Despite what you might think, rarely is the cause of lower back pain at the site where it hurts. Most people and their therapists think it is. That's why they want to heat, rub, crunch, vibrate and slice the spot where it is most painful.
In fact you can tell how good a therapist is by watching where they go in the search for the cause of the pain. Just attacking the spot where it hurts sends out a big amber light.
Surprisingly, lower back pain is a merely a symptom that some of the bones in your lower back are out of alignment. Your immediate task is to get them back in alignment. Do that and there's a good chance the pain will go away.
When the vertebrae move out of alignment, ligaments, tendons and muscles are stretched beyond their pain threshold. The nucleus of discs is squeezed out and the disc collapses. Often the nucleus hits the spinal cord. That's when the pain really starts. You can't sneeze or cough without it feeling like there's a red hot poker being jammed into your back. You can't bend over the basin to brush your teeth. You can't bend down to put your socks on.
So what causes the vertebrae in your lower back to move out of alignment?
Answer! If the pelvis has moved out of alignment, it's highly likely the bones above it have moved out of alignment as well.
Treat the pelvis as the foundation for the bones that are above it and consider this analogy. If the foundation of your house moves then the walls will crack. You can patch up or paper over the cracks, but you'll probably have to continue to keep patching and papering until kingdom come. The solution is to underpin (and square up) the foundation so it can't move.
So the precondition for a spinal column that's in alignment is a pelvis that's in alignment.
So what causes the pelvis to move out of alignment?
Answer! Tight calf, hamstring, buttock and hip flexor muscles.
Which brings us back to the question of what are the best exercises to relieve lower back pain?
Answer! Flexibility exercises that impact on the alignment of the pelvis, particularly exercises that loosen off tight calf, hamstring, buttock and hip flexor muscles.
But that's not the full story. You also need to strengthen the whole musculo-skeletal ecosystem by regularly going to the gym and working out - or if you're averse to lifting weights start on a regular and systematic strength training program at home that includes situps, pressups, squats and the Superman back arch.
It makes sense to have a body strong enough to keep the bones of your spinal column in correct alignment.
Interestingly one of the best predictors of risk of lower back pain is the ability to do pressups. While you're doing pressups the muscles of your trunk are all being strengthened, front, back and core.
If you're looking for targets for situps, pressups and squats, 20 of each is good, 30 is better and 40 is best. Build the Superman back arch up to a couple of minutes of gentle ups and downs without your chest or legs touching the floor.
The last piece of the lower back exercise jigsaw is some relaxing exercises to settle the spinal column down, exercises where you lie on your back with both legs bent at 90 degrees and the lower legs supported by an ottoman. This is known in the trade as the static back exercise and lying in this position for 20 minutes will bring temporary relief from back pain, and over the weeks and months assist the vertebrae to gradually get back into better alignment.
Another relaxing posture using the ottoman is lying on the floor with one leg on the ottoman and the other outstretched on the flood for 20 minutes - then change legs. This is the supine groin stretch. Over 20 minutes the hip flexor muscles will gradually relax and over the weeks and months allow your vertebrae to move back into better alignment.
If you're diligent you'll spend a couple of hours on the floor each evening while you watch TV, read a book or just drift off with the faeries doing the flexibility exercises and the relaxation exercises.
The strength exercises you can do after you've been for a walk, shuffle, jog, swim, cycle... in the morning.
Now just as Rome wasn't built in a day, your lower back pain wasn't caused in a day. For most people it happens over decades, due to a poor sitting posture and lack of strength and flexibility exercises. Being 20 or more Kg over weight doesn't help matters.
Neither will back pain be cured in a day. Depending on how far out of alignment your pelvis and the bones above it are, it may take a couple of months for you to experience real relief and up to a year before you can say, 'I no longer have lower back pain.'
But the good news is that if you start doing something now, there's an 80% chance for 80% of people that they will get themselves back to 80% of good nick within a year. If you've got back pain them's good odds.
In the meantime stay tuned, highly tuned and make an immediate start on a serious strength and flexibility training program.
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