Should You Flatten Your Lower Back For Back Pain Relief

Watch The Podcast

Anyone who’s been unlucky enough to experience sciatica or low back pain will know that the first thing you’re instructed to do to “relieve your back pain” involves flattening your lower back, or in some cases actually rounding it completely. This is supposed to provide relief of pain and you’ll find immediately that there is a degree of pleasant stretching sensation that gives you the feedback needed to know that this is a good feeling. Certainly a better feeling than the back pain or leg pain that was penetrating every waking moment!

You see it is so common that people fall into this habit due to the immediate feeling of relief. Some unfortunately become unknowingly dependent on this activity to the point at which stopping it is akin to coming off prescription medication. Perceptions of how beneficial this exercise or that exercise is continue to solidify, in spite of how bad the back remains and how little the individual with back pain or sciatica is able to do on a day to day basis now.

It gets to the point that if this rounded stretching was a drug, friends and family members might raise eyebrows at the frequency with which it was used or the apparent dependency we have developed on it. 

Because the extreme rounding of the lower back felt so good at the start we never bothered to evaluate “what” it is doing “how” it is providing that momentary relief and what the “cost” is that comes with doing this exercise so frequently. 

Your body is a marvelous creation – even if it doesn’t feel that way now

All of us, no matter how vulnerable or horrible we might be feeling in the moment, are fantastically complex and intelligent. Almost everything in our body has the capacity to change and adapt without us being consciously aware of this transformation. As we regularly practice certain activities, our nervous system hard-wires these patterns into our brain and makes them more autonomous. As our body is subject to more or less load through specific parts, let us say the spine or hips, we lay down more supporting formations within our bones, increasing density and strength. Our muscles respond to regular strain of resistance training and become stronger. To the point a trained individual at the age of 80 can exert more strength and force than an untrained individual at the age of 30 – yes there is research showing this – goodbye to the  “yes but I’m too old” misconceptions so many have! 

Then there are the ligaments of your body, these change too if they are so stimulated. 

The thing with all of the above changes is that the body is intelligent. It knows that if you do something once, there is no need to change or waste valuable energy consolidating and storing, or changing the structure of a bone or ligament. There are plenty of irregular activities that we partake in that we would not want our body to make more efficient. If the body was changing all the time in such dramatic ways it would be chaos. 

For example, astronauts undergo significant change during their extended time in a low gravity environment; enough to require significant rehabilitation on their return to earth. Imagine how inconvenient life would be if every time you went into the swimming pool (reduced strain on your skeleton and muscles) your body changed!

Your body knows this and it is listening and remembering, so as you start to use your body in the same ways over and over, things start to adjust. And if we start to become accustomed to the same rounding of the lower back in pursuit of ever more temporary relief, your body only knows the frequency of action, it does not know whether it is good or bad. At the end of the day, the body assumes that you wouldn’t repeatedly do something bad – it has no obvious way of telling you you’re doing the right or wrong thing. It just adapts. You could see a similar example in the alcoholic who can somehow consume and have their liver process significant quantities of alcohol compared to the individual who rarely drinks. Adaptation, whether objectively good or bad will take place. 

Your daily back rounding practice started long before your back pain.

Take a moment to look at your daily habits, what is the one action that you partake in daily for many hours of each day, consistently month over month, year over year. Sitting, whether in the office, at home in the evenings, on the weekends, every day. Practicing molding to the shape of the seats we sit in, slouching ever deeper into the seat. Even for those who sit relatively upright, there is still the inevitable strain being placed on the lower sections of the lower back. This is perhaps why we see on spinal imaging (MRI or X-ray) such a significant association between the recurrent lower back pain and the significant reduction in lordosis of the lumbar spine. 

What’s actually happening in our lower back from all this flattening?

We have to acknowledge forces and efficiency within the body, and that our body will make adaptive change. Many will argue that there is no ideal posture! No ideal alignment. That how someone uses their body will dictate the adaptations and strengthening that takes place, and while this is true in the un-injured individual. When injuries take place, we’re starting from 0 again.

For example, if you stand fully erect with “good posture” you’re bestowing certain mechanical efficiencies to the body, not least by the vertical alignment of the centers of mass. Contrasting this, the stooped posture will be argued by some professionals as being efficient if that individual has developed that posture over their life and if they have no pain. The problem is not there before injury occurs. They will have increases in muscle mass, ligament and tendon densities in certain proportions that differ from the former individual with “good posture”. These adaptations did not take place however over-night, the habits that form them did not either.

If for example, this individual has spent 30 years developing the “stooped posture” and all the adaptations that take place and habits, if they are unlucky enough to become injured, all of a sudden, they have injured tissues at a region that is under significantly more strain than it could be. Not only this, but habits are ingrained that make it all the more difficult to consistently adopt a more mechanically efficient way of being. Certain stiffnesses and rigidities, and other flexibility have proliferated in the uninjured body, but now form major roadblocks. The tissue, let us say the segment L4, L5 in the lower back is now damaged, it’s lost the benefit of 30 years uninterrupted adaptation, and it is beginning afresh to heal, slowly as ligamentous structures do. During this time the mechanical forces that are increased due to habit are all the more noticeable in this individual making relapses more common, recovery more difficult, especially when the individual is not aware of this issue. Because of the more frequent relapse and difficulty the lower back has getting momentum with the healing process, muscles that were stronger begin to waste from disuse, further allowing the “bad habits” to pressure the tissues trying to heal.

