How to treat a stiff back, according to physical therapists

Whether you’re always on the move or spend most of your day sitting, chances are you’ve felt tension in your back at some point. This common discomfort can stem from a variety of reasons — an acute injury, overuse, or even prolonged inactivity. Regardless of the cause, a stiff back can be more than just a nuisance. It can make everyday activities like exercising, standing up from a chair, or bending to tie your shoes feel like a challenge.

In most cases, a stiff back can be treated with conservative, at-home measures. Physical activity is especially powerful in helping you recover. “Gentle exercises that strengthen and stretch your back and surrounding muscles are among the best ways to relieve and prevent stiffness,” says Renee Bullis, PT, DPT, a physical therapist at Hinge Health.

Read on to learn more about what causes a stiff back, along with how to treat it — especially with exercises recommended by Hinge Health physical therapists.

Causes of a stiff back

Back stiffness can happen for several reasons. Often, it develops in response to an injury, whether it occurs suddenly or over time. “Our bodies are smart,” says Dr. Bullis. “When they sense a potential injury, they want to guard and protect the area from further injury.” Some common causes of back stiffness include:

• Muscle tension. Tension in your back muscles can certainly lead to stiffness, but tightness in nearby muscles can also play a role. For example, tight hip flexors or hamstrings can alter your posture, which may increase strain on your lower back and contribute to stiffness. 

• Lack of movement. Prolonged periods of inactivity can cause your muscles to tighten and lose flexibility, often leading to stiffness. For instance, if you sit for long stretches during the day, you might feel stiffness in your back when standing up or moving around.

• Muscle imbalances. When your back muscles are significantly stronger than surrounding muscles — such as your glutes, hips, and abdominal muscles — your back may overcompensate during movement. This can sometimes lead to muscle strain and stiffness. “When mobility is limited above or below your back, your back tends to take the brunt,” says Dr. Bullis. Improving strength and mobility in areas like your hips, core, and shoulders can help reduce stiffness and prevent overuse of your back muscles.

• Awkward sleep position. There’s no one-size-fits-all sleeping position, but certain positions might contribute to back stiffness. For example, sleeping on your stomach may feel uncomfortable for some people, while side sleeping could be the culprit for others. Finding a position that feels supportive and comfortable for your body can help reduce stiffness.

• Underlying conditions. Certain medical conditions can contribute to back stiffness. For example, arthritis can contribute to changes in your spine, such as inflammation or reduced joint flexibility, that may result in stiffness, particularly in your lower back.

• Overuse or muscle strain. A stiff back can also result from overuse or a strain in your back muscles. This occurs when a muscle or connective tissue stretches beyond its usual capacity, such as when raking leaves, shoveling snow, or lifting heavy objects for the first time in a while.

Symptoms of a stiff back

The symptoms of a stiff back can vary from person to person depending on the cause, but here are some of the most common symptoms:  

• A general feeling of tension in your back muscles. This can occur in your lower, middle, or upper back, often feeling like a tight, restricted sensation.

• Stiffness after staying in one position. Prolonged periods of sitting, standing, or lying down can make your back feel especially stiff when you try to move again.

• Difficulty with bending or rotating. Everyday activities like bending over to put on socks or twisting to reach something in the backseat of your car may feel challenging or restricted.

Back stiffness may or may not be accompanied by back pain. Sometimes, pain itself can trigger stiffness, while other times stiffness develops without any pain at all. 

When your back feels stiff, moving your body might not come naturally — especially if discomfort makes you hesitant. But gentle activity is one of the most effective ways to support a healthy spine and ease stiffness. The exercises above, recommended by Hinge Health physical therapists, provide a safe and accessible starting point to help you regain mobility and get back to doing what you love.

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.

Treatments for a stiff back

If stiffness is holding you back, there are plenty of ways to manage your symptoms and regain mobility. Here are some of the most effective at-home interventions. 

• Physical therapy. Guided exercises from a physical therapist can work wonders for relieving back stiffness. Strengthening exercises, in particular, help address muscle imbalances and prevent stiffness from limiting your movement in the future. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Gentle movement. Even light activity gets your blood flowing, which can help ease pain and stiffness. If your back feels tight, try taking a walk or doing a gentle stretch session (including the exercises listed above).

• Heat or cold therapy. Heat can increase blood flow to stiff muscles, helping them relax and move more easily. Cold therapy, on the other hand, reduces inflammation and swelling. “Choose whichever approach feels better for you,” says Dr. Bullis.

• Massage. A simple massage — whether with your hands, a tennis ball, or a device like a massage gun — can help relax tight muscles and promote a sense of relief. “Massage is a great addition to your pain management toolkit,” says Dr. Bullis.

• Ergonomic adjustments. Spending hours sitting can contribute to stiffness, but small changes can make a big difference. Dr. Bullis suggests standing up, stretching, or walking every hour to break up long periods of sitting. If you work in an office, adjusting your chair or desk setup for better support can also help prevent stiffness.

• Sleep adjustments. Supporting your spine while you sleep can reduce strain on your back. If you’re a side sleeper, try placing a pillow between your knees. If you sleep on your back, try a pillow under your knees.

• Mind-body relaxation techniques. Stiffness often stems from an overactive nervous system. Relaxing your mind and body can ease tension, making movement feel easier. Dr. Bullis recommends practices like diaphragmatic breathing or guided meditation to help calm both body and mind.

How to prevent a stiff back

Taking steps to keep your back flexible and strong can help you stay active and prevent further injury and discomfort. Dr. Bullis recommends these simple routine tweaks to keep your back healthy. 

• Move your body frequently. Anything you can do to move your body more during the day will help keep your muscles strong and flexible. Hitting the gym is a great option, but even simple movements like walks or stretch breaks throughout the day can help prevent a stiff back.

• Ease into activity. While physical movement is one of the best ways to address back stiffness, don’t overdo it. If you’ve been sedentary for a while, try to ease into movement. Start slow and gentle, and increase the duration or intensity of your exercise over time. 

• Listen to your body. When exercising or tackling physical chores, it’s important to tune in to how your body feels. Some discomfort is normal as your muscles engage and adapt — it’s a sign your body is working hard and building strength. However, sharp or persistent pain isn’t something to push through. 

• Move in ways that feel comfortable for you. Finding ways to lift, carry, and move that feel natural and comfortable for your body can help reduce strain on your back. A physical therapist can guide you in building strength and confidence for everyday movements, helping you feel more capable and resilient in your daily activities.

PT tip: Create a movement toolbox

Staying active is one of the best ways to manage and avoid back stiffness, and incorporating specific exercises into your routine can help ease discomfort. Consider identifying a few stretches and strengthening moves that work well for you before stiffness sets in. “That way, if your back does feel stiff, you’ll already have go-to exercises that you know bring relief,” says Dr. Bullis.

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

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3. Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., Fu, R., Dana, T., Kraegel, P., Griffin, J., Grusing, S., & Brodt, E. D. (2017). Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine, 166(7), 493. doi:10.7326/m16-2459

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5. Park, D. K. (2022, February). Spine Conditioning Program . OrthoInfo - AAOS. Retrieved from https://orthoinfo.aaos.org/en/recovery/spine-conditioning-program/