What to Do About Your Low Back Pain in the Morning

You wake up in the morning and give it a big stretch before rolling to the side to start your day. Then you stand up and your back gives you a sharp twinge. What do we do now?

Is it your back or your hips?

Our back would include areas directly over the spinal column or off to the sides.

Our hips would include anything below the top of your pelvic bones. Things like SIJ and piriformis related issues can be lumped into a hip issue.

It’s Your Back

Issues related to spinal column dysfunction can generally be categorized as mechanical or neuro. Meaning either there’s something about how you’re moving (not moving) or you have some nerve involvement. Ultimately, restoring motion through a segment of the spinal column that doesn’t currently move is the key to create measurable change in a spine.

I think of this exact scene anytime I’m teaching isometric ramping.

It all begins with increasing ones ability to sense an area of the body. If you can’t voluntarily contract an area, you don’t have control and thus will have changes at rest.

If you have neural (nerve) symptoms, this changes things a bit but at that point I would have referred you to an in-person provider.

It’s Your Hips

Can you move your femur? How well does your pelvis move around a fixed femur?

These are two distinctions within hip mobility and both require a slightly different approach. When starting with the femur on pelvis, I’d like to see go IR and ER.

Easy place to start is with a 90-90 hip shift. This comes from PRI, where the goal is help get you into a position to be able to access neutrality. Not keeping you in a state a neutral, which is theoritcally impossible, but to transition.

What you may notice is a smoother walk afterwards and potentially less lower back pain.

This was my go-to approach for managing most hip issues. But what I’ve learned is that you can ramp up for days, but unless you’re able to access both sides of your pelvis in a more balanced and controlled way, the benefits will always be limited.

Takeaways

• Take a moment to stay calm, it can be jarring to get out of bed and be in pain.

• Get your body to settle down using a 90-90 hip lift with shift.

• Increase tension through the lower back with 2 positional isometrics (Hip IR and lumbar spine)