Low Back Pain and Fat Loss


Low Back Pain affects over 50% of the US adult population. Over 80% of people with low back pain will feel better within 1-2 months, spontaneously, just by doing a small amount of exercise each day. However, none of these issues are being solved.

Have you suffered from low back pain?

If so, did you truly fix the issue, or did you ‘just’ get out of pain?

It’s amazing to find out just how many people expect to have pain at least 1-3x per year because of an ‘old back injury.’  I’ve got news for you – that injury is there all the time, and it’s stopping you from getting in great shape.  In fact, you’re accepting less from your body than you should.

Also, it’s worth noting that any low back pain is going to force you to ‘inhibit’ or ‘turn-off’ most of your muscles – the end result:  You’ll get far less from every exercise you do.

If you’re able to get out of pain, and you don’t have to watch what you do for most of the year, you should be able to feel that way all the time.  Instead, you might always be worried that you’re going to do something that will “throw your back out” again.  That’s no way to live.

Let’s talk about what happens when you “throw your back out.”  There are really only 5 possibilities:

1. Herniated Disc – typically associated with pain/numbness down one/both legs, relief with backwards bending, standing, and walking.  You’ll typically have pain with  coughing, laughing, sneezing, bending, twisting, and lifting.

2. Stenosis Flare-up – this is extremely rare unless you are 55 years or older, and it’s a disorder of narrowing canals where your nerve roots exit from your spine. Basically, because there’s less room for the nerve to begin with, pulling a muscle or ligament can create swelling in this area, which further irritates the nerve root, causing pain down one/both legs.  In this case, you’ll typically find relief by forwardbending, sitting, or riding a bike.  Standing, walking and backwards bending tend to cause more pain.

3. Stuck Facet Joint – this is the most common of them all, as it tends to happen quickly, take a week or so to “resolve” as your spinal column adjusts, and then the pain goes away. Imagine two of your vertebrae ‘kinked’ on one another, as if you’re bending to the side, but your body remains straight.  Now, your body tries to keep you upright, so it starts side-bending other spinal segments in the opposite direction to keep you upright.  In reality, what you need to do is ‘unkink’ the problematic segment and relieve your pain altogether.  This type of injury tends to cause you to deviate to one side when forward or backward bending, and you’ll often find that you’re more comfortable if you slightly rotate your trunk to the left or right, instead of facing forward all the time.  It’s hard to find a comfortable position unless you sit/stand, or lay slightly rotated or in an awkward position.

4. Muscle Strain/Sprain – this is an acute injury, and you’ll know it.  It’s often associated with a ‘burning’ sensation when the injury first happens and blood rushes to the area, is clearly identified to have associated pain with movement, and stretch. It’ll feel like any other muscle you’ve ever strained, in that contracting or lengthening the muscle causes pain.  Since most muscles on your back either help you extend or rotate your trunk, these movements tend to be the most painful.

5. SI Joint Pain – this is pain where your pelvis and spine meet, or that radiates out to the side of your hip, deep in your buttocks, or occasionally in the groin.  Rarely, you’ll feel pain in the front of your mid-thigh when you have an SI joint disorder.  Movements that cause irritation of this injury are transition movements.  It tends to hurt when going from laying to sitting, sitting to standing, or standing quietly to walking.  Generally speaking, you’ll want to repeatedly twist your hips or crack your back when you have this, but the real goal will be to ‘untwist’ your pelvis or ‘derotate’ your sacrum.  This responds well to a figure-4 stretch for your piriformis, posterior pelvic tilts, and balance-oriented exercises like balance board squats, etc. It tends to subside when you’re in one position for awhile, but it sucks when you go to move.

Now, let’s talk about what happens when you truly resolve a back issue, instead of just masking it with postural adjustment and your body’s natural response in the absence of true healing.  Ultimately, your nerves get agitated, at their roots, so they respond by decreasing signal to the rest of your body.  Here’s how this works:

Agitated Nerve Root —> Less Signal To Surrounding Muscle For 2 Reasons:

1. Surrounding muscle will pull on your spine, creating further agitation.

2. Signal strength is directed towards your brain, instead of to your muscles, as your body is attempting to protect itself and convey the amount of pain its in.  Traffic is  going the other way.

By resolving the issue at its heart, you are winning.  Your body will begin to self-soothe, and your pain signals will go away.  The message to your brain will be to grow more muscle, and your nerve roots will allow all of a muscle to contract more easily. As you know, the more muscle you get involved, the faster you’ll lose fat.

Does this sound like something that’s happened to you?
Please comment below and let me know, so I can follow-up with you and help.

COMMENT RULES: Be awesome. Your comments, feedback, and questions are hugely appreciated, so thank you for being cool and using good judgment. All rude or offensive comments will be deleted. Please do not put your url in the comment text and please use your PERSONAL name, not your business or screen name. Have a blast and thanks for adding to the conversation -- you rock!

  • C. Favre

    I am 69 y/o, had spinal surgery about 8 years ago. Herniated discs. Just recently my back started hurting ago, severe pain in my lower back. When I am sitting or in my bed, all is fine, until I stand! I am under treatment with a pain management specialist, taking for pain, OXYCODONE AND MORPHINE SULPHATE. Ihave been taking these for years, at first pain was gone! And as time went by, the pills no longer seem to help! What do I do?

  • Tina

    I am 55 years old. Six years ago I lost 40 lbs. My back pain was horrible, it limited my activity& I gained the weight back.The pain went away.Now I’m using an exercise bike and dieting( lost 40 lbs.). The horrible pain has returned.

  • tan

    I am 33 years old and have scoliosis, I have had discectomy and decompression on L4 and L5 recently my pain is worse at the bottom of my back and also radiating through my stomach I have put on extra stone In weight which is really getting me down. I have sciatica down my left leg and my left knee is prone to giving way. Any suggestions to help would be gratefully received. Tan

  • Tammy S.

    I am currently suffering from a herniated disc in the L4 and L5 area as well as SI pain and stenosis (diagnosed with a MRI). I have tried physical therapy with no relief and find that even if I wake up relatively pain free and take only acetaminophen, by the end of the day I am taking Hydrocodone and Cyclobenzaprine just to get any relief. It’s almost impossible to lie on left side or my back as the pain (which feels like someone is pinching and then twisting under the skin on a permanent basis) starts in the L4-L5 area and radiates to midway into the glute and continues on down the back of the leg to the knee. I have had steroid injections into my SI and most recently into the L4-L5 area (2 weeks ago) with some relief but still experiencing some excruciating pain. The orthopedic specialist said that the next step is back surgery. I am not convinced since the pain seems to be the worst when I sit (and I sit at my job most of the day). I am being mindful to get up and stretch and walk around every hour or two but by the time I climb into my car after work for the 40 minute commute home, my pain is excruciating setting me up for pain killers and muscle relaxers to cope. If I truly needed the surgery, it seems to me that the pain would be at the same level all day but it seems better in the morning (3-4 out of 10 which I can tolerate) but amps up to a 8-9 by the end of the day making me right on the edge of tears. Is there anything that can be done using these techniques or a recommendation to a reputable massage therapist that might be better? You only get one back in life and I really hate to go the surgery route unless it is the last resort. Thank you so much for your time and attention to all of us. :)

  • shontae petero

    I have just recently popped all my discs in on my spine and i have never ever felt normal since then, its all supposedly put back in but am stil experinecing extreme pain in around my buttocks/ butt crak and cheeks and underneath heading towards the my front end, so flippin sore. Majority of my symptoms if you would call it that are pretty much the same as the si joint pain but I also have noticed that I have a tendency to twitch my neck often and I sweat so bad I could possibly sweat a cup fill in one minute I have never experienced extreme bad sweating like this before i have also gained so much weight since my back problem do you think it could be due to my bank pain/problem. I’m sick of spending so much money on doctors that are only prescribing me with all kind of pills that aren’t helping. Please could somebody help me

  • Vera

    I my L4-L5 are laying together nothing between then and I have a Pinched nerve in the left side

  • Modestus

    The lower back pain I’m experiencing fits the description for SI Joint pain. The pain restricts me tremendously and my chiropractor has not been able to bring much relief. Can you give some guidance?

  • Mary

    I meant L4-L5, made a typo.

  • Mary

    I have a bulging disc between my L2-L5, pressing on my sciatic nerves. I take 80mgs of OXY ( slow-acting, twice a day!doesnt help much, as when I try to do simple things like mop the floor, the pain comes back! I am using Magnesium Oil Spray that works in five minutes! Should I start weaning off the drug OXY ??

  • http://www.irongimp.com Kituhwa

    I am a stroke survivor, having had a TIA the 6 months later a right-hemisphere ischemic and left-hemisphere hemorrhagic 1.5 years after the bleed in 2008. It seems I have SI joint pain. About 6 months ago I started using the treadmill in my exercise regimen to assist me in my quest to defeat foot drop (left foot). I also have on my right foot 3 hammertoes along with a 90-degree rotated big toe due to a failed bunionectomy about 3 years ago. I am fit (I exercise about 10 hours each week doing weights and cardio at gym) at 12% body fat and live independently – though disabled – following almost exclusively a plant-based unprocessed food regimen for over 5 years. The only animal meat I eat is fish (tuna and salmon) and no land animal meat at all. As of May, 2014 my doc took me off the remaining meds I was on. I’ve beaten type 2 diabetes and reflux. Any thoughts and help is appreciated.