As mentioned earlier, so frequently, rounding of the lower back is part of this adaptation. With the rounding of the lower back the ligaments on the back portion of the spine, the ones that are vital to the stability of the low back, become elongated. In this position, there is more loading through the front of the vertebral body, and like a lever, this creates a stronger stretching effect on the back portions of the vertebra. This also enlarges the exit foramina. Bony holes where the nerve roots exit the spine. When we go into a standing position, the spine should normally move back into a position of neutral lordosis. 

The problem is, now when we stand those ligaments are relatively “off tension”.

If the normal tension is not there it creates a greater degree of free movement or “instability” at this level in the load bearing position. To counteract this, we might do something like a pelvic tuck when standing to put more pressure on the ligaments again so they provide tension and stability again – this is a slippery slope!

The process of doing this pelvic tuck further compresses the front portion of the vertebral body, focusing strain to the back part of the intervertebral units AGAIN! This time in the standing position too.

You can see how these practices start to become ingrained in the individual.

When your lower back is injured what happens?

All of this flattening of the lower back has led to a degree of instability in a region that requires tension so weight bearing can take place effectively. Instead, we have localized sections in a chain of vertebrae that have significantly more “give” in them, especially at the sight that is injured. 

This instability is at the root cause of the frequent relapses that occur on a daily basis from silly little tasks that “should not” cause pain or injury. It is why even the safest exercises, like those in the early parts of the program can be a challenge as we re-learn to provide stability safely to the spine. 

We find that the holes, those exit foramina we mentioned earlier, are so enlarged, they allow inflammation to build up “undetected”. This is commonly why some will feel sharp pain the moment they try to really straighten up with good posture, and move those spinal joints towards a normal lordotic position.

It is no wonder that people get stuck rounding the lower back over and over to provide increasingly less relief. And why they find it so difficult initially to begin with some of the proper exercises. But just like we discussed at the outset of this piece, your body will change, if you regularly expose the body to these challenges. 

Doing your exercises once will not work!

Why would you expect to be able to do them correctly the first time either? Especially if you’re regularly injuring your lower back for “no reason”. If you could already do these simple tasks, you wouldn’t be in this difficult position on a daily basis. The trick with rebuilding your back is to adjust the physical intensity of the exercises to the capacity of the body at that time. They should always be almost out of reach, and so the body realizes adaptation must take place.

Stop flattening your lower back from today on!

I can already hear it “but your back is meant to bend forwards” and you’re right. But what if your back is already bending forwards when you think you’re standing straight? What if your back has been flattened so much and so frequently, adapting to the relentless assult of knee hugs, pelvic tucks and child’s pose, not to mention the perhaps hundreds of thousands of hours rounded in your office chair, sofa, and car seat. 

Trust me, you’ve done plenty of rounding, enough to last a lifetime!

Some of you will be so badly rounded in the lower back that even when you bend backwards your spine doesn’t reach neutral! How crazy is that! Even when you think you’re bending your back backwards it’s still bent forwards! 

How do we know this, because clinically we’ve worked on tens of thousands of lumbar spine images over the years. Granted that not everyone is this bad, but if you have more than a few weeks of consistent back pain consider the idea.

We know that even in the most ideal of circumstances, you cannot stop your spine moving into a small degree of flexion, even with the best posture and even with the most careful movements, there will be some. However, you will not be able to restrict flexion to “some” if you don’t aim for “none” especially in the early days of recovery!

Restore your normal low back alignment

With time and practice of exercises like the towel decompression you will improve. As you can see from the article thus far. Much of your life will have been rounding the low back – even before you started those dastardly knee hugs and childs pose. It is completely normal for you to find restoration of the normal lower back curve with exercises like the towel decompression difficult to start out with.

You’re not conditioned to do it! 
But your body, with frequent and consistent application, will begin to embrace this more and more, and the benefit will start to be born. We talk often about timings, with the towel, encouraging 5 minutes only at a time. For those that have objective imaging to show a decreased (measured) lumbar curve, there are rationals to work at the towel for longer than this, up to 20 minutes at a time. However we’ll cover that in another article. For the time being, those of you that are interested in this can check out this video here which shows what can be done with consistent application of backward bending in both the lower back and neck – real human being examples.

Comment of the Week – Celia

“When I started out, I was struggling to get in the car; 5 weeks later, I drove for 5 hours with breaks but no lasting pain.”

You can read Celia’s full story “A back story to inspire you to action” on her website here

Learn More About Premium Membership

Related Articles


Fixing Low Back Pain


Just what you need if you’ve been struggling with any of the following:

Visit The Homepage