Low Back Pain Eliminated For Good: Real Strategies That Work

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Lower back pain is a huge issue that is poorly understood by many which is why so many struggle to find lasting relief, there are real challenges to back pain compared to say, ankle or knee injuries which can make it a little more difficult to deal with. However, with the right understanding, and a principled approach lasting relief can be possible for us all. We know this is the case as we’ve had all manner of back injury diagnoses come through the Back In Shape Program membership and clinically over the years. When you start doing the right things, you get better, and it lasts. Today we’ll be going through a thorough guide with real strategies and examples that you can follow to help resolve your lower back pain for good. 

So if you have experienced pain in the low back, be it aching, or sharp pain, maybe referred into the hip region or even down the leg as in the case of sciatica, you’re in the right place! 

Your back pain diagnosis

So many with back pain that’s lasted longer than 6 months desire a diagnosis but often the understanding of such diagnoses is very limited. When it comes to the low back there are limited things that can go wrong, as there are only so many structures in the region. There are two main classifications of diagnosis in our experience and we’ll cover them briefly here.

Back pain diagnosis: “Pseudo-diagnosis”

These diagnoses are common but they don’t actually tell us anything useful and are about as helpful as saying “you have back pain”. Patients often do not quite understand these diagnoses but they are not really telling you the whole picture. Examples include the following:

  • Chronic Low Back Pain
  • Non-specific Back Pain
  • Stenosis (of varying subcategories)
  • Sciatica

All of these above tell us nothing of the injured tissues, they merely state, “there is back pain”, in the case of the first two, or that there is leg pain in the case of sciatica, or that “holes in the back are smaller than they should be” in the case of the varying stenosis sub categories.  These must be combined with the second classification of back pain diagnosis for effective understanding.

Back pain diagnosis: “real diagnosis”

These are actually referring to a structure that is supposedly injured or damaged, the “tissue” that is compromised. These injuries can then give rise to the “pseudo-diagnoses” above.

  • Lumbar disc herniation or bulges
  • Degenerative disc disease
  • Spondylolisthesis (various grades)
  • Sacroiliac joint injury
  • Facet joint injury
  • Vertebral fracture (very uncommon)

As you’ll see above, there are a limited number of tissues that can actually be injured in the lower back. However because back pain is so poorly treated it leads people to the illusion that it is more complex that it needs to be.

The muscle spasm myth

Notice that there was no inclusion of “muscle spasm” or “piriformis syndrome” in the lists above. The primary reason for this is that muscles are never primary injury drivers, apart from in special circumstances, and in such circumstances, perhaps you failed lifting a 200kg deadlift and tore the back muscles, the implications for the structures, such as the discs in the spine, will be severe. The back muscles will heal quickly and the discs much more slowly. 

In our experience across over 10,000 patients and many more members of the program, more or less no one has injured their back in this manner. 

Unfortunately, the muscle spasm myth is perpetuated in every doctor’s office, because it is by far the most common “miss diagnosis” that is made when you first go to your doctor or GP suffering from back pain. You’re given some stretching, muscle relaxants and told it will get better in 6 weeks. 

This is one of the biggest reasons why back pain doesn’t get better, shoddy practices like this prevent people from getting the right advice immediately so they can avoid back pain turning chronic.

The real cause of low back pain: understanding this is the key

The reality of lower back pain is that the specific diagnosis matters a lot less than you might think. This is because all the structures in your lower back work together, the body is a great system that is interconnected. You cannot really compromise one structure without another being involved. And this is why it is so confusing when you see one surgeon who says it’s the disc and another who says it’s the facet and another who says it’s the Sacroiliac joint. 

If you’ve got a herniated disc at your L5-S1 segment, the last mobile joint in your spinal column, the disc will have lost some height and integrity, this has consequences as the facet joints now are not going to have quite the same spacing on the front, as well as the fact that the segments natural “stiffness” will have been lost slightly, so you’re likely to irritate the facet joints. On top of this, you’re likely to adopt positions that are not helpful for the L5-S1 including rounding the lower back to reduce the pain and back pain or sciatica your experience, this has the effect of flaring your sacroiliac joints and making them less stable. On top of that you’ve got your muscles getting tight, particularly in the low back, hips and thighs, because they’re getting signals from your low back telling them to tighten up! But that only makes the problem worse and pulls on the L5-S1 and SIJ more!

You see in the above example, that although there might have been a “primary” issue, unless you’re jumping on this issue immediately, you’re going to have to deal with second and third order consequences within a week or so of injuring the low back. And we know for a fact that you didn’t injure your lower back last week.

