpful initially, long term rest can often worsen the pain. Here are some effective tips for managing acute low back pain:
- Stay active throughout the day
- This can include gentle stretching, walking, or even riding a bike. The goal is to work on balancing this with rest. Resting for long periods of time can increase stiffness and symptoms, so working on moving frequently can be helpful to improve blood flow throughout the body and promote healing.
- Continue to exercise
- Injuries do not necessarily mean that you cannot exercise or move your body. It just may require you to modify for a little bit. Instead of following your normal programming to a T, maybe start with cardiovascular exercise.
- You can also continue to workout by modifying the range of motion, intensity, and volume of your workout.
- Find positions that feel good
- When resting or getting ready to sleep, find positions that feel comfortable or alleviate your pain. This can help to improve the quality of your sleep or your recovery.
- This can include sleeping on your side with a pillow between your legs or under your knees
- If you are resting on the coach and feel discomfort with your legs straight out, try bending your knees, rocking your knees side-to-side, or sitting in a figure 4.
- Work with a physical therapist!
- PT’s are movement experts, as well as excellent sources for helping to manage pain, recent or long term injuries, and can help guide you back to living your life fully.
- A physical therapist can help by performing an initial evaluation, determine the impairments at hand, and help to address those so you can reach your goals. They can also provide many natural ways of managing pain with pharmaceutical or significant medical interventions.
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Typically, once people get into their 3rd trimester of pregnancy, they focus on winding down, resting, and focusing more on stretching. While stretching is helpful, there is more you can do in your 3rd trimester to better prepare for labor, delivery, and recovery after childbirth. Birth prep physical therapy during the third trimester (weeks 28–40) focuses on helping the body prepare for labor and delivery, relieve discomfort, and support postpartum recovery. Here's what it typically includes: Optimize Pelvic Alignment & Mobility Encourages smoother fetal positioning and reduces chances restrictions from your pelvis and surrounding structures. This can include incorporating different positions to help open up different areas of the pelvis, which allow for a smooth transition as the baby moves through the pelvis. Reduce Pain & Discomfort Targets low back pain, pelvic girdle pain, sciatica, and round ligament pain as the baby continues to grow. Diaphragmatic breathing to help manage labor pain and regulate intra-abdominal pressure Prepare Muscles & Tissues for Labor Pelvic floor coordination and perineal mobility can ease labor and reduce tearing risk. Learning to engage abdominal muscles to assist with pushing. Gentle core exercises for transverse abdominis support. Empowerment Through Education Helps you understand pushing mechanics, breathing techniques, and labor positions. This can include: Pelvic Floor Work Focus is on coordination between diaphragm, pelvic floor muscles, and abdominal Learning how to relax the pelvic floor (just as important as contracting it). Gentle perineal massage techniques (usually after 34 weeks). Postural Adjustments & Alignment Body mechanics for daily life (getting out of bed, lifting other children, etc.). Pelvic tilts, cat-cow, and modified squats to maintain mobility. Laboring positions and strategies for fetal positioning Practice labor positions using birth balls, stools, or partner-assisted techniques. Learn strategies for optimal fetal positioning (like Spinning Babies techniques). Manual Therapy Myofascial release, sacral mobilization, and soft tissue work to relieve tension. Addressing hip or SI joint pain. Ultimately, birth prep is tailored to the needs of the mother and her goals when it comes to her birthing experience. The items listed above are just a snapshot of techniques that can be incorporated into sessions to help one become more educated and aware of what the birth experience may encompass, as well as address aches and pains along the way.
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