Physical therapist Barry Shafer, DPT (left) and orthopedic surgeon Kevork Hindoyan, MD

Almost all American adults will experience lower back pain sometime in their lives. More than 25% are experiencing it right now. It’s been described as a design flaw in human anatomy, and it’s the second most common reason people are hospitalized.

Cedars-Sinai orthopedic surgeon Kevork Hindoyan, MD, says he sees two main causes of lower back pain in his patients:

• Muscle or tendon strains, which can be caused by lifting something heavy, lifting the wrong way, or even just twisting or bending over. 
• Nerve impingement, when there’s pressure on a nerve in the spine. This can be caused by a narrowing of the canal in the spine that holds the nerves (stenosis), a vertebra shifting out of place (spondylolisthesis), or a bulging, herniated or degenerating disk (the soft cushioning that sits in between the vertebrae).

The lumbar spine, or lower back, is a vital connector to many of the muscles that allow you to walk, run, sit, lift and twist around. It supports most of your body’s weight and provides balance. 

“All that work can put a lot of pressure on the spine and the muscles around it,” said Hindoyan. “If those muscles are weak or inflexible, if you’re carrying too much weight or have bad posture, the result can be back pain.”

Lower back pain generally is either localized in one spot or shoots to the buttocks or down the leg. This is known as radiculopathy, more commonly referred to as sciatica, and is usually caused when a nerve is pinched by a bulging disk or some other impingement in the lumbar spine.

Lower back pain often responds well to rest, over-the-counter pain relievers and maybe some ice. But if the pain persists, or if you want to prevent it from coming back, the stretches and exercises below, recommended by Cedars-Sinai physical therapist Barry Shafer (626-396-8150), can help and be done at home without special equipment.

“The most important thing is to keep moving,” said Shafer, who treats many patients with lower back pain. “Exercise is so important to your health. Don’t let back pain keep you from being active.”

Read: Back Pain: Nonsurgical Treatments

Hamstrings and gluteals—your butt muscles—are two big muscle groups that connect to your pelvis and lower spine. 

“They’re the most important muscles to stretch if you’re dealing with low back pain,” said Shafer. “Take your time and relax as you do these stretches. Do the ones that are most comfortable for you. Listen to your body. Don’t push past the point of discomfort into pain.”

Lying on your back, take hold of both legs behind the knees and pull them gently in toward your chest. This lengthens the muscles in the lower back and usually feels good. Hold that position for at least 30 seconds before you release your feet back to the ground. If holding behind your knees is difficult, you can hold the tops of the knees.

Seated: Sit up tall in a chair with feet flat on the floor. Maintain the good posture as you extend one leg straight out and flex your foot, pulling your toes back toward you. Hold for 5 seconds then relax the leg. Repeat the stretch 5-10 times. Hold for 30 seconds on the last repeat. Switch legs.

Standing: Place one heel on the seat of a stationary chair (no rolling desk chairs). Straighten both legs and stand tall. With a straight back, fFold your torso forwarddown toward the raised leg and flex your foot toward you as you feel the stretch. Hold for 5 seconds then stand back up. Repeat the stretch 5-10 times. Hold for 30 seconds on the last repeat.

(HINT: If the chair feels too high, use a lower step or box.)

Lie on your back with knees bent and feet flat on the floor. Place your right ankle on your left knee. Hold behind the left knee and pull the legs toward your chest until you feel the stretch in your gluteals. Flex your right foot toward the shin. Hold for 5 seconds then relax the legs. Repeat the stretch 5-10 times. Hold for 30 seconds on the last repeat. Switch legs. 

Variation: If holding behind the knee is difficult, you can hold the shin and ankle of the crossed leg.

Lie on your back with knees bent and feet flat on the floor. Cross your left leg over your right so the knees are stacked. Keeping your shoulders flat on the ground, let both legs drop to the right side. Hold the stretch for 10 seconds, bring the legs back to neutral and repeat 5 times. Hold for 30 seconds on the last repeat. Switch legs.

Variation: Increase the stretch by holding the knees down with one hand and reaching in the opposite direction with the other arm. You can also turn your head to look away from your legs.

“Your stomach muscles, what’s known as the core, provide essential support to your lower back,” said Shafer. “Many people suffering from lower back pain find that strengthening the core makes a big difference.”

Seated to standing: Sit tall, brace the abs and, keeping the spine neutral, tilt forward and stand up straight. Keep the abs engaged as you sit back down. Repeat 5-10 times.

Standing and bending down: Stand tall and brace the abs. Keeping the abs engaged, bend down and pick up a light object, such as a briefcase, bag or purse. Put the item back down, stand up tall and release the abs. Take a moment. Repeat 5-10 times, switching sides.

There are many variations. Work with what feels comfortable for you and progress as you strengthen.

Basic Plank on Knees or Toes: With elbows and forearms on the ground, engage the core and lift up onto your knees or toes with a flat back. Pick the version that you can hold without your back arching or sagging. Hold for 10-30 seconds. Repeat 2-5 times. Increase hold time and repetitions as you’re able.

Variation: Reach top arm up, then reach underneath your body and back up again 10 times (add a small hand weight to increase the workload).

Read: Regenerative Medicine for Orthopedics