  • Josie M Zariski

    I definitely have the SI joint pain. It keeps me from walking and riding my bike.

  • Amanda Carter

    I think my problem is muscle strain. I was taking clothes out of the washer and putting them into the dryer when I got this awful pain in my lower back that stopped me in my tracks. I couldn’t move because the pain was so bad. I had my daughter help me to my bedrooms where I took some over the counter medication and put a heating pad on it. Right now nothing is working.

  • marless

    I guess what I have now is “stuck facet joint”‘ . Didn’t know it was called that. This has happened to me in the past. My physio therapist retired,and I can’t find another one who can get the vertabre unstuck. Tried one last weekend, and she seemed to make it worse. It has been really painful this past week. Am trying a another one on Tuesday after work. It’s very difficult to find someone good in this are. Wish you were here, in Canada.

  • Sue

    Thanks for this information. I now know that I have suffered from SI Joint Pain for the majority of my life, including right now! I will try the suggested exercises to see if they help.

  • Tara

    I’ve been diagnosed with hypomobility SIJ on the leftside and hypermobility on the right, as well as hip issues. Yesterday immediately following the prescribed exercises when I released my tucked spine into a neutral position laying supine, my low back spasmed and locked up. It took many minutes to get my back to relax so I could extend myself and get up. I felt very susceptible to it going out again so I nursed it all day and did no more exercises. Today at PT my SI was rotated. Took the PT a good hour to get me put back together again. I asked him to watch me do a particular exercise to see if I was doing it correct (supine on the floor and then tucking the tailbone and engaging the core keeping low back pressed into the floor, I lift both legs and arms up into a V. He said I did perfect (and I knew I did…lots of years of Pilates); however, as soon as I allowed my back to relax into a neutral position it locked up. My PT helped me but really it took a good 10-15 minutes of me rolled in the fetal position until we were able to get me extended. He now thinks in addition to my SIJ and hip I could have disc issues as well; but he said they definitely weren’t bulging (whatever that is). I have a marathon I hope to run May 31st but as of now, other than the antigravity treadmill, I’m hardly doing anything besides gentle walking and PT exercises. What’s up? I’m very frustrated and nothing I read above or in the comments below explains what might be causing the low back (higher than the SI; and on curve of spine) to cease up. I’ve been in remission from RA for nearly 20 years and as of two weeks ago have been told it’s still at bay. I’ve never had any back problems and take incredible care of my body. I hike/climb, cycle century and double century bike rides on tri-bars and have run several half marathons; and I do pilates and resistance training weekly.

  • Gerard- Dr. K’s Assistant

    Hi everyone! On behalf of Dr. K who’s currently overseas in Puerto Rico, thanks for writing in and apologies for the delay in response. Will give him the heads up about your posts so he can respond to your comments. In the meantime, you can also get in touch with us through support@drkareem.com for detailed advice regarding your back and pain issues. Thanks again and wishing you a happy, healthy and prosperous 2014! 😉

  • Maria Roman

    I’m in constant pain in my spine. From my neck to my lower back due to a car accident. I was a pedestrian walking along a parking lot when I was hit by a ford bronco entering the parking lot hitting me directly forward. I put my hands up as a response and both my wrists where fractured and I was knocked off my feet hitting the concrete so hard I was knocked almost unconscious. I was rushed to the hospital and given percasets for pain. I was fortunate that my ribs weren’t broken. This happened in 2010 and had physical therapy for only five months then released. Since then I have not been active and am suffering with constant nagging pain up and down my spine. I have tingling and numbness in my left hand which comes and goes during the day everyday. I have trouble sleeping at night and can’t really relax during the day. I know that I need some form of physical movement such as exercise but I’m afraid to. I don’t know where to begin! I’m not sure if I can do your program.

  • Mary Ann

    Hi! I have been having numbness in my right thigh area for a few months and the MRI shows a partially herniated disk. So, now they want to give me a cortizone injection in my back. ugh! PT didn’t help the numbness so I went to an ortho surg. and he sent me for the MRI. Now I am going to pain management where they’ll do the injection.

  • janet56

    I am ready to get going on this program..but am having trouble with the tight hips, sore feet++ PF
    I was excited to read the article from January 4th promising help with stretching exercises to relieve some of the discomfort….now I have tendonitis in my arms from the push ups…help!!

  • zakk

    I have degenerative discs and arthritis in my back. I workout daily and watch what I eat, 6 days a week. I try to eat organic and include lots of fruits and veggies. The carbohydrates I eat, other than fruits and veggies, come from sprouted bread, organic potatoes, organic bulgar and quinoa. On occasion, I will have pasta or white bread, but rarely. I have been seeing a chiropractor for years, use a tens machine, stretch and have been to physical therapy. Nothing has helped my lower back and hip pain, and I now can not rid of my lower belly pooch no matter what I do. I would like to be able to get back to feeling and looking and feeling better.

  • Kay

    I’m 69 years old and have arthritis and bone spurs. After reading your reasons for lower back pain, I would say stuck facet joint and SI joint pain clearly describe the symptoms I feel. I try to do the “cat/cow” yoga stretch and I’m so stiff I can’t do it. I have pain after sleeping four hours (side sleeper) and when I go from sitting to standing. I have difficulty stranding up straight until I make a concious effort to strand tall. At this point I don’t have a clue what exercises to do to help my condition heal. Thanks, Kay

  • M.Espinoza

    I’m 36 years old and have arthritis in my hips and lower spine. First diagnosed about 8 months ago. Suffering from stenosis flare up finally got me into the doc. After losing 55 lbs. and a adrenalectomy as a result of the MRI still dealing with the numbness and tingling pain in my left leg. However general health and activity have increased/improved.

  • Helen

    Firstly would like to TQ for all the info. However as I am not sure how best to rectify my problem (different people giving different views and I am confused) I hope you will be able to help.

    I have a reversed curve on my neck and has spondylosis. I recently did yoga everyday and found that my numbness on both hands came back with a vengeance. I also felt tingling on my R Leg and discomfort on my lower back. Xray shows I have spurs on my lower back too. A nerve test confirms I have carpal tunnel on both hands (L more severe than R). I love zumba and have been jumping recently compared to when I first started!!! I also take my dog for walks and she tends to pull me a lot.

    Can you please please advise me as to what exercises would be best to help me keep off my FAT without hurting myself more? I have lost 2kg by being more active with my exercises but am now wary of doing more as I tend to ache all over now. I am 57 but feel like an old lady of 70???

    Please Help

  • Cammie Poore

    I was in a car wreck about 7 months ago, and it messed my back up even more. I have tearing slighted disk, as well as a bulging disk in my lower back. I have had issues for standing a long period of time, as well as sitting. Times I cannot even move to get out of bed in the morning. I have tired to walk around easing my way up but I can even do a half a mile, without hurting. I have tired to do some simple exercise and it still puts me in a lot of pain(Sometimes pains going into my hips and legs). I went to a chiropractic, a back specialist, etc. I know that me being over weight is not helping none but I cant find an exercise I can even do with out being in pain. Is there something else I can do to relieve the back pain as well as lose some weight????

    • Gerard- Dr. K’s Assistant

      Thanks for writing in! Aside from losing excess weight, you might want to try avoiding inflammatory foods- processed meats such as hot dogs, salami, etc., as well as chips and candies. Try sticking to ‘whole’, natural foods high in fiber and which have their natural nutrients intact. On behalf of Dr. K, sure hope this helps and wishing you the best!

  • blackbart

    My lower back has excessive curvature due to two vertebrae that are sort of ‘pinched closer’ on the back side and more open to the front. It has been x-rayed by my chiropractor. He mentioned it is a ‘degenerative’ condition and is ‘treating’ it with chiropractic. I am on a weekly maintainence schedule, but the dull pain never goes away. It is my biggest health concern. He has given me stretches to do. My hip flexors seem always tight as well as my quads and the muscle running down the left of my spine is sore……. What exercises can I do to counteract tight lower back muscles that may be forcing the curvature? I do a lot of work over my head, looking up towards ceilings as a plaster contractor. Thanks for your help.

  • http://DocWellnessFormula.com/ David Orman

    I hyperextended my back doing a (heavy weight) military press. All kinds of spasms going on.

  • Patricia

    I don’t have back pain. I have been going to a deep massage therapist for muscle release. My jaw and my neck muscles (left side) where damaged during brain surgery. Since I could not exercise for many years she is working on all muscles. I am having a lot of problems with severe muscle cramping all over. I have been taking a lot of magnesium to help with these but still have some severe cramps all over body. I am 74. I am trying to do some of your stretching exercises and Qi Qong as well but balance problems limit me. Thank for the good emails. I use what info I can to get better. Patricia.

    • fitness barbie

      Patricia. Taking magnesium is great, but do you supplement it with calcium, potassium and LOTS of water. An over the counter postassium supplement can really help when it comes to muscle cramps. And don’t forget plenty of stretching!

  • Susan

    SI joint pain is exactly what I have… When I keep moving I’m kind of ok…when I sit and especially when I go to bed that’s when all hell breaks loose!