Time and time again, when we sit down with a patient at their first appointment in the clinic, or on our welcome calls for new premium members for the Back In Shape Program, we hear that this back pain or sciatica actually has been going on for months or even years.

Simply put, the cause of back pain could be the following

A failure of the lumbar spine to deal with the load of the body, resulting in primary injury to a segment, of the spine, say L5-S1, with second order consequences such as stiffness & muscles spasm in the back hip and thigh musculature.”

Back pain elimination strategies: 4 steps to lasting results

Now we know what the causes are, we can start to create a strategy for dealing with the real cause. Your lower back is trying to heal every single day, so with these strategies we’ll be able to support that healing process and recover fully, and get back to doing the things you love.

These 4 parts are based on the detailed principles we teach in the Back In Shape Program, a program that’s helped thousands of people with all manner of diagnoses recover from back pain, so we know it will work for you too, if you follow it correctly.

Part 1: Control your core

This is essential, learning to control the muscles that stabilise your spine in the neutral position is the foundation of success in your lower back. Right now there will be a lack of control and some amount of instability in the lower back. Learning to engage the corset of muscles around your lower back particularly in the area between your belly button and pubic bone is vital. This section of your abdomen is the level that stabilizes your L4-L5 and L5-S1 segments, people often really struggle to control this area well, perhaps one of the reasons the back was injured in the first place. 

Here’s a great exercise that anyone can do to help this:

Core-set engagement drill:

  • Lie on your back with your knees bent, feet on the floor
  • Breathe in deeply with your diaphragm, your tummy should rise.
  • Breathe out fully and your tummy should fall
  • As you complete the out-breath, use your deep core muscles
  • These core muscles help expel the last of the air from your lunges
  • Then repeat for 10 reps. 
Visual Demonstration Of The Core Engagement

This exercise should be done without the spine doing a pelvic tuck, as many of you will have been previously taught. If you do this correctly, you will feel your core tightening. Some will struggle and that is why we have a dedicated video on the “candle drill for core engagement” which can help you get this core engagement right if you do find it more difficult.

Part 1: Mobilise your hips

The simple truth is that your hips are going to tighten up because of the back injury, in spite of your best efforts to keep them mobile. This is because they will be getting signals from your injured lower back.

Too many people stretch their hips in a way that does not help the low back at all! It actually makes the low back injury worse. This is why we put together a nice little 10 minute hip mobility routine to help you release your hips safely, and you can practice this a couple of times daily to keep strain of your low back.

Part 1: Decompress your neutral spine

The lower back needs to be stretched safely, to take pressure gently off the discs of your spine, but this should be done in the right way, without hugging your knees or any other twisting or bending exercises that are commonly prescribed. The towel and bed decompression are two of our favorite stretches to help you unload your lower back discs and help them recover effectively. Ideally you would do these decompression stretches for 30 seconds to 5 minutes a couple of times each day. Here’s a link to a complete video that demonstrates how to do these safe and effective decompression stretches for your lower back that you can do at home. 

Towel Position Demonstration

Part 1: hot and cold therapy for your low back injury

Inflammation management is a huge part of lower back pain. It is a simple hack that can have a tremendous benefit to reduce day-to-day pain without the side effects of drugs or injections. Everyone can do it, and aside from a little effort it is side-effect free:

Contrast therapy step-by-step

  • Use a hot water bottle for the heat and cold pack for the ice
  • Find the two bony bits at the base of your spine on the back
  • This will be about the level of your waistband
  • Place the heat there for 3-5 minutes
  • Swap to cold for 3-5 minutes
  • Repeat this 2 to 3 times

You can watch a step by step video guide to contrast therapy for lower back pain to help you get this placed in the right location, and repeat this routine as often as you like daily, we usually recommend 2 or 3 times. 

Part 1: Review of strategies for immediately reducing your lower back pain

These are many of the things that you should be doing with immediate effect, decreasing strain on your lower back, keeping your hips mobile and managing the inflammation that can build up to painful levels every day. If you do this right, many of you will immediately notice things improve. But we cannot stop here!

Part 2: Learn the movements that make a healthy back

There are three central movements that make for a healthy lower back. These are central because they teach you to move your spine correctly and no matter how bad your back is, you’re going to do these every day anyway. So you may as well start learning them right now!

These movements are: the hip hinge, the squat and the reverse lunge. Simple examples of these include:

  • Washing your face & brushing your teeth (hip hinge)
  • Getting out of bed or in the car (squat)
  • Going up a step or staircase (reverse lunge)

So many people do these in ways which are making their backs worse every day so you need to start to learn how to do them better immediately.

