Lower back pain is one of the most frustrating pains. I have broken numerous bones, been sick and bedridden for weeks, and nothing comes close to the invisible, debilitating lower back pain I dealt with for 4 years. The reason I'm writing this is because 3 years ago I figured it out, and created Back Muscle Solutions as a result. Since I have helped hundreds of folks find lower back pain relief, this post is a guide for you to analyze your lower back how I did - and how I found full, lasting relief.
Help, My Lower Back Is Killing Me!
First, I need to include a disclaimer, how to use this article, and who this article is for. I am not a doctor, just a guy who had a lot of back pain and figured it out. I am a biomedical engineer, active fitness enthusiast, and researcher in my free time.
This article is not meant to be a monkey-see-monkey-do follow-along. The point is to give you a holistic view of the root of lower back pain, and what steps make sense to combat the roots. My story is not yours, but I am willing to bet there are a handful of similarities and gems you can take away from it.
This article is for anyone frustrated and fed up with their back pain. There is a lot of garbage information out there and many professionals walk on eggshells to avoid giving real answers. I write this with a hint of anger because I once consumed and tried all garbage advice consumable, and trust me when I tell you it is nearly entirely fluff with no substance - and never written by anyone who actually lived in the back pain trenches and came out the other side.
The source and resolution steps I discuss are heavily focused on one mantra: fix the muscles, fix the pain - if this line resonates or if you are at least open to the idea of muscle pains, you are in the right place.
Now, the 4 steps I learned after 4 years of trial, error, research, expert help, countless professional visits, and self-education that allow me to walk around active and pain-free today.
Step 1: Getting Out Of Acute Lower Back Spasm
The first, most important, non-negotiable step of answering "Why is my lower back killing me?" is getting your muscles to calm the hell down. Without getting out of angry muscle spasms there are no corrective exercises, habits, posture, or lifestyle that will get you to permanent relief.
My Step 1 Story: For 4 years I was in and out of chiropractors, PTs, doctors, etc. and never found more than temporary relief. It wasn't until I desperately stumbled on the trigger point therapy school of thought that I realized a basic truth: muscle tension is the source of an incredible amount of bodily pain, and it will continue to manifest pain until it is directly dealt with. Until this, I thought I had a back spine, bad nerves, a curse - anything but a problem with muscles. This quote from source  helped me understand this:
"The solution for your back pain may be simpler than you think. Many people are haunted by the fear that pinched nerves, ruptured disks, or arthritis is causing their back pain, when there’s a good chance that their pain may be coming solely, or at least in part, from myofascial trigger points in muscles. Even when back pain is due to genuine problems in the vertebral column, myofascial trigger points often contribute to a major part of the pain. In fact, there’s reason to believe that trigger points can be the root cause of many spinal problems because of the muscle tension they maintain. Short, tight muscles can displace vertebrae and cause compression of nerves and disks. When investigating back pain, trigger points should be at the top of the list, because trigger point therapy is noninvasive, has few side effects, and can be done on yourself (Travell and Simons 1992)" 
This section (get the book in source 2 if you want a complete picture of step 1) gave me hope for the first time in years. It immediately resonated with me because I had always worked my muscles intensely through sports but had never paid attention to tension release and recovery. Over the next few weeks, I dove into massage and trigger point therapy head first and was able to find the most relief I had in 4 years. I can't overstate this enough - if you ask the question "Why is my lower back killing me?" the short likely answer is "Because you have an incredible amount of unresolved muscle tension, and it is dying to be physically worked."
Lower Back Massage Release With QL Claw
Step 1 How To: Learn the 5 main muscles that contribute to lower back pain when tight, read their trigger point charts, and work on thoroughly releasing them with a professional or an at-home tool like QL Claw (the tool I designed for this purpose). In addition, products like TENS units, anti-Inflammatory topical lotions, and muscle relaxants can aid with this step of getting the muscles in and around your back to simmer down. Depending on the severity of your case, this step can take anywhere from 10 minutes to 4 weeks. Regardless of the time it takes, take the time to commit here - this genuinely broke a 4 year lower back pain spell for me.
Step 2: Stretching For Freedom Of Movement
Once step 1 is complete, step 2 becomes easier. A spasmed, trigger-point-ridden muscle is nearly impossible to stretch, so the sequence is crucial here. Our newly relaxed muscles can now be lengthened to take pressure off our poor lower back and give us greater freedom of mobility so our lower backs do not scream whenever we try to do something.