  • Carla Simpson

    I have chronic pain which has led to total and permanent disability. Nevertheless I do medically supervised gym work 6 out of 7 days per week. It hurts like crazy, but I “go into a zone”. Core muscle fitness is essential. My concern is that I am overweight, my diet is down to 1000 kcal, my workout around 300-600 kcal per session depending on duration. I do weights 3-4 times a week, the other days I walk 3km at various gradients and speeds. A recent exercise ECG determined that I was 98% fit for my age. My health is my number one focus! I am concerned that the latest suggested exercise routines like turbulence, intense interval or other programs cannot work for someone like me. Is it that I am afraid? Or should I stay clear of this type of training regime? Advice is appreciated. Cheers.

    • fitness barbie

      Hi Carla. I believe 1000 calories a day is too restrictive and is actually negatively affecting your weight loss goals by slowing your metabolism. Have you looked into his 14 day fat loss plan? If you look into the implementation section he talks about reducing carbs and sugar and increasing fiber intake. Make sure you eat enough to get full. Instead of calorie restriction, focus on eating plenty, and eating super clean. Nothing processed. Believe me, its not how much you eat but what you eat thats important.

  • Savannah santos

    Ive had 2 operations on my back and I have lost feeling in my keg I take morphine and nerve damage pills im over weight and what ever I do exercise wise I end up in agony what can I do x

    • fitness barbie

      I’m assuming you had lower back operations. I am curious as to which leg and what was the feeling before and after surgery. If the operation went well, feeling in your leg should return eventually. Sometimes it takes a long time because of extensive nerve damage and nerves can take a long time to heal. In addition to range of motion exercises and walking, make sure you are eating well. This is a great start to weight loss and Dr. Kareem has a lot of helpful info about nutrition. Weight loss is so very important to getting out of pain. Every extra pound is added stress to the joints and spine. In addition, stay far away from inflammatory foods… anything processed. Clean chicken, salads, and whole grains. Nothing packaged or pre-made. Nothing “white” This would be a great start for you.

  • Annette

    yes;I have si joint disfunction.I went for a 7 hr eoad trip two weeks ago and it is worse since.I am also gai.ing weight at a drop of a hat despite extensive exercise and healthy diet.lost 7 lbs and put back 12 wirh no change in esting or exercise…so frustrating

  • Robert Means

    I have 1,2,3,and 5 for back pain causes. What kind of exercise regimen do I need. I have come to the point where If a movement hurts, I don’t do it. It doesn’t help that I’ve put on 50 lbs, all in my belly.

  • Danny

    I’m suffering from SI Joint pain for most of my adult life. I go to chiropractors and they usually help after about 2 weeks. This time after 3 weeks I’m still in pain. I would like to know more about what I can do to help my back.

  • Irene Scallon

    This was a pretty interesting article since I have back pain a lot. I have also suffered from sacroiliac joint disorder.

  • Lucy

    SI Joint pain!!  I could not have described it more accurately. 

  • Cedilote

    I have a herniated disc that touches the nerve and inflames the surrounding muscles. 

  • Jenny

    I have a diagnosed sacro-iliac problem.  Old injury on left side, now more or less pain free, new one on right (9 months ago), still keeping me awake at nights and making hip area stiff and sore especially when moving from sitting to standing, just as you describe.  I am 65, and used to road run a couple of miles every day (that’s how I got both injuries), and do weights at home.  Since the second injury I haven’t been motivated, or energetic enough, to exercise much outside a bit of walking, so have piled on weight.  What’s the best way to get back to my healthy self? P.S. I find your site excellent for giving proper explanations and clear instructions.  Many thanks.

  • Stephiejo1

    My back hurts but only after the day I lift legs

  • We87110

    I was born w/ a spinal deformity, the tail bone reverse curved, I was w/ low chronic pain until now.
    As life went it becme worse. And caused skin difficulties and more problems, Doing twistimg postures and the like produced energy cysts cervical/ lumbar sections and twisted 4, 5 discs.
    constant swelling there and coccyx for years. Spiritual healer helped to reverse this somewhat and the Healthy Back Inst. In Vermont provided help recently. Lucas Rockwood Gravity Poses did a good deal also. X rays showed a disc wih little space; lumbar area looked like a telescoping radio antenna all compacted.
    I have been all over and found very little help in commercial MSM or alternative medicine.
    Magnets help in a very short term. Collagen and Nitric Oxide and vitamic C therapies as well.
    A person I met explained his disc was repaired after he did long term Vitamin C and no strain or movements for 12 months – the disc rebuilt and regained its fluid.
    Inversion therapy has helped in the beginning but there is a big picture I am ignorant of. Strength training proved a great pain and did make the spinae erectors stronger but this problem is not going away after a life time. I say it may be compounded injuries.

  • Renee Mack

    No doubt about it. Low back pain has followed me since the 70’s. I was in a car accident and ten years later I fell on the ice backwards getting a concussion and seeing stars literally.  I pursued chiropractors. But because of  my job for over 30 years requiring 8 hrs a day on the computer, everything in my body was aggravated. I did a lot of swimming back then. It helped to a point. Now, I do not have regular access to a pool. So I have been looking for “land” exercises to no avail. Since I have been following you, Dr. K., I have learned so much more about my body. I am becoming more and more conscious of posture, particularly when sitting. I’m 5’1″ and have a problem with chairs  fitting me properly so it is an ongoing dilemma. And also, when I am walking. How I walk and where the pain starts. And yes, not all stretches are good for me and not all exercises good for me. Being 62 yrs young and going through menopause is also a contributing factor. Whatever you offer will be greatly appreciated.

  • Elizabeth

    SI joint pain for sure.  What stretches/exercises would be best for this?

  • Pradeep

    My wife has a back pain problem that was caused by severe muscle sprain about 15 years ago in  a car axccident where a car jammed into her car from behind as she applied brakes to avert a collision occuri ng in front of her.   
    Also, I sprained my left foot badly in a misstep in a cinema hall 6 years ago,  Despite much treatemnt, some residual pain remains. Can you help relieve it?

    Finally, my wife has week ankle ligaments and a tendency to get a foot sprain evry 6 to 12 months. She also gets a severe swelling and pain in her legs from having to stand up (say in kitchen work ) for even 30 to 60 minutes. Doctors don’t seem to know a cure. Can you help?

    Pradeep Agrawal

  • TB

    I have SI Joint pain – phyisotherapy for the past 4 weeks, hot tub, epsom salt baths, infrared heating pad, ice, stretching, pilates/yoga….

  • Lunnmaude

    yes, this is what I have, muscle strain, my sympoms are just as you described, xray will not decect the probably, looking forward to getting relief with exerise.
    thqank you connie.

  • http://twitter.com/Marielxox16 Mariel

    actually the 3rd kind 😉

  • http://twitter.com/Marielxox16 Mariel

    i have low back pain and im just 16. the second one.
    i’d love to know what i can do!! 
    it isn’t constant but usually it is in the mornings or afternoons

  • http://www.facebook.com/people/Cindy-Morris-Saenz-Baltazar/100000853485890 Cindy Morris Saenz Baltazar

    Just got to your discussion on lower back pain blog. I recently was getting ready to shower and just before getting in the shower all I did was undress and felt a pull on my left lower back muscle, so right away I started stretching to get it to feel better and then in the shower put the hot water on it to help. Well to no avail my lower back just got worse and a night of sleeping uncomfortabely. Went to the doctor the next day and the doctor ordered time off of work, pain killers for the pain because I’m allergic to muscle relaxers and some stretching exercises along with heating and cooling on the area. I would like to know why this happens? (just getting undressed; don’t feel I moved in any weird way, just my normal everyday movements). Am I doing the right things? The only thing I can think of is that I’m out of shape or my age, 50 years old? Just curious as to why this happens? Thank you for your responce, Greatly appreciated.  Cindy =)

    • http://www.facebook.com/people/Cindy-Morris-Saenz-Baltazar/100000853485890 Cindy Morris Saenz Baltazar

      Thought by now you would of answered our e-mails, you had mentioned you would this weedend and so far I keep checking and you still haven’t???????
      I understand that you probably have a lot but this is the job you chose, to help out people, so sure wish you would answer back to your followers??????? Thanks!

      • Tara

        Did anyone ever respond to you?

  • http://pulse.yahoo.com/_3SEUBP7VGWNZ6GUBMC4ANHIPJY biducy

    i was in a couple of car accidents in the past one rear end one t bone i was told i have a strained spinal column it has been about 6 years now what can i do

  • Victoria

    Ya but what particular exercise do u do. How do u agitate the nerve. Most PT use extension of the back, they help but not completely.
    Thanks I would be gratefil for your help.

  • Robin

    I’ve been suffering lower back pain since July this year. It happened shortly after I was training intensely getting ready for my holiday to the Indian ocean.  I was walking along the beach one day and I suffered what felt like a massive bolt of lightning from my lower-left back right down my left leg. I collapsed to the ground and couldn’t get up for several minutes.

    After I returned home, I went to see my chiropractor who mentioned I likely have a slipped/herniated disc in my lower back. Unfortunately 3 months of treatment have had no effect and i’m in constant pain. I’ve even been to a physio regularly for deep tissue massage and although that helps the relief is only temporary. I haven’t been able to go back to the gym for this long and it’s affecting my motivation at home and at work.