Squat instructions:

  • With the feet shoulder width apart bend your knees slightly
  • Engage the core and back muscles with good posture
  • Slowly bend your knees and push your bum backwards
  • Lower yourself into the squat position without bending your back
  • Stand back up tall and repeat for 10 reps
Squat Technique Example

Hip hinge instructions:

  • With the feet shoulder width apart bend your knees slightly
  • Engage the core and back muscles with good posture
  • Slowly push your bum backwards bending at the hips only
  • Lower your torso like a drawbridge, without bending the spine
  • As your hamstrings become tense, stop the movement
  • Return to upright and repeat for 10 reps
Hip Hinge Technique Example

Reverse lunge instructions:

  • With the feet shoulder width apart bend your knees slightly
  • Engage the core and back muscles with good posture
  • Load your right leg and slowly reach backwards with your left leg
  • Drop into the lunged position focusing weight more on the front leg
  • Return to the starting position and repeat for 10 reps
  • Repeat on the other leg
Reverse Lunge Technique Example

Mistakes when doing these exercises you must avoid

There are some common mistakes you must avoid when doing these exercises, these include the following:

  • Squats: knees wobbling towards one another
  • Squats: the back rounding
  • Hip hinges: the knees bending
  • Hip hinges: having the knees locked out
  • Hip hinges: the back rouning
  • Reverse lunge: the knee wobbling to the midline
  • Reverse lunge: the back arching 
  • Reverse lunge: the back tilting to one side or another

One of the most common errors is the spinal movement, this common movement leak is really problematic for those who are trying to recover from back pain, that is why we released a full video on the tape test, a great hack to fix your squats. It can also be used for the hip hinge and split squat too.

Part 2: Apply these lessons to your daily life

Too many people work hard during their rehab for say 30 minutes to 60 minutes a day, only to completely forget their back during the other 23 hours of the day. If you’re to be successful in recovering from lower back pain, you must make sure that you work to protect a neutral spine, bend correctly and engage your core properly during daily life. Failure to do this is one of the major sources of relapses and confusion.

It’s the classic case of “my back pain keeps coming back each day and i have no idea why, i didn’t do anything in particular”. You cannot wear a cast around your back like you can an ankle to force you to stop aggravating the issue, and you would hop on a sprained ankle either. Yet too many unwittingly are making their back pain worse every day. Make sure you avoid doing this – you’ll notice again, near instant improvements in the daily patterns of your pain when you get it right.

Part 2: Review strategies to build a foundation for back pain recovery

When you start to move correctly and rectify bad daily habits, you’ll find things start clicking  into place. It can take some time to learn to move correctly, as chances are the bad habits you have, and the poor ability to do the squats or hip hinges is something that has been lurking in the background for a long time. But as you do make changes on these fronts, your recovery will begin to compound. Your back will now be ready for the next step, just remember you might not be pain free just yet. That’s ok, healing takes time!

Part 3: Starting to build strength into your back

This next part of the recovery is to start exposing your back to some loading, to help build resilience in your muscles and guide the healing process. Let’s face it, children of your own, or grandchildren, even if you have shopping, laundry or a dog, you’re going to be doing some load bearing activity. So your back recovery strategy needs to include the safe and gradual application of load to the movements we discussed in Part 2. 

We recommend starting out by adding in the use of resistance bands, primarily because they complement the natural difficulties with these exercises. As you lower yourself through the squat movement, you’ll find it gets more difficult at the bottom third of the movement, compared to the top third. The nice thing about bands is that they are at their strongest when stretched most, and when you lower down, they reduce their load the further you go. This allows for a slightly safer exposure to the use of load.

Doing the previously mentioned exercises, squat, hip hinge and reverse lunge, for sets of 10 reps repeated 3 to 5 times can be a great way to start out building some strength.

For a great mix of 5 exercises you can put together for a core workout, check out the video on 5 core exercises for back pain which will walk you through them all with demonstrations.

You do not need complex exercise or workout regimens, or a laundry list of different exercises, this only means you need to spend more time working to learn how to safely do lots of different exercises. Simply focusing on a handful of simple, highly relevant exercises gives you the smoothest pathway to building your back health!

Part 4: Building strength for the long term

The last part of the puzzle is the long-term part, this is how we continue to focus on 2 key parameters in our rehab to make sure that we continue to support the rebuilding of a healthy back and go on to reduce the risk of future lower back injury. 

This comes down to progressing with the weights that you are using, this is the primary driver of strengthening of the muscles of your hips, core and back, as well as the very spine and discs themselves. 

For all of us, our back will fail at some point, the question needs to be, do you lose composure in your back when lifting a 3kg shopping bag or when you have a 30kg suitcase, or when you lift a 100kg barbell. No matter what age you are the further you push that point of failure, the safer your day to day life will be.

