¿Tienes dolor lumbar cuando te inclinas? Qué significa y qué puedes hacer, según los fisioterapeutas

“Yesterday, I did some yard work that required continuous bending to the ground and standing up, which normally results in an extreme increase in my back pain that lasts for days,” a Hinge Health member recently told us. “While I was still a little stiff after each bend, I did not experience any residual pain after I completed the task. This is a really big deal because it’s one of the goals I wanted to achieve when I started the program.” 

Maybe you have a history of persistent back pain that's caused you to change the way you do certain activities or stopped you from bending over altogether. Or maybe you experience occasional bouts of back pain from bending that flare up after a long weekend of yard work or helping a friend move. Regardless, back pain when bending over can be inconvenient and sometimes concerning. 

Here’s the thing to know: Back pain when bending over usually doesn’t indicate a serious issue and it can often be treated with simple at-home measures that don’t require a doctor’s visit. Read on to learn more about the common causes of back pain when bending over and how you can prevent and treat it, especially with exercises from our physical therapists.

Why Does My Back Hurt When I Bend Over? 

Many people notice worse back pain symptoms during certain activities or movements, such as bending forward. Bending your spine shifts your center of gravity, which changes how the load is dispersed through your body. 

“If you have pain when bending forward, that doesn’t mean it’s worse than any other position,” says Maureen Lu, PT, DPT, a physical therapist at Hinge Health. “Any direction you bend changes how the load is dispersed through your body. It’s just that we tend to bend forward more than we bend in other directions, which is why people notice pain with that movement more.” 

Normally, changing how the load is distributed through your spine doesn’t matter. “Our spines are strong, flexible, and resilient. They’re built to bend in a lot of different directions,” says Dr. Lu. But if you have certain issues with your back, that combination of factors can cause you to notice symptoms. The following are some common conditions that may contribute to lower back pain when bending over:

• Muscle spasms. Muscle spasms are an involuntary and sudden tightness or pain in your muscles. They can occur anywhere in your body, including your lower or upper back. They’re often related to dehydration, stress, muscle fatigue, or a sudden increase in activity. They’re also very common and can affect anyone. “A lot of times, the pain or discomfort people feel when they bend over boils down to muscle spasms,” says Dr. Lu. 

• Muscle tension. Tightness in areas in and around the spine, such as the hips, can contribute to back pain when bending over, says Dr. Lu. (Read more about the connection between hip and back pain.)

• Herniated disc. Your spine is made up of 33 vertebrae (bones) stacked on top of one another. They are separated by strong, fibrous discs that are about a half-inch thick that act as shock absorbers between the vertebrae. A disc herniates when its center pushes against or through the outer ring, causing pressure that can, at times, cause back or leg pain. It’s worth noting that discs are designed to bulge so we can move. A herniated disc is only a problem if it catches a nerve root and causes symptoms. 

• Sciatica. The sciatic nerve runs from the low back down the legs. If it gets pinched or irritated, it can cause shooting pain that travels down the buttocks and into one or both legs. 

• Spondylolisthesis. This occurs when a vertebra shifts out of its normal position. If there is an excessive motion of the vertebra or if the vertebra puts pressure on a nerve, it may contribute to symptoms.  

• Arthritis. Osteoarthritis is one of the most common types of arthritis, characterized by changes in the shock-absorbing cartilage between bones. Sometimes, these changes don’t cause any symptoms, but they can contribute to symptoms such as pain and stiffness that tend to worsen after activity. Other types of arthritis affect the back, too, such as spondyloarthropathies — chronic inflammatory diseases that can affect the spine and pelvis.  

Some causes of back pain can sound scary, but they are usually not serious and can be treated at home with gentle movement and treatments like ice and heat and NSAID medication. 

Should I Be Worried? 

Your back is involved in many everyday activities — perhaps more than you realize. Anytime you toss a ball to your toddler, lift a box from the ground, or even sit in a chair, the muscles, tendons, ligaments, and other structures in your back are all active participants. “The back is one of the most common places to experience pain because our backs give us so much freedom to move,” says Dr. Lu. “But beyond red flag symptoms (which are very uncommon and not related to bending over), like a sudden loss of sensation in your legs or bowel and bladder changes, back pain when bending over is nothing to be alarmed by.”