    I feel all is lost and the only avenue left is pain medication.

    • http://DrKareem.com Dr. Kareem

      hey Robin,

      Glad to help you in any way I can!

      For starters, it’s time for a fresh set of eyes…. I’m sure your chiropractor is great and very intelligent, but anything that doesn’t produce results in a 2-3 week period requires a change (myself included.)  You should be able to experience total relief, even if only temporarily, as a sign of proper injury management.  Typically, you can re-position the body and get it out of pain, but then it returns – this keys you into the right position.

      Now, if you are experiencing pain relief while there, but it comes back, this could be a neuromuscular reeducation issue, meaning your muscles need to be immediately trained to hold you in the right position after every manipulation. 

      Ok, so with all of this said, it’s time to re-examine this diagnosis – walking on the beach and a herniated disc? 

      Sand is a dynamic surface (like using a dyna disc, but real life), so it’s a challenge to your core.  With one leg behind you and the other in front, it’s much more likely that your abs would give out for a moment (multifidus also) and your SI joint might slip out of place.  This is the most likely diagnosis for this mechanism of injury.  Second, and probably concurrently, would be a stuck facet joint.

      As a result, it’s really hard to imagine full relief without addressing both together.  For example, as your SI joint rotates back into place, other areas of your spine will experience a shift, so the facet joint may act up.  This may fool you into thinking the pain is the same, slightly better, or even worse.  However, describe it to yourself – where is it?  What does it feel like compared to what you just felt?

      By learning about your pain, you can get rid of it much more quickly.

      Wishing you limitless success and pain relief,


  • Abby Wagman

    Definitely SI joint pain.  I am 49 years old and too young to be having this much difficulty changing positions!

  • River

    I’m 38years old and have had SI back pain for at least 20years. I truthfully don’t believe there is anthony to take care of it so I just deal with it. It is very frustrating though since I have three teenage boys who I would love to play sports with, go hiking, etc. but am very limited because of my back pain. I am 6’1″ and about 220lbs. If you have any answers or ideas to help Would very much appreciate it.

    Sincerely, Kyle

  • amanda

    I have been diagnosed with L5 disk protrusion and some spinal stenosis….my left leg is numb to the knee and standing long periods or walking for long distance results in pain.  To add insult to injury, I slipped on a Bounce Dryer sheet(after being in the dryer thay are extrememly slippery on hardwood or linolium/tile floors!) and my left leg went straigth out to the left like the split on one side, resulting in a groin sprain. It has been 3 months and i am in physical therapy 2x per week with very slow reults. I suffer from severe osteoarthritus and hurt all over upon rising. Caffeine (coffee) tends to help this in the mornings as well as stretching.  I live in fearof this all crippling me eventually. I am overweight and age 67 female. I don’t know if I have correct diagnosis or physical therapy sometimes.  I am losing patience and used to actually be athletic. Help!

  • macnut

    My back has been a problem for quite a few years now.  I live on my families farm and that requires lifting 75 and 100 lb bags of nuts and coffee.  The other day I got one side of my low back to pop and have had great relief on the right side but have severe pain on the left side still.  I have a hard time getting out of bed in the morning and cannot bend to pick up anything before I get my back to release.  I do get relief from my inverdion table, but it is not long term by any means. 
    I am 47 and am overweight.  I have recently lost 12lbs, and am continuing to loose.  I cannot get on my knees, I had a hard fall on my right knee and it feels like I have cut all the connective tissue from my patella to my lower leg.  It is quite different than my left knee and is obvious if you  run your hand over the front of both knees.

    I am a 3rd grade teacher and spend much of my time bending over students or sitting for reading or math groups.  I have a hard time standing up when I have been down for 3 consecutive groups.

    • http://DrKareem.com Dr. Kareem

      It’s really nice to hear from you, and I’m excited to help you recover.

      For starters, it sounds like you had a stuck facet, gained relief, but may have simultaneously gained an instability of a nearby spinal segment.  Often times, if you feel pain on the opposite side following a manipulation, which is basically what you did to yourself, it’s a result of causing minor disc protrusion or pressure on a spinal nerve root above or below where you were stuck.

      Congratulations on all of your weight loss – I’m very proud of you!

      For now, I’d concentrate on building your core and continuing to lose weight, if I were you, but always icing after every workout (provided you don’t have a cold allergy). 

      To ice properly, it would be a wet paper towel (soaked) directly on your skin, and a thin bag of ice (ziploc is too thick and ice packs are no good) directly on top of your paper towel.  The water increases the conductance of the ice to help you ice deeper (up to 3″) 

      5-7 minutes, after exercise + every morning (first thing) + every evening (last thing) is the typical protocol.  For a long-standing issue like this, plan to keep the icing going so long as the problem is relatively unaddressed and you are continuing to stress your body with weight loss efforts. 

      Lastly, make sure you get this issue totally resolved and avoid painful exercises.  Anything that causes pain is no good; there are plenty of exercise options out there.

  • Brouwerlisa9

    Sounds like I have #3 or #5. Have had herniated discs a couple decades ago. I now have had swelling on my right hip for a few months and constantly feel as if I have to twist my back or bend forward over a chair to find relief.

  • http://pulse.yahoo.com/_6BJE3NDUIX2AL5T7NQDMWH3UHU ashok

    What about mild degeneration of spine( L-4/5)? Thats what I have been diagnosed with about 2 years back and told to abstain from lifting weights. But that was impossible for me, so after the pain eased of I gradually began my weights and am continuing to do them.I am also doing your 5 exercises(upper traps, lower traps,bridge, plank etc.) for muscle balance.MY exercise are- clean and press,dead lifts with rows,bench press,front squats,strt, legged dead lift( 1/4th for hams),D’bel press, Calf raises, curls and triceps.For a change I incorporate pull downs for lats, tricep push downs, seated rows etc.Any suggestions?

  • http://www.facebook.com/profile.php?id=722228724 Sarah Schofield Wimberley

    I have the beginning of stenosis, and have had to quit running for the last year.  I’m doing elliptical and weights, but would rather run.  When I do, I feel like I’m six inches shorter.

  • Rudy

    I got into an accident in 2005.  I had lower back pain for about a year.  The doctor said that it was a herniated disk but the pain was too much and it got to a point where I couldn’t walk anymore so the doctor said that I needed surgery.  I had a diskectomy in 2006 but that didn’t help.  The pain was really bad that a year later I had another surgery, L3-L4 fusion.  Now my back is always really stiff, I still have back pain and my right leg keeps getting numb.  I can’t work out as hard as I would want to because of the pain or just because I am afraid of getting hurt even worse.  What do you think I should  do?

  • Terri

    I suffer from lower back pain.In 2003 I was diagnosed with a herniated disc-S1.Tried the epideral shot and got some relief.Had a disc ectomy 3 months later.Now  I have to be cautious.The pain seems to really flare up with standing in one spot or with a lot of bending over.Severe muscle spasms usually occur.I’ve senn several chiropractors and have tried accupuncture.Get some temporary relief.I’ve tried stretching,heat and ice.I am 49 and exercise 3-4 times a week,always taking precautions of course.I am open for any suggestions.Thanks!

  • smg1929

    I suffer from chronic lower back pain as a result of a herniated disk.  Intense pain after sneezing or coughing.  Regularly exercising for the first time in recent years, but having more back pain now.  My trainer makes sure to be very careful with my back, but having a constant issue.

    This article does not really make any suggestions. 

  • Kim

    Suffered from lower back pain after tying to move an oversized boulder in the garden 10 years ago. I experience pain and tingling down front of leg. As noted in your comments, I suspect it may be herniated disk as sneezing almost brings me to tears. Went to Chiropractor but did little to help, finally settled on Chinese accupuncturist which did wonders at first but now not so much. Going for an MRI but 2 month wait. We bought a Tempurpedic mattress but it actually seems to have made things worse rather than better. Tried sleeping with pillow under knees or between, but little relief. I’ve tried stretching but I find very little helps. I’m putting on weight and yet exercise is very painful regardless of the warmups I try.
    Any suggestions?

    Kim – Ottawa

  • Station309

    Dear Dr. K ,
    I am a fire fighter and a long time back pain sufferer. I am 42 yrs. old and I have suffered back pain since 1979. That’s 32 yrs of pain.
    I was diagnosed with Schuermans disease as a child. I wore a back brace for 4 years. To make matters worse I herniated two discs in 2003, L-5 & S-1.  I have pain in my upper, mid, and lower back. I also have pain in my groin area, as well as intense pain shooting down both sides of the outer leg.  The pain is so great that it kills me to do lunges. I go to a Chiropractor, but find little to no relief. I stretch and exercise, but with little relief. I even had a epidural shot back in 2004. Pain was manageable for six months then came back.
    I love my job as a fire fighter but I dont get to enjoy it cause im constantly in intense pain.
    Can you help me???
    Darren from New York

  • Mark

    I have suffered from muscle imbalances for over a decade.  In may this year i saw a kinesiologist were he performed the ‘NOT’ technique on me.  Neural Organisational Therapy i think it is.  Since May i have been noticing massive shifts in my skeleton and muscles.  Mainly around my pelvis but also right through my lower, middle and upper back. (legs and arm included)

    He told me my body was stuck in a state of survival mode and consequently my muscles adapted a new position to accommodate this. 

