Acute Low Back Pain? Try This First

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

If extreme low back pain or sciatica comes on suddenly, there are some basic steps you can take to help speed your recovery. Remember, while most low back pain is not dangerous, it is a good idea to check in with your healthcare provider 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, go to your healthcare provider or emergency room immediately. These symptoms may be a sign of a serious problem that requires medical care right away.

There is no one treatment that is right for everyone. In many cases, acute low back pain and sciatica respond well to self-care treatments. Check in with your healthcare provider, 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 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. 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.

Sciatica Pain So Bad You Can't Walk

Walking can actually improve sciatica pain, so it may help to push through. To reduce pain, go slow, shorten your stride, and try to put your foot down between the middle of your foot and your heel. Taking a nonsteroidal anti-inflammatory drug like Motrin (ibuprofen) can also help.


Lie Face Down

Photo of a woman lying prone.
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Many times, standing, walking, or sitting with low back pain is nearly impossible. So your first 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 bed is fine.

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

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

After a few minutes 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 on your elbows. This 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, 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. 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 or lying position. Repeat this cycle three to five times. 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 first two 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. 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. Then 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 your range of motion and the forward curve in your spine are restored. As you press up, look for any changes in your symptoms. Remember that if your pain moves closer to the midline of your spine, it's a good sign.

Repeat the press up 10 to 15 times, then relax once again on your stomach. To get up, simply press up one last time. Slowly bend one knee up, and then the other until your feet are on the floor and you can stand. Try to maintain the forward curve in your spine as you stand.

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. If pain persists for more than a few days, it's time to see your healthcare provider.


Maintain Upright Posture

Correct and bad spine sitting posture

neyro2008/Getty Images 

The exercises to help you ease your low back pain or sciatica are important parts of your emergency back pain treatment. Maintaining proper posture for your low back is equally important. It is vital 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 against the back of a chair, 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.


Low back pain or sciatica can come on suddenly. When it does, you may not be able to move, sit, stand, or work as well as you normally do.

Many times, this kind of pain can be relieved by gentle stretching. But if your symptoms include loss of bladder or bowel control, or you feel weakness in your legs, go to the ER or a healthcare provider right away. These symptoms can indicate a serious problem.

To relieve some of the pain, start by lying on your stomach with your hands at your sides. After a few minutes, prop yourself on your elbows to gently arch your lower back. If you can tolerate this stretch, press up onto the palms of your hands for a deeper stretch.

In each position, pay attention to how your back feels. If a position or movement is too painful, stop.

A physical therapist or another healthcare professional may offer you different exercises based on your needs. As you recover, keep in mind that good posture can prevent low back pain.

A long period of bed rest is not recommended. Rather, walking and light exercise, like the ones described in this program, will help you feel like yourself again.

Frequently Asked Questions

  • What causes sciatica?

    Sciatica happens when something presses on or irritates the sciatic nerve. That nerve controls and provides feeling to the muscles of the knee, lower leg, feet, and toes. Common causes include a ruptured disk, spinal stenosis (narrowing of the spinal canal), injury to the pelvis, and piriformis syndrome. Rarely, a tumor is responsible.

  • Can I treat sciatica at home?

    Yes. Unless you have symptoms that indicate you should get emergency care, you may be able to relieve sciatica with a combination of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil or Motrin) and applying ice to the painful area for a two or three days.

  • What type of healthcare provider should I see for sciatica?

    If you have a general or family doctor, start there. They can assess whether you should see a specialist and what type. This might mean a physical therapist, orthopedist or orthopedic surgeon, spine specialist, or neurologist. If you want to go directly to a specialist, check with your insurer first.

  • Should I stop exercising if I have sciatica?

    Only temporarily. Wait two or three weeks before returning to your regular routine (if the pain is gone). Meanwhile, keep moving. Take it easy, ask your healthcare provider or physical therapist for back exercises if appropriate, and do not lift anything heavy or twist your spine for at least six weeks.

  • How do healthcare providers treat sciatica?

    It depends on the source of the problem. When self-care measures don't work, physical therapy or chiropractic care may help. Steroid injections may relieve inflammation that is putting pressure on the nerve. Sometimes surgery is need if nothing else works or muscle weakness gets worse.

6 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. Harvard Medical School. Sciatica home remedies and self-care.

  3. Cornell Health. Low back pain.

  4. Albert HB, Hauge E, Manniche C. Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesionsEur Spine J. 2012;21(4):630-636. doi:10.1007/s00586-011-2018-9

  5. Johns Hopkins Medicine. Chronic pain.

  6. Penn Medicine. Sciatica.

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

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.