Even if you have been diagnosed with arthritis, a herniated disc, or something else, you are not powerless to make changes and take control of your symptoms. While a structural change in your back, such as a herniated disc, can certainly be a factor in your pain, it’s unlikely to be the sole cause of your pain. In fact, studies show that many people with spine “abnormalities,” such as a herniated disc, have no pain at all. 

“We all live on planet earth and planet earth has gravity. That causes normal changes in the spine over the course of someone’s lifetime. But those changes in and of themselves don’t equate to pain,” says Dr. Lu. Pain is always due to a combination of factors, which is why it’s more important to focus on what you can do to heal and feel better, and less important to focus on why your pain might have started in the first place.

How to Prevent Back Pain When Bending Over 

Most people will experience a bout of back pain at some point in their life. “What many people don’t realize is that you’ll always heal from an injury that causes low back pain, even without any intervention,” says Dr. Lu. “Simple interventions, however, will help prevent recurrent episodes of it.” If you’re prone to back pain, here are steps you can take to prevent it from occurring, especially during activities such as bending over: 

• Stay active. Muscles love movement. The more you use them during activities like walking, biking, stretching, and anything else that keeps you active, the more resilient they become and the less likely you are to experience pain and injury. “It’s remarkable to think about what muscles have the power to do,” says Dr. Lu. “They create space in the spine and support the vertebrae. By simply using your muscles, you’re helping to keep them flexible and strong, which counteracts natural changes in the spine that occur over the course of a lifetime.” 

• Mix up your movements. “We tend to fall into the same movement patterns from day to day, which prevents the spine from moving in all the ways it’s designed to move,” says Dr. Lu. Changing positions throughout the day is very helpful, but it’s also good to change how you move. Do standing back bends while waiting in line at the store or do twisting motions while sitting in your chair at work, suggests Dr. Lu. “These little changes in your normal movement patterns just give your joints more nutrition in your day and help prevent pain from setting in.”  

• If you smoke, get support to stop. Research shows that smoking can worsen back pain because it narrows blood vessels so less oxygen and nutrients reach the spine. If quitting smoking seems daunting, reach out to a professional for help. Small steps can make a big difference when it comes to your back health.  

• Take steps to manage stress. We know — this is easier said than done. Stress can lead to back pain because it causes muscles to tense up. While this isn’t necessarily a bad thing, if your muscles don’t ever have a chance to relax, it can cause back pain over time. Stretching has been shown to increase serotonin levels, which is the “feel-good” hormone that helps stabilize mood, reduce stress, and increase feelings of calm. You could also consider adding yoga, meditation, or deep breathing to your weekly routine, or find ways to replace a little bit of screen time each day with activities that are meaningful to you.

• Do exercise therapy. Targeted gentle movements, exercises, and stretches increase the strength and flexibility of the structures in your back. This reduces stress on the spine and helps reduce the risk of low back pain. (More on this below).

Is There a ‘Proper Way’ to Bend and Lift? 

Despite what we’ve all been told — lift with your legs, not your back — there’s not actually a right or wrong way to bend over or lift something heavy. A common myth is that lifting is inherently bad for your back. Recent evidence has challenged the idea that you should avoid lifting to protect your back. Even if you experience pain or flare-ups, lifting is almost always safe and can be an important motion to help get your back pain under control. As you lift, remember to:

• Be intentional about your body position. We are naturally stronger in certain positions. Take a moment to find a firm stance and squat down if your back is sensitive to bending over at the moment.  

• Engage your core muscles. 

• Keep the object being lifted close to your body. 

• Keep your neck in a neutral position (not looking up or down). 

• Above all, lift in a way that feels comfortable for you.

As for bending over: If this causes pain, it doesn’t mean it’s a bad or dangerous movement. Pain from bending over often causes people to avoid this movement, which can cause muscles to weaken and actually contribute to more pain or difficulty bending over. 

The truth is, it’s okay to nudge into the pain — this actually makes your back stronger and more resilient to different movements so you experience less pain during everyday activities. You may just want to ease into it. Start by bending forward from a seated or kneeling position or bend over to pick something up off a low table instead of the ground, suggests Dr. Lu. This helps load your spine in a way that feels safe and allows your back to get accustomed to that motion gradually.