    My question is:  As my body is slow realigning itself after all these years,  should i be focusing on any specific excercises, staying away from others, doing anthing specific to help my condition


  • D Kelly

    Always interested in back pain solutions and i can relate to some of the symptoms you mention. I have had a lower back problem for at least 10 years now – i’m 36 now. I had MRI scan 4 years ago identified ‘degeneration of L4/5. Mild posterior disc bulge associated with an annular tear which extends into the right lateral recess and resulting in moderate lateral recess stenosis. No evidence of foraminal stenosis. There is also a small osteochondral defect in the inferoir endplate of L4 and superior endplate of L5′. 
    I cant take part in any sports involving twisting or turning as it will flare up and i’ll be suffering real bad pain for days. I attend a chiropractor about every 6 weeks and it seems to help although i just cant get back to the sports i would love to be doing or kicking football with my 3 sons. I’m not overweight and do some light weights and circuits about 2/3 times a week to try and keep some level of fitness/tone.How can I improve my situation and what does the MRI scan findings actually mean? Thanks,Damian

  • Liz

    I pulled a muscle in my hip about 1 1/2 years ago, it took the doctors 7 months to find it :o§  I could sit on a chair but as soon as I had to move that pain was to much. physiotherapy helped me, something they said was that I’m way to tense all over my body, guess I have to learn how to relax.

  • Lori

    #5 is a good description for my back/hip problem(s).  My chiropractor believes I developed this problem at a new job that requires a lot of documentation (desk work). My desk chair had bad ergonomics and I habitually crossed my left leg (above the knee) over my right.  He noted my pelvis was rotated up and forward on the left side.   I am very physically active and have been for years.  My back first “froze up’ midway through a workout (quadratus lumborum);  my T. F. L. is often tight.  I was doing a lot better (quit crossing my legs, for one thing), but DURING an adjustment (at Chiro for maintenance) something seems to have gone wrong again. This pain feels like it’s more directly in the erector at the base of my spine (and the T.F. L.).  Since this problem began, my hip has started popping during internal rotation on the injured side ( an inside crescent kick, for example).   I do a lot of foam rolling, hip mobility and yoga.  I have good flexibility and my training program is thorough (though I can’t expound on that here, of course).   The chiropractor’s adjustments don’t seem to have any lasting effect.   Is there anything I can do to “derotate my sacrum (as you said)?”     I would be so grateful for any suggestions or insights.  

  • John Kilpatrick

    Mike L
    THIS MAY HELP . You have described a condition which I had some time ago.The reason ?I was not sufficently hydrated.While as a natural thing I would drink some water during the day and got better as the day wore on.At night I would stop and as your discs are made up of a lot of water they would drain out overnight so in the morning you had to start the re-hydration process all over again.I now drink at least 8 glasses of water during the day and one big glass of water as I went to bed.I would then refill that large glass and put it beside my bed.Every time I woke during the nightI would have a good mouthful.Initially you will find yourself  going to the bathroom(toilet) more than usual but hey there are benefits in that as well.If you are prone to gout it helps to flush the uric acid out of your body,one  of the key  factors  in gout.Hope that works for you too.
    John       Australia

  • Karen

    I have a bulging, herniated disc – L1 or 2. Have had sciatica three times, either side affected. Also have arthritis- so back, hips and legs tighten up. Because of lack of exercise, front of thighs are weakening too. I also get tingling in my feet. I think I have scar tissue in upper outside of arm from a dumbell. Guess I described myself as a real mess. Try to exercise – either can’t do some of them or so sore for a number of days and afraid of hurting myself more. I’ve purchased a few of your programs, with high hopes, but getting quite frustrated at spending the bucks and not being able to benefit from them. Hopefully you have some good answers for people like us. 

  • Kpappraisal

    I have been going to a chiropractor for over a year and have decompression twice a month.  My lower back pain is not as constant and severe but it is still there.  Some days are still bad.  I sit in front of a computer all day and some times it is very painful to get up and stand.  I would love to actually cure this problem.

  • Jachacs

    I’ve pretty much experienced it all at some point in time or another – pain and numbness down my legs, laughing, coughing, sneezing, twisting, stepping; feeling like the bones are “locked up” or “kinked”; feeling like a nerve is being pinched; burning sensation; going from laying to sitting, rollong over, sitting to standing; radiating out to my hip, and/or  deep in my buttocks; across the small of my back; 

    the solution varies, too. sometimes, walking is the best thing; sometimes exercises where I pull one knee to my chest with the other leg straight, and alternate; sometimes lying on my back with both knees raised imitating a walking movement rolling my lower back on the floor to massage it; sometimes, bending backwards – depends on the current pain

    1,3,and 5 seem to be a persistant part of my life, making me very afraid to work out and exercise for fear of agravating it again. – squats REALLY seem to be a problem

    • http://DrKareem.com Dr. Kareem

      I’m so glad you wrote your story up here!

      …and I’m sorry you’ve been in so much pain, but I’d like to help you work towards a solution.

      It’s all a matter of sequencing things, but you’re right that there can be interplay.  Here’s what typically happens when you get a herniated disc, if it’s not properly managed:

      Step 1) Laughing, sneezing, coughing, bending, lifting, twisting, etc. all suck.
      Step 2) Your body adjusts and your SI joint goes out (usually several weeks later, but sometimes concurrently)
      Step 3) Now you’re kinked and tilted to one side, preferencing that side for weight-bearing, so your body locks down and tries to hold you there.  Hence, a stuck facet.

      The solution – reverse engineer the process, beginning with Step 3, then Step 2, then Step 1.

      When done out of sequence, the results are temporary and not nearly enough to count.

      hope this helps!


  • Stephanie

    I, too, live in fear of recurrent back pain. I will do great for a few months, then experience what I’m pretty sure is muscle strain in my left lower back. Often happens after pulling weeds in the garden (so my garden is terribly overgrown because I’m afraid of weeding! lol). I am aware that stress can also be a trigger — for example, it happened a couple of years ago two days before I was about to host Thanksgiving dinner. I couldn’t lift the turkey in or out of the oven, or make the beds for my guests. Recovery tends to be 2-4 weeks, which for one who thrives on exercise is an eternity. I suspect I have an imbalance of some kind since it always happens on the same side, but I haven’t been able to figure this out. Would LOVE help!

  • Rlbmate

    If I sit on the couch with my legs under me faced to the left, it it painful and I have a hard time walking when I get up.  Also, today, many times when I got up out of my office chair (newly bought to sustain proper posture), the joint in my upper right thigh, at the hip area, pained me to the point of my saying “ow!)  What is causing this?

  • Barry

    I have been diagnosed with “hypermobility” in my lumbar vertabrae.

    Regular strenghening/stretching exercise of the core muscles keep the episodes at bay for a short periods (4-6 wks) but the episodes return.
    Which as you mention above causes a weakness in the muscles of the whole core, which prevent good posture and an inability to exercise due to the pain and spasm.
    The only option is taking it easy until the pain subsides and vertabrae re-align.

    Any suggestion of an exercise routine to lengthen the periods of normality, or life without pain would be very much appreciated.


  • Joyigray

    My right side, because of a broken foot is affected with pain.  I have been having physical therapy, and it is helping, but my lower right back is still weak, and so I have to use a walker, which I dislike intensely.  I am 82, and otherwise very healthy.  How do I get RID of that pesky pain ?   joyigray@gmail.com

    • Joyigray

      Joyigray says to please answer my query, immediately above.  I am having physical Therapy but it is taking so long to take effect.

      • http://DrKareem.com Dr. Kareem

        hey Joy,

        You got my attention :-) 

        (but that’s a dirty trick and won’t work next time)


        What are you doing to exercise your right leg?  You see, your left side is constantly tense to support you, in your lower body, so your right low back will typically take over to balance you out and help you stand up.  As a result, QL tightness tends to create a super-achy back.

        Have you tried a foam roll on your QL?  If not, you can see what I’m talking about here:  http://doubleedgedfatloss.com/Mission_Unbreakable.html

        hope this helps!  wishing you well,


  • Steve Naylor


    It sounds like I suffer from number 3. My back will go out of alienment and cause a great deal of pain. I have tried stetches, but they don’t seem to help much. Any suggestions?


  • Anthony

    Hi i have a slipped disc, I have weight trained all my life, obviously the wrong way, which has led me to you to get educated. Currently I am due to start some yoga with the emphasis on strengthening my core muscles. Then a personal trainer has been recommended to help monitor my return to lifting, not sure what that involves.
    Your guidance is much appreciated.

  • Kay B

    Oh, yes, I recognized #5 and the S1 description right away.  I have had frequent bouts of pain with the Piriformis muscle (Dr. diagnosed)  -to the point of excruciating pain.  When this happens I will mentally force myself  to walk from room to room and sometimes get stuck in the middle of a room  unable to move because it hurts so badly.  I try to do some stretching movements and then rest.  It usually just takes time to go away.  I have missed some days from work due to not being able to move.  It is a debilitating pain.  It has been a while since the last incident, but I do keep it in the back of my mind to be careful.-   Kay

  • Ali Khan

    I have l5 s1 disc herniation also i have high hip on the right side. I cant do most of the exercises that you recomend because i cant twist and bend. I have tried tried all the doctors, physio therapist, chiropractors have to offer i am using inversion table, i did help a bit but not for long. Now some one recomended prolotherapy, any advise? I used to be a tennis professional so hard for me to just stay put. Iam 50 now and i have had this problem for 25 years 

    • Margo

      I tried prolotherapy and let me tell you the benefits did NOT outweigh the horribly intense pain I went through with each session. Even after all that, it did not help me much. I had 4 injections in each hip and 2 in the pubic bone each session for 15 sessions, and the pain was so intense during the injections I had to pump my fists to keep from passing out. I would STRONGLY encourage you NOT to do this therapy unless there is absolutely no other choice.

