First - let's clarify your case. Why did you land here on lower back pain when bending over?
- (Acute) I sharply threw out my lower back when bending over
- (Chronic) Every day my lower back hurts when I bend over, there was no real harsh initial event
We'll cover both case 1 and 2. A disclaimer - I am not a doctor, I am a biomedical engineer and a guy who had years of horrible back problems before figuring it out. And I'm going to give you my best guess on how you can get better.
Our school of thought is to fix you on the level of muscles - yes, those angry, spasmed, sticky, pain-wrecking, probably dehydrated muscles.
The objective of this post is to biomechanically relieve pressure, impingement, and pain in the lower back caused by bending over. Best of luck!
Case 1 - I Sharply Threw Out My Lower Back When Bending Over (Acute)
You may be here just hours, or even minutes after this fun event. Sorry I've been there, it is anything but fun.
You may have done one of these to get here:
- Suddenly caught a falling object
- Stood up too quick
- Reached across a counter
- Bent over and lifted a heavy weight
Regardless of the source, you likely have what is called lower back muscle spasms. They hurt like hell, they make it hard to move, and drastically lower quality of life. Movement in any direction is painful - including and especially, when bending over.
The Reason/Mechanism:
The reason/mechanism for this spasm event is this: your back signalled to your brain to signal to your muscles that your spine was at risk, so your lower back muscles better guard and lock up to protect it.
This mechanism is great short term (it literally protects our spine from vertebrae damage), but it is painful and annoying long term. When your lower back is safe hours, days, or even months later, it can still hold its spasm/guarding.
The Solution:
The solution to acute muscle spasms is relaxation, massage, and time. There are several schools of thought on this, but I personally respond best to deep breathing and targeted deep tissue massage - ideally with a purposefully made tool like QL Claw (it targets the lower back pain specific muscles).
A physical therapist or massage therapist will be your best bet for managing lower back muscle spasms. It may help to educate yourself on the specific muscles to understand their treatment - read about QL, Psoas, Iliacus, and Gluteus Medius at the respective links.
Case 2 - My Lower Back ALWAYS Hurts When I Bend Over (Chronic)
This one will likely require a professional opinion in person. However, this is my two cents and what worked when I couldn't bend over comfortably for years.
The Mechanism:
Consistent lower back pain when bending over is often due to lack of spinal stability. In other words, lack of strength in particular muscles in and around the lower back.
You may be very strong in some areas, but if you have had lower back pain when bending over for several months or years - something is missing. There is some functional area of your trunk that isn't pulling its weight.
Even if you were strong when back pain bending over started, chances are high you have lost some muscle since (because using the muscle hurts, so you don't use it, so it weakens).
The Solution:
Read up on a guy named Dr. Stuart McGill and his big 3 exercises. Dr. McGill is the king of improving spinal stiffness and training the back to securely oppose movement in several positions - including when bending over.
The McGill Big 3 exercises are easy and simple on the outside, but they contain subtleties that make them very hard to get right for optimal relief. Take the time to learn, and watch this video tutorial on a McGill Big 3 follow-along:
That is lower back pain when bending over in a nutshell! Read on for more details if you would like:
Lower Back Pain When Bending Over - The Muscles
A great deal of lower back pain when bending over can be boiled down to tension and imbalances of the muscles [1]. To be more precise, lower back trigger points should be at the top of the suspect list when investigating lower back pain when bending over because resolving them is non-invasive, inexpensive, and can often be done right at home [2].
Muscle 1: Quadratus Lumborum
The Quadratus Lumborum (QL) muscle lies deep in the lower back on both sides of the spine. The QL muscle tends to develop painful knots and trigger points from repeated bending over (fatigue triggering) or from a single high-impact event (immediate triggering).
Muscle 2/3: Gluteus Medius/Minimus
Gluteus Medius and Gluteus Minimus are upper buttock muscles that lie on top of each other. Both muscles refer pain directly to the lower back when trigger points and tension arise, and both should are crucial in side-to-side stability as well as lifting off the ground.
If you have lower back pain when bending over and are not sure where to focus - these 3 muscles are your answer. Optimizing these muscles with the 3-step process of 1) massage, 2) stretch, and 3) strengthen is the exact set I used to get out of debilitating lower back pain and bend over pain-free today.
Lower Back Pain When Bending Over - Releasing The Muscles
In order to rid the QL and Gluteus Medius/Minimus muscles of their current, constant tension caused by trigger points, a thorough deep tissue massage is needed. An effective deep tissue massage is extremely therapeutic - it can potentially release years of constant tension weighing you down and causing you pain.
How To: Trigger points and constant muscle tension can be released by the hands of a physical or massage therapist, or at home with a purposefully made tool like QL Claw. QL Claw was specifically designed to release the 6 main muscles that contribute to lower back pain when tight - including the 3 listed above. Check out tutorials on QL release and Gluteus Medius release with QL Claw to get started.
Exercises For Relieving Lower Back Pain When Bending Over
After a thorough deep tissue massage of the muscles above, you may be right on the cusp of burying your lower back pain when bending forward for good. The next level of reaching forward bending levels is through the following exercises:
Stretch - Elephant Walk Exercise: Build confidence when bending over with this exercise. The Elephant Walk movement forces you into an extreme forward bend position - and it forces you to get comfortable there. Perform this exercise multiple times a day for the most dramatic effects, and your lower back will thank you.
Strengthen - QL Exercises: QL strengthening exercises, including the side plank and suitcase carry, train strength and endurance in the exact areas you need in order to confidently lift objects off the ground again. These exercises not only work the QL muscle but also the obliques, upper glutes, and spinal erectors contributing to a strong, healthy lower back.
Lower back pain when bending over is just one piece of the complete back pain relief package. Read these articles next to fix the muscles and fix the pain for good!
Sources/Influences:
[1] Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.
[2] Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.