Other Treatments for Lower Back Pain

Back pain usually does not indicate a serious issue. It can often be treated with simple at-home remedies, including: 

Hot and cold therapy. Both ice and heat can be effective therapies for back pain. Ice is most commonly used for new injuries and when there is swelling, redness, or if an injured area feels hot (a sign of inflammation). Heat is typically used for muscle stiffness and managing stress and tension. Use whichever one feels good to you. More often than not, you’ll intuitively know which is best for you. 

Over-the-counter medication. Pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol), can be helpful for back pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

Consider your sleep position. “This can be a really important intervention for people with back pain,” says Dr. Lu. For some people with back pain, sleeping on their side is most comfortable, though sleeping on your back may be the best option for you. Research suggests that this may help keep the spine aligned for some people. Bottom line: The best sleeping position is the one that feels best for you.

No matter which positions you prefer, using pillows for additional support can help prevent pain. Place a pillow between your knees if you sleep on your side, under the backs of your knees or under your thighs if you sleep on your back, or under your lower abdomen for stomach sleeping to reduce stress on your lower back. 

Check your office setup. How and where you sit, as well as how long you sit, can play a big role in back pain. You can’t always control how long you have to sit, and if you spend a good part of your day in an office chair, it might be worthwhile to change your desk setup to make sure it works best for you. Consider these tips: 

• Place your computer right in front of you, at eye level, and arm’s reach away from you (about 18 inches). 

• Look for a chair that has a built-in lumbar roll to help maintain the natural curve in the low back, or place a rolled-up towel between your low back and chair. It also helps to have armrests so you can relax your elbows and arms as you work, which can help prevent back and neck pain.

• Consider using a standing desk for part of the day to help you change positions periodically and reduce tension in your back. If you use a laptop, you can perch your computer on a countertop for periods throughout the day.

Incorporate “movement snacks” into your day. Our bodies weren’t built to do the same repetitive activity for hours at a time, whether sitting at a desk or on the couch or even sleeping awkwardly. Every half hour to an hour, take a break from sitting to stand, stretch, take a brief stroll, or even just shift your position. This gives you a chance to tune in to how you’re holding your body and reset it in a more relaxed position.

Exercises that stretch and strengthen your back and core muscles are very effective in preventing and treating back pain. Here are some of the best exercises for lower back pain when bending over, recommended by Hinge Health physical therapists.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Bend Backward Before Forward

A lot of people experience pain when bending forward because that’s the bending motion they make most often. “But your spine isn’t just meant to forward bend. It’s meant to do many other things, like bend sideways and backward,” says Dr. Lu. “Encouraging other positions that bend your spine will always improve your ability to bend forward if that’s when you experience pain.” So before picking something up off the ground, consider doing a few spinal twists and bending backward or to the side. “That little warmup may be all your spine needs at that moment.” 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., Halabi, S., Turner, J. A., Avins, A. L., James, K., Wald, J. T., Kallmes, D. F., & Jarvik, J. G. (2014). Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. American Journal of Neuroradiology, 36(4), 811–816. doi:10.3174/ajnr.a4173

2. Green, B. N., Johnson, C. D., Snodgrass, J., Smith, M., & Dunn, A. S. (2016). Association Between Smoking and Back Pain in a Cross-Section of Adult Americans. Cureus, 8(9). doi:10.7759/cureus.806

3. Wipfli, B., Landers, D., Nagoshi, C., & Ringenbach, S. (2009). An examination of serotonin and psychological variables in the relationship between exercise and mental health. Scandinavian Journal of Medicine & Science in Sports, 21(3), 474–481. doi:10.1111/j.1600-0838.2009.01049.x

4. Dreisinger, T. E. (2014). Exercise in the Management of Chronic Back Pain. The Ochsner Journal, 14(1), 101-107. 

5. Cary, D., Briffa, K., & McKenna, L. (2019). Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review. BMJ Open, 9(6). doi:10.1136/bmjopen-2018-027633

6. Ventrudo, J. Why you have lower back pain when sitting down or bending. New York Spine Institute. https://www.nyspine.com/blog/why-you-have-lower-back-pain-when-sitting-down-or-bending/

7. Lower Back Pain When Bending Over: What You Need To Know. (2022, September 15). HealthMatch. https://healthmatch.io/lower-back-pain/lower-back-pain-when-bending-over