      • http://DrKareem.com Dr. Kareem

        Thanks for your honest input, Margo.

        Personally, I’ve heard mixed reviews… some swear by it, some say it didn’t really help and have a similar sentiment.  It’s one of those new areas that’s rather unproven, but can sometimes help.

        Have you tried adding a lift to your left shoe to balance out your hips? 

        I’d start there…

  • Irene Paulton

    I had a car accident in 1988 which badly tore the muscles adjacent to the right side of my spine from about T10 down to L5.  I did a LOT of work to get mobile again, including Pilates, but there is always what might be called a “weakness” on that side and I am prone to pain there if I ever overdo any exercise.  In addition, although I have a really good mattress, I can wake up some mornings with a thoroughly twisted back and only doing some specially prescsribed exercises as soon as I get up helps.

    All this makes meaningful exercise difficult at times – evening swimming can be a problem, not because of the swimming but because of getting undressed and dressed!

    Got any good suggestions of what else I might do to keep a reasonable exercise regime going?

  • chris j

    well i dont think i have an injury, i weigh 245 and 6ft 2in i have a big belly thats why i think my back hurts all the time i think i have about 45 pounds in my stomch and that puts alot of stress on the lower back, im diebetic take insulin but i have a hard time trying to lose the belly fat, im very fustrated can you stear me in the direction i need to start out, thanks chris

  • Jutta1634

    I have lower back pain when I bent down.  I am avoiding to bent.  When I stay active as in walking
    and just moving around it goes away.  Aerobics makes me feel soooo good.  When I sit on the couch
    for a long time or on the computer, my lower back hurts when I get up.  I exercise a lot and that
    feels good.  I used to have a lot of groin pain with burning sensation but due to the exercise it all
    went away. 


  • Janet

    I have sI joint problems frequently they can vary between hip lack of motion, mid thigh pain, or literally a pain in the butt!  I can get relief from a chiropractor, but I NEVER GET TO THE SOURCE OF THE PROBLEM.  If you could help with a perminent fix that would be awesome!!!


  • Rhonda

    I have a herniated disc and SI joint pain.  I can usually put my SI back in place, but I wish it would stay put.   If I do press ups every morning the disc doesn’t give me much trouble, but if I don’t, it’s bad news.

  • Suzanne

    I’m was at a Tom Hortons Coffee Shop getting my morning Java.  When I leaned forward to pick up the cup, I was suddenly stuck in that position!  It was very painful if I moved, hurt to lay down, hurt to get up, hurt to twist….I went straight to my physiotherapist who said  it was my facet joint!  I never want that to happen again!

  • Awren

    I am new to back pain and the SI joint problem sounds like exactly what I am feeling… any advice or exercises I can do?

  • Big707Grin

    I had back surgery to replace a herniated and torn disc at L5-S1. After surgery I saw a non force chiropractor who showed me how to untwisted my pelvis by myself, but it is easier to have a family member help me.
    First I lay on my back. I put my feet by my buttocks and raise my hips off the ground. I then lift both feet and stretch out my legs together on the floor. I have my son( friend, mom, or whom ever) look at my ankles and see which ankle it slightly higher then the other. I then turn over on my stomach and have the other person raise my shorter leg off the floor about 9 inches supporting my knee. I then relax into the hold and take a few deep breaths and have them raise the leg a little more. That’s it my hip pain is usually gone or much better after that.
    The main problem I have now is at night, when I lay down, my right leg feels like it wants to jump around, I assume it is the irritated nerve root you talked about. But it is bad enough it won’t let me sleep, so I end up taking pain meds, ultram, or norco if it is real bad.
    Every great once in a while I have a few days where the nerve irritation is gone and I don’t need medication. Doesnt this mean I am out of alignment some where?

  • Joleen Kiniston

    I have longterm problems with the SI joint, and this was an excellent description of what you feel when it’s not aligned correctly.  This has been a problem for me over 50 years, and no it didn’t improve when I was thin and active and yes it’s gotten more painful over those past 50 years, so I am slowly finding that this program of excerise is helpful to my back, but brings a lot of pain to both of my knees which also have longterm damage from working for years on concrete flooring and injuries.  Thank you for this important message and the excerise plan.

  • Theresa

    What do you do for a sciatic nerve????

  • Mike

    I know your a busy guy but anything on scoliosis? had it since my teenage years very difficult to exercise without getting hurt especially in the lower back

  • Tom

    I strained or pulled my lower back muscle on the right side, just above the hip back in 1992ish.  It has bothers me if I do lifting, or if I walk/run for too long a period of time.  Currently I’m age 33, male, 5’8.5″ and 255 lbs.  So I need to lose weight however my lower back pain limits me.

  • MJ Edgreen

    Your topic addresses my issues.  I have MS lesions (inactive) on my spinal cord (left side) & I have spinal cord injury from prior stenosis @ the C-5 level.  The impact on my cord was significant & impacts my right (previously dominant) side….unilaterally.  I had spinal fusion 3/2009, which halted my downward spiral.
    I am scheduled for aggressive PT with SCI specialists @ Kennedy Krieger in Nov.  Depending on that outcome/benefit, have you worked with SCI & to what extent is your expertise in that area?
    My physical ability has been impacted significantly & I work diligently for incremental improvements.

  • saurabh

    looks like i have Stenosis Flare-up . but im only 27 yrs old

  • http://pulse.yahoo.com/_RCBHUYR6NCIIDDPDRZHNLYW5DQ Devorah

    My back was never the same after I gave birth to my oldest child, 31 years ago, and I did not have an epidural to blame it on. I’ve had sciatica in subsequent pregnancies, and also had it not pregnant about 12 years ago. An MRI showed a herniated disc, but I don’t clearly remember which one, something like L1 or L2, higher up than is usually associated with sciatica. It was terrible –  starting in left buttock and radiating down the leg to near the ankle. I also had dropfoot – couldn’t dorsiflex the left foot for all the money in the world. I was prescribed Vioxx, which I didn’t take, went to a chiropractor, which didn’t help (thank G-d for insurance), and went to a Felednkrais – yoga class. I also read John Sarno’s material. I also have SI pain. Eventually it improved, but still flares up occasionally. Right side also. I know that I need to work out, and I’ll push myself in spite of the pain, but that’s not good either. My job is also physically demanding, which doesn’t help. I would love to have the time to work on this with a PT.

  • Laserado

    Hi Dr. K.,

    I have had an L4/L5 fusion 7 years ago to relieve severe stenosis and herniated disc symptoms. I have a  cage, rods, and pins. Now L3/L4 seem to be the problem. I will turn 60 in March. So far I have lost 45 lbs but still have 50 lbs to go. Losing some weight has lessened the severity of the symptoms so I’m hoping, that as I get closer to my goal, I will be able to avoid a second surgery. Any advice you can offer will be greatly appreciated. Best regards, PJ

  • Jeanne d’Arc

    I suffer from the SI Joint paint. I am 60.

  • http://pulse.yahoo.com/_P2ZXKSXUAFDD5BO4LPA26WPOIY Lisa

    I have been in SI joint pain for about 15 years.  I can work through the pain with the help of chiropractic care. But I don’t like where I’m at. I want to loose this weight and be able to be active like I have been inthe past.
    So far I have been unable to do your prescribed excercises due to knee injuries in the last 1 1/2 years. What should I do?

  • Dhuet63

    Hello Dr. K, I have a significant injury to my L-4 L-5 disc. I have had a surgury on the injury, however the scar tissue build up is progressing rapidly. Due to this my gym activity has declined to a point of 1 to 2 times a week. I really need to find a core excercise that does not inflame my lower spine. Looking forward to your input. Regards, Dwight

  • Kathy G

    Hi Dr K, I regulary have lower back pain. I think it origianted from doing a gym excercise some 20 years ago where you need to extend the spine. It does restrict me from doing normal things but I do notice the pain more after I vacuum, mop or stand for a long period of time whilst ironing. When I lay in bed the pain is more acute and all  I want to do is strech my spine.So I’ve either got muscle strain or SI joint pain I’m not sure which one. Can you suggest some strengthening exercises? Regrads, Kathy

  • Hillet

    Dr Kareem. It sounds as all 5 above causes are my problem except I am not 55. I am 35. Ive been a competative gymnast for 10 years. Last year my back pain got so bad I ended in the ER. With a MRI scan they saw that I had 2 prolapses. S1 and L5. Ive had a neuro surgeon inject steroids into the area to break the pain cycle and had phisio for 3 months plus pilates and strenthening excercises to rectify the problem. Went to see an Osteopath who also said I had an SI joint problem and my facet joints dont move as they should. I excersice 5 times a week and ending each excercise day with lower back strenthening and stretching! I am fed up with pain. I use to run 10km 3 times a week and were told I will never run again! Please help.
    Desperate from Dubai……Hillet

  • mch

    Hi Dr. K,  I have lower back pain due to deteriorating discs.  I have gotten a few injections, which gave me enough relief to be able to go through physical therapy.  I now have flare-ups periodically, but do some of the stretching that the PTs taught me about 4 times a week.  I am trying to strengthen my core, but due to the rate at which my lowest disc is going “flat,” it is a rough path.  Thanks for your help.