My Step 2 Story: After unlocking my lower back pain with trigger point and massage therapy, I was still stiff and walking on eggshells most of the time. I didn't have much freedom of movement with my lower back, and I moved around gingerly to avoid angering the lower back Gods. I found stretching as a positive amplification of Step 1 - lengthening the muscles further after they are rid of their trigger points and rigid tension. Stretching allowed my muscles to slacken and work with me even more, and relieve a ton of pressure on the lower back (via less nerve compression, less joint strain, and more range of motion). I fell in love with stretching at this point because, for the first time in my life, I was benefiting and growing from it. Here is a picture of me after a few weeks of dedicated and intentional stretching - keep in mind I could NOT touch my toes just months before this:
Flexibility After Step 1, Step 2, and Flexible Back Training
How To: 3-5 days a week, take the time to stretch the muscle groups that wrench on the lower back when tight - especially the hip flexors and glutes. The Back Muscle Solutions YouTube channel has several tutorials on how to do this, and we also created a plug-in program Flexible Back for a guided approach.
*Update 7/17/23: Read 13 Stretches For Lower Back Pain
Step 3: Strengthening For Resilience
Step 3 is arguably the most important, and it does not necessarily need to be done last in order. I strength-trained specifically for my lower back for years and although it helped - it did not solve my pain until I tackled steps 1 and 2. After steps 1 and 2 were hashed out my strength gains came much easier, and the exercises I share below finally rounded out my lower back to become darn near bulletproof.
My Step 3 Story: I grew up very active and strong. Until around age 18, I beat up my body intensely through weight training, playing hockey, running, working manual labor, playing pickup basketball, and more which kept my body quite durable. The problem was I never paid any attention to form, posture, stretching, massage, or recovery - and at age 18 it caught up and I paid the price. My first horrendous back spasm happened at 18 after catching a Power Clean with a warmup weight, and I am not exaggerating when I say I crawled for 4 days and didn't walk right for 4 weeks. Even 4 months out I was not healed, and my back pain never went away until 4 years later.
The reason I bring this up and the reason strengthening is so important - during the 4 years I had back pain, the muscles in and around my back seriously weakened and atrophied. Training my lower back hurt, so I didn't train my lower back, so my lower back got weak, so my lower back was more fragile, so my lower back hurt more - you get the point - in a downward spiral. By the end of the 4 years, my core and lower back was a shell of itself, and I needed to build up strength badly. Figuring this out took a lot of time and trial and error, and this routine got me most of the way there:
The video above shows the 3 most universal, least-risky, effective strengthening exercises for the lower back known as the McGill Big 3. The McGill Big 3 consist of the 1) McGill Curl Up, 2) Side Plank Ups, and 3) Bird Dog Holds. Each exercise has very specific set of queues, so follow along in the video above or research McGill's material on your own to make sure you get the most out of the movements. Doing the McGill Big 3 exercises 3-4 times per week can have you out of "my lower back is killing me" in no time.
Step 4: Habits
Step 4 should be titled: "How I Stopped Doing The Stupid Things That Made My Pain Worse". The point of building back-friendly habits is this:
- The less back pain you have, the less back pain you have
- Desensitizing pain compounds over time. Avoiding X pain triggering activity today can allow you to do the same X activity without pain in the future
The less you trigger back pain and the more wins you build, the less pain triggering events happen.
My Step 4 Story: Bending forward was a huge pain trigger for me. I always tested it to see if maybe it wouldn't hurt, but it always hurt. Do you know how I fixed this? I stopped bending forward. After a few weeks, the movement of bending forward was no longer mentally associated with a pain-triggering event, so my body didn't spaz when I did it. This may seem simple but it helped as much as any step in this post. Try avoiding your pain triggers at all costs for 2 weeks and see what happens.
I understand that avoiding every back pain trigger isn't always feasible or going to be the cure all, but the point is significant. I gained a lot of progress from temporarily avoiding pain-triggering events (bending forward, hockey, weight training, etc.) and building the foundation with steps 1-3, only to come back to the same habits later and find no lower back issues. I am not an expert in why this works, but Stuart McGill has a great section on it in his book Back Mechanic.
Why Is My Lower Back Killing Me?
If you are still reading thank you, and I sincerely wish you the best of luck. I hope my story and notes resonate with you on some level, and I hope you can pull something (or everything you need) out of here to improve your situation. Lower back pain is the worst, and my mission with this website and business is to help as many people find relief as possible. Feel free to email me at firstname.lastname@example.org or click one of the links above to read more about conquering your pain - you got this!
 Donnelly, Joseph M. Travell, Simons & Simons Myofascial Pain and Dysfunction: the Trigger Point Manual. 3rd ed., Wolters Kluwer Health, 2019.
 Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 3rd ed., New Harbinger Publications, Inc., 2013.