Acute Low Back Pain? Try This First

If you have low back pain, then you know how painful and debilitating this condition can be. Sciatica, or pain in your leg that comes from irritation of the sciatic nerve from your back, can cause pain and numbness or tingling in your leg and can limit your ability to sit, drive, walk, or go to work.

If you develop a sudden onset of extreme low back pain or sciatica, there are some basic steps to take to help you quickly recover and get back to feeling normal again. Remember, while most low back pain is not dangerous, it is a good idea to check in with your doctor or physical therapist, accurately describe your symptoms, and make sure you are doing the right things for your back.

If you are having neurological symptoms like leg weakness or loss of bowel or bladder control because of your pain or sciatica, you must go to your doctor or emergency room immediately for treatment. Those things could be a sign of a serious problem that requires medical attention right away.

There is not one treatment that is right for everyone, but in many cases, acute low back pain and sciatica can respond well to these self-care treatments. Check in with your doctor, and then follow these step-by-step strategies to manage your acute low back pain.


Acute Low Back Pain: First, Don't Panic

Photo of a man holding his back.
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When acute and extreme low back pain strikes, your first reaction may be one of worry. The pain can be so severe that it may limit your ability to lie down or sit comfortably. Standing upright and walking may be difficult, and going to work may be impossible.

Remember that most low back pain and sciatica gets better quite quickly, and many cases resolve completely in a few short weeks. Sometimes, your low back pain may go away with no treatment whatsoever.

Rest assured that while your current pain is intense and your functional mobility is limited, you can be up and about in a few short days with the right treatment and advice.


Lie Face Down

Photo of a woman lying prone.
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Many times, standing and walking or sitting with acute low back pain is nearly impossible. So your initial treatment should be to lie face down on a hard surface. This is the first step in the progression of exercises used to treat low back pain. If getting to the floor is difficult, then lying in your bed is fine.

Lie down on your stomach, place your arms at your sides and turn your head to one side and relax. Try to breathe naturally and relax your back while lying down.

While lying on your stomach, take note of your symptoms changing. Make note of centralization, which is the movement of pain on one side of your back, buttocks, or thigh closer to the midline of your spine. Centralization of pain is a good sign and means that you are doing the right things for your back. If the pain moves away from your spine and worsens in your thigh or leg, you must change positions right away.

After a few minutes of lying on your tummy, move onto the next step in emergency low back pain treatment.


Prop Onto Your Elbows

Photo of group exercise class performing prone prop up.
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While lying on your stomach, slowly prop yourself up onto your elbows. This maneuver should cause your low back to bend back slightly. Take a few deep breaths and try to relax in this position.

While propping on your elbows, again try to monitor your symptoms for any changes. A decrease in your symptoms or centralization of your pain is a good sign here.

If your low back pain or sciatica worsens in the propped up position, simply return to lying face down and relax for a few more minutes, and then try to prop up again. Sometimes the pain is simply too intense to get into the propped up position. If this is the case, wait a few hours and try again.

Remain in the propped up position for a few minutes, and then slowly return to the prone lying position. Repeat this cycle for three to five repetitions, and then move on to the next exercise.


Perform the Press Up Exercise

Photo of a woman performing the upward dog yoga position.
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After successfully performing the lying face down and the prop up on elbows maneuvers, it is time to move on to the prone press-up exercise. This exercise is great for restoring the normal lordosis, or forward curve, in your low back.

To perform the press up, lie face down with your hands flat on the floor under your shoulders. Be sure to keep your low back relaxed, and then slowly press up so that your upper body rises while your lower body remains on the floor.

If your symptoms are pretty intense, you may not go very far. That is fine. Slowly lower down and rest for one to two seconds and press up again. Try to go a little further each time. Your movements should be slow and rhythmic as you press your upper body up while your lower body relaxes on the floor.

As you perform the press up, you should try to go a little further each time so that your range of motion and the forward curve in your spine is restored. As you press up, be sure to monitor any changes in your symptoms and remember that movement of your pain closer to the midline of your spine is a good sign.

Perform about 10 to 15 repetitions of the press up exercise, and then relax once again on your stomach. To rise from the floor, simply press up one last time, and slowly bend one knee up, and then the other until your feet are on the floor and you are able to stand. Try to maintain the forward curve in your spine as your rise.

The three exercises-lying face down, propping onto your elbows, and the press up-can be performed many times throughout the day. Don't be surprised if you need to do the exercises every hour or two for the first few days. This is common.

The exercises are designed to help you quickly restore the normal position of your spine in the event of an acute episode of low back pain. Remember, if pain persists for more than a few days, a visit to your local doctor or healthcare provider is in order.


Maintain Upright Posture

Correct and bad spine sitting posture

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The exercises to help you quickly decrease your low back pain or sciatica are important components of your emergency back pain treatment. Maintaining proper posture for your low back is of equal importance. It is essential that you keep your back in the proper position while sitting and standing.

Whenever you are sitting, use a small pillow or lumbar roll to help maintain the forward curve in your low back. Press your back up against the back of a chair, and then place the pillow or roll behind you at the level of your belt. You can adjust the roll up or down an inch or two for comfort.

A Word From Verywell

When a sudden onset of acute low back pain strikes, don't panic. Be sure to start the emergency low back self-care exercises and monitor your symptoms. Maintain proper posture when sitting, and try to remain as active as possible. A long period of bed rest is not recommended. Rather, walking and light exercise, like the ones described in this program, are essential to help you quickly get rid of the pain and get you feeling like yourself again.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Koes BW, Van tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334(7607):1313-7. doi:10.1136/bmj.39223.428495.BE

  2. McKenzie R, May S. The Lumbar Spine, Mechanical Diagnosis and Therapy (2nd Ed, Limited Edition Hard Cover). 2003.

Additional Reading
  • McKenzie, Robin, and Barry Graves. Treat Your Own Back. Royal New Zealand Foundation of the Blind, 2012.