    • Golfcollecting

      I’ve been dealing with deteriorating discs at 3 levels for 3 yrs now. I was told back then that eventually will need a 4 disc fusion. I have tried about every new thing that comes out. I was at a party one night and a pain management dr. was there and told me to try these shots out. He called them radio frequency shots my orthopedic dr. calls them eblasions. Not sure how you feel about shots but it’s been the most effective treatment I found. The only drawback is like everything else it’s only temporary and start wearing off at about 4 1/2 to 5 months. Insurance only allows it once every 6 months. Basically they give you a shot to numb the area and go in under x-ray directly to the nerve and zap it. It takes 6 months for nerves to grow back. I follow up with SI injections 2wks after. Most everybody thinks I’m crazy for doing it but to me beats going under the knife. Not sure if your lower back is as bad as mine. If it is then it might be something to think about. I will be checking in from time time to see what Dr. K has to respond to the different posts.


      • http://DrKareem.com Dr. Kareem

        What a fascinating and relevant discussion! 

        Steroid injections are a whole blog post in and of themselves. 

        Here’s the scoop, in short, though about getting steroid (cortisone) injections:  Short-term relief, which provides an AWESOME window for exercise. 

        The downside:  The break down all tissues, not just one, so your ligaments get looser and wear thin, along with the integrity of your spine. 

        In summary:  Get them if you absolutely NEED to, but make sure you follow your shot with plenty of appropriate exercise, so you can heal more quickly.

        Depending upon the source you read, these injections start to cause damage in 1-3 shots, or some extremely liberal sources say 3 per year, although I’ve seen conflicting clinical evidence… most people seem to get away with one, but it’s a ‘mask,’ so be careful and use your opportunity wisely.

        Hope this helps clarify!

        As for the deteriorating discs, adding a ‘flexion’ bias to everything you do helps tremendously.  The theory being, if you can ‘open’ your spine by having it bend foward, just slightly, you can slow down the deterioration and swelling process, ultimately providing a healthier state to your spine.

        My thoughts are that you may need to add a flexion bias (talk to your PT about this), especially around the area of these discs, while balancing out thoracically (mid-back) with improved thoracic extension.   By increasing this level of mobility in both areas, and then stabilizing into the new position, you’re likely to experience a tremendous amount of relief…. but then again, this is just a guess based off of a description you gave me.

        Hope this helps you feel a million times better!

  • Promiskpr1

    Dr. K, I’ve been struggling with low back problems for 20+ years; possibly as a result of spending the last 29 years sitting in a patrol car as a police officer. After spending several years going to MD’s and getting the usual “week in bed with muscle relaxants” prescription, I finally went to a chiropractor and started to see good results. Although I’ve never been 100%; I still have flare ups on a regular basis requiring an adjustment at the chiro. and have pretty much constant soreness (if not actual pain) in my lower back.  I do back exercises/stretches every morning which get me through the day, but don’t seem to get my back/core stronger. I am 52 and overweight (5’6, 250), but it seems like everytime I start a workout routine, I’ll be fine for a week of two and then my back flares up and knocks me out for a few days to a few weeks, throwing me off track and back to square one.  I really love to work out, and want to get in shape, but I just can’t seem to stay healthy long enough to make any real progess.  Any help would be greatly appreciated!!

  • http://DrKareem.com Dr. Kareem

    Goodmorning everybody,

    First of all, congratulations on some awesome comments and feedback.  Here’s how this is going to work… over the course of the next several days/weeks, I’ll be stopping by to add my comments and help you get a bit closer to success.

    All blog posts will be this way from now on, as I’d like you to revisit them frequently, and add value to each one over the course of months, instead of days.  In the end, we’ll end up with the best fitness and rehabilitation resource on the internet, which will provide answers to SO many people out there who are struggling for solutions.

    The more you interact with others, offer suggestions, and help them work through their personal situation, and/or the more thoughtful your comments, the more I’ll be focusing on you.

    It seems like a fair way to handle it from my perspective, and I want you to realize how important others comments and experiences are in your growth.  Carve out a bit of time to learn from and help each other, and you’ll realize your goals faster than you dreamed.

    It’s time to end pain and lose fat. 

    I’ll be in touch soon – please keep up the great work.

    speak soon,


    PS – I’d love for you to not only comment, but stumble, tweet, like, and share this stuff. You can see how many people this is affecting… it’s time to reach out and help those you love and care about. I’m here for them too, but they have to know where to look.

    Do the right thing… and be cool and help me out. Let’s blow this up, together, and make it so that you can find any answer you want right here, on the blog.

  • Mark Otto

    I have lower left back pain. It has persisted for months. Don’t recall specific injury event.

  • NikkiDeO

    Yes, 15 years of mild pain from falling off horses and 2 knee reconstructions, and 8 years of on/off intense pain with SI joint and paralysing lumbar pain. About 1 year of certain relief from specific exercises for pelvic floor muscles, glute and leg strengthening, postural awareness and stretching. I’m much happier without the pain – changed my life actually, but I still am wary of the “next episode”. How can you help Dr K??? Love to know more, thanks!! Nikki

  • Dean Brooks

    Hi Doc!  Worked EMS for 20+ years.  Been dealing with a on the job back injury for now over 10 years.  Wow it has been that long now.  There are good days and bad.  Being stuck in an ambulance for many hours on end sure isn’t helping.  This injury was from lifting a rather heavy person one day and I just haven’t been the same since.  Occupational Med. told me it was muscular and to do a few exercises and I’ll be good as new.  That was over 10 years ago.  It’s lower back right side lumbar area.  I’m using an inversion table to help the pain etc. but I don’t think that is helping either.  Being 6’4″ and almost 41 isn’t helping my case either I’m sure.

    When I have a bad day(s) standing upright can be a chore to say the least.  I’m sure I looke like about 90 years old for the first few steps until I can finally straighten out and walk “normally.”  It’s really affecting my life as there are things I just can not do or can’t do for very long anymore.

  • MaryEllen

    Hi Dr. Kareem: Like Mike L. commented I wake up with low back or mid-back pain and it works itself out as I move around.  I have 30-yr. old injuries in my neck and low back (which I see a chiropractor for). I also have plantar fascitis and can no longer run, even walking will throw my hips out of whack.   I cannot do shoulder raises or ab work on the floor.  I do benefit from standing ab work to strengthen my core.  Are there more specific excercises I should be doing for my back/neck?

    MaryEllen D.

  • Petronella

    Great to see that you’re bringing up low back pain!
    I have suffered from scoliosis, most prominent in the lumbar region (39 degrees at my worst stage, but less now, actually), since I was a kid. I also have an excessive anterior pelvic tilt, and slightly knock knees. I’m “used to” my daily back and hip pain (that greatly resembles your description of SI joint pain), especially when getting up in the morning, and after sitting for prolonged periods. I change my position often, and I’m always aware of my posture, but I still get pain. I do (and teach) yoga up to four hours six days a week, which helps a lot, and I also see a chiropractor from time to time. I’ve lately started focusing on lengthening my iliopsoas and gluteus medius muscles, and strengthening my gluteus maximus and hamstrings to see if I can correct the imbalance that leads to my anterior pelvic tilt. This seems to help a bit, but it is still too early to tell. I am very flexible in forward bends and hip openers, but not in backward bends. I notice that in a full wheel pose my upper back/chest is open, but my lower back and hip flexors remain fairly straight. Am I onto something here? I would love any tips that can help me correct any imbalances, relieve pain, correct posture and increase my ability to bend backwards.

    I’ve also had incidents of extreme, disabling pain. I used to work in film (I lugged around a lot of heavy equipment), and after an intensive shooting period I had a growing pain that eventually got completely out of control. I had a specific moment when something just went “wrong” in my spine, and I needed help to even get across the floor and onto the bed. I was in horrible pain, so bad that I could hardly breathe or speak, let alone move my neck or legs. I’m a tough girl and, as I said, used to pain. But this was really something else (much, much worse than removing tonsils, as a comparison). Pain killers were useless. This lasted for about five days, then slowly subsided. When I could sit I needed to hold onto my hips or schair to keep my spine a long and erect as possible to avoid immediate pain. It took a good month to be back to normal, and I’ve had onsets of this kind of pain twice with a few years inbetween, but I’ve managed to get myself to a chiropractor and taken anti-inflammatory drugs, both of which have helped me recover a lot faster than the first time. I haven’t been to an MR, so I can’t say for sure if this was a prolapsed disc.

    Jeez, this ended up being a long post. I hope this can help others connect the dots and recognize their symptoms.