Strategies and tools that will help you build back & spine strength for the long term:

Dumbbells and kettlebells: These, especially the adjustable kind for home users, are great tools to help you increase the weights you’re using safely over time.

Weighted vests: We covered these in a dedicated video on weighted vests for back pain, but these can be particularly helpful if your arms are not very strong. They can help you continue to add weight in increments of as small as 1kg at a time!

Barbells in the gym: Naturally for most, the progression to using barbells in the gym can be a great option to continue to progress the squat and hip hinge in particular.

Provided you steadily expose yourself to more weight or resistance, whilst maintaining goof technique, you will find that you gradually increase the strength of your back, making relapses a thing of the past. Over time you will continue to improve your strength and the mobility of your hip joints so your hips take part in more of the movement. At this stage in the recovery process you will find that you can use the very exercises you are doing for strengthening as tools to improve your mobility too, by focusing on the repetitions during your workout. 

Sometimes however, it can be helpful to use some more dedicated strategies to improve mobility in the hips. We recently covered a specific video on 5 steps to improve your hamstring flexibility which you can follow for a way to make instant improvements in your hip mobility via the hamstrings. Just do not do it before a workout!

Bonus: Leveraging specialist treatments to help optimize your recovery

When it comes to treatment, it is a resource that some lean on to help in the process of recovering from lower back pain and it certainly can play a powerful role in speeding up the recovery process, and helping you along the way as you progress through the “4 parts” outlined in this article. We break down these treatment modalities into two parts, so you can understand how your given treatment is helping the process of back injury recovery.

For clarity here, we’re talking about purely non-invasive, natural treatment options and will not cover pain medications either.

Basic Natural Treatment For Low Back Pain:

It is important to understand that many of these therapeutic options work in similar ways a list of the various options would include:

  • Osteopathy
  • Physiotherapy/Physical therapy
  • Chiropractic
  • Accupuncture
  • Massage
  • Cupping

Although there are many different techniques that might be employed by these professionals, there is a common truth that you must understand amongst all of them. This is not a criticism, but a mere statement. These therapeutic options work by releasing stiffness, relaxing muscles and helping joints move properly again. Or in other words, adding back in mobility to the body and getting things moving better again. Generally speaking this cannot be done to directly intervene in the area that is actually injured.

For example in the case of the injured L5/S1 segment, say the herniated disc, the role of treatment is to mobilise the hip joint and muscles below, the thoracic spine above and upper part of the lumbar spine, so that they can take their fair share of motion and help give the injured segment of the spine chance to recover. 

Think of it like helping the other areas of the body take up the slack while the injury heals, such as your arms helping the process of walking via crutches when you’ve broken your leg. 

Optimal natural treatments for back pain healing

Although clinically we have made use of the above treatment techniques in the past, and still do today, there are better modalities, thanks to science and technology, that allow us to directly help optimize and support the healing process in the injured tissues, in this case the disc herniation at L5/S1. 

Two of these treatment options we have intimate experience with are IDD Therapy and Class IV Laser therapy (K-Laser Therapy). Both of which we have used with patients in our clinics over the years. You can learn more about these at backinshapestudio.com.

IDD Therapy is a means of safely applying spinal decompression to the targeted section of the low back, to create a gentle intervention at the level of the disc to help take pressure directly off the herniated disc. You can read/watch more about this specifically in the full podcast episode on how to leverage IDD Therapy for your lower back pain.

Class IV Laser Therapy is another great bit of technology that pairs perfectly with the IDD Therapy to safely target the injured section of the body to help optimize the healing process no matter how severe the back pain.

Both of these options offer the clinician a way to help those with back pain by offering a more targeted approach to the problem. At our clinics over the years, we’ve sought out the best approach we could possibly develop to help work with people locally and around the world to resolve their lower back pain in a way that lasts. Investing heavily in technologies where they’ve proven to add value to the lives and outcomes of the individual suffering from back pain.

Hopefully you’ve found this deep dive into lower back pain of interest and helpful, if you want more guidance, there are a couple of ways we can help you further:

  • Free Fixing Back Pain Masterclass: A free 80 minute workshop where we guide you through the process of fixing your back pain
  • Membership to The Back In Shape Program: the renowned program of 4 Phases complete with all the education and demonstrations across over 300 video segments.

Visit us at the clinic: Come to visit us at the clinic and we can help you in person with your back pain. Virtual appointments/consultations are also available.

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  1. I shared this video with a work colleague today. I feel like the workshop/demo video that you have is too long to share with somebody as they probably wouldn’t take the time to go through it but this being only 32min is much more reasonable for somebody to start to educate themselves with

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