    All the best,

  • Beatmydrum

    Hey Dr. K, My back is usually in good shape but for the last 2 years I’ve noticed that I’m getting back strain in my lower back on an average of every 3-4 months, and it always lasts a few days at least or a couple of weeks at most.  I thought it might just be an age thing (I’m 42..), but then again I’m not sure.  I just subscribed to FTFL about 3 weeks ago and have been doing the exercises and feeling much better, but this just happened to me again yesterday (I’m a musician and was only leaning forward to bring the music stand closer to me when it happened), and now I don’t feel like I can even work out at all until the pain starts to subside. Don’t know what you can do to help, but if you can, then please help!! Thanks, Roxan  

  • Kevin Spurway

    Hello DrKareem
    I was doing exercise and got pain down my left leg for days arfter and lost the exercice so I felt that I was’nt doing it right so can you help me get back on track that was the first lesson you showed me
    Thanks Kev.

  • Mike L.

    Hey Doctor Kareem, I have experienced some of the same scenarios as you discuss above. I have had two herniated discs at L-4 and L-5 in the past and I have overcome that here lately. The pain that I am having now comes on in the morning as I am getting out of bed. It hurts to stand up initially and stays with me for a few minutes until I can walk it off. Usually the rest of the day I am feeling Ok and I usually feel good at bedtime. What is causing my condition to deteriorate over night? Thanks for your help, Mike.

  • Charmianpretorius

    I rolled my car about 16 years ago and pulled the muscles on either side of my spine from the middle to lower back. I can not sit on a bar stool for more than 5 minutes, stand in a cue for long and as soon as I start to exercise, that is it, can’t move properly for days.

  • David

    My problem is osteoarthritis but you didn’t address it.

  • Dave

    Dr.K., thanks for the article. I suspect that I have legacy back problems from years of playing rugby. I cannot stand and watch an event for 80 minutes without lower back pain. I find now that even with “body weight” squats from your program(s) I can get a problem that takes 3-4 days to clear. Any help on fixing the problem(s) permanently and then strengthening the back prevent future problems would be most welcome.

    Dave in Dubai

  • http://www.facebook.com/profile.php?id=567492139 Sarah Cecilie Hougen

    Me no, but I know someone with 2 herniated discs who would rather not go under the knife to get it fixed if there is another solution. I’ve been trying to research the best exercises to help strengthen the surrounding muscles without aggravating the  discs, but there is precious little specific information. One kinesiologist that I knew personally told me to have this person come see him – rather than telling me what I could do (I’m a personal trainer and do have a “clue” in general, but when it comes to a spinal issue I’m careful). So yes, though it’s not me personally, I do have an invested interest in this person’s problem :) so any help is more than welcome.

  • Kate

    I’ve had muscle strains and SI joint pain, and after a few days to a few weeks of stretching, icing, etc, I’m usually “ok” again, but it tends to come back more easily than it used to.  

  • Moni

    I would definitely love some help with my back pain. I usually wake up with it and sometimes it last for days. I exercise regularly: yoga/pilates, skipping and long walks with my dogs. Lately, I’ve noticed that when I’m walking when I lift up my left leg there’s a strain in the back. I’m only 27 and don’t want to start falling apart already… :(

  • Spincleat

    SI Joint Pain is definitely what’s troubling me…especially after my soccer games.  What  can I do to correct this dysfunction?

  • Trevor

    Great article and very personal to me but where is the solution???

    • http://DrKareem.com Dr. Kareem

      Stay tuned, my friend.  It’s coming… love everyone’s participation today!

  • Carol Rosy

    Great article and compact description of possible causes of lower back pain. Looking forward to learn how to resolve the issue at its heart for each of these situations.
    Carol Rosy

  • Vinnie Curto

    I am an ex-world champion boxer who has a bad back from 107 pro fights and over 300 amateur fights and your description of the SI joint pain sounds familiar but the muscles are also very tense in my whole spinal area. I also train at-risk kids in boxing for free to try and help get them out of gangs, etc., which keeps me in shape. But!  I still have this bad back pain off and on.  Any suggestions?  Thanks, Vinnie Curto. PS Look me up on http://www.boxrec.com

  • John Kilpatrick

    Dear Dr.K,I have had  problems with my back for some 45 years.An MRI scan showed a separation of L4,L5& S1.Two years agoI had spinal fusion surgery and a steel  titanium rod was screwed onto all three to stabilize the area.I used to lose the use of my left leg due to the pinching of the sciatic nerve.Since the operation I have fad full use of my left leg but I experience back spasms from time to time which as you would know can be very painful.Is there any exercise I can do to support the surgery which for all intentional purposes appears to have been a success.As I am 64 years old I have been unable to do your new program.I am just not that fiexible any more.I used to be.Hoping you have the knowledge to help. Thanking you  in anticipation.
    John Kilpatrick    Australia.     I was one of your competition Winners and it pains me not to be able to participate.I will try whatever you suggest.I have a lot of faith in you.

  • Mr Macs Fitness

    Wonderful article.  I have hated god for a long time because I prayed and fasted for 2 years straight begging him to help me get out of pain and he hasn’t done anything despite all my efforts of stretching and exercising and paying thousands of dollars to doctors.  All I want is to get out of pain.  That’s it.  I could die a year later and be satisfied with my life.  I just want out of the pain.  Your article just gave me a new-found hope.  I seem to keep finding hope through people, and not god.

    • abundantlife

      Do not know that GOd works through people and guides you to those that will help you – provided of course, both ends are listening!
      Just something for you to think about!

    • http://DrKareem.com Dr. Kareem

      You’re very welcome, and I’m touched by your kind words.  There IS hope, but you can’t stop working towards success… trying isn’t good enough. 

      My best suggestion for someone that’s had this length of time in pain is to start seeking a trained physical therapist’s help who specializes in Myofascial Release.  This will give your body some ‘give’ back, and allow you room to heal.  Alone, it’s not the answer, but it’s likely an important piece to the puzzle.

      Hope this helps!

  • dino

    I struggle with lower back pain for years. I was diagnosed with herniated disc(s) this summer.
    I can recognize a lot of the things you talk about. Lower back pain ussualy happens to me when I am stressed. It is very much ‘mental’ thing.  I learned to manage it to certain extend but it certainly prevents me from going to the gym regularly and to the full of my capacity.
    Can you talk more on:” By resolving the issue at its heart, you are winning. “? How do you resolve it?

  • kirby

    Thanks for the info Dr K! 
    I did something crazy to my back just this last week – I was doing research out in a game reserve and was carrying some seriously heavy stuff…a lot. Since then my lower back has just been completely finished – right at the base of the spine. I’m just taking some homeopathic anti-inflamatories, but I don’t know what else to do to help with the recovery – any ideas? More importantly – how can i avoid this happening again? I thought I had a pretty strong core, but do you think that maybe I just need to strengthen my back muscles more? I’m just starting my MSc so I’m going to be doing lots more similar field trips in the next few months and it would be pretty lame to be incapacitated after each trip (O_o)
    Thanks again for a sweet article – always love the information you give out!

  • Todd Leyte

    I would love some help on this, I beleive I have something with my hips and pelvis. I injured my back when I was 22 years of age and have had on-going back issues ever since. Luckily I do workout and take care of myself and do everything I can to not have a belly. Which I know will aid in back pain and stress. I currently have a body fat of 15% and I am confused why my belly protrude so much when I stand even when I do not have a belly. I commonly get pain in my lower back in my L3 area and my hips are always in constant ache, especially if I run. Would love to correct this problem. I have such a huge S curve in my lower back it’s insane. Please help me correct this if possible

    Thank You

  • Annemarie Naude


    I hurt my Coxix (tail bone) when I was about 13, I am now 34 and still can’t sit in certain chairs.  At work I sit up completely straight which is obviously good for my posture but it causes me to have spasms in my back, neck and shoulders.  I cannot sit back with my back against the chair because it presses against my tailbone which hurts after a while.  It is not something serious, more of irritation to me that can make me extremely uncomfortable.

    Do you have any advice for this?

    Annemarie Naude

    • http://DrKareem.com Dr. Kareem

      Actually, that’s a great question, Annemarie!

      Yes, I do have advice for you… but first, it’s worth understanding if you have sacral torsion taking place…. this would fall under the SI joint area, but it could be that you placed weight on your Coccyx and your muscles contracted, ultimately creating a position of tilt that has made this an ongoing discomfort for you.

      I’d follow up with X-rays and see what’s going on… could also be a hairline fracture that never healed.  Then, begin an icing routine and balance out the muscles in your back.  Normally, with this long of a period of time in a ‘flexion tilt’ of the coccyx, your spine will adjust and throw your posture forward.  Try stretching out Pec Minor – see this video for more examples:  http://drkareem.com/video/my-exact-fat-loss-rehab-program-a-gift-for-you/#

      Also, abs stability is huge.  You may want to work on this, as a part of every day.

      Stay in touch – there’s hope, but someone needs to take a careful look :-)

  • Kaylwoollen

    Just had back surgery in Dec 2010 for herniated disc.   Was lifting weight 3x a weight and doing Tae Kwon Do 3 to 4x a week.  

    • http://DrKareem.com Dr. Kareem

      hey Kaylwoollen,

      Sounds like this is particularly relevant for you.  How’s it going for you so far?

      Have you had a chance to check out http://BackInjuryGuide.com yet?  It’s super helpful for learning about back exercises to speed up recovery, what to expect from your doctor, etc.

      Hope this helps!

      have a great day,