Lower back pain is remarkably common. Most of us will experience it at some point, and some people deal with it far more frequently than they'd like.
It's frustrating, limiting, and can significantly impact your quality of life - from how you sit at work to whether you can stand long enough to cook dinner or play with your children.
The good news? The most common type of lower back pain is something you can actually work on and improve. But first, let's talk about when you shouldn't try to handle it yourself.
When to See a Doctor (Please Don't Skip This Bit)
Not all back pain is the same, and some types require immediate medical attention.
See a doctor promptly if you experience:
Severe or sharp pain (not just discomfort)
Pain lasting more than a few days without improvement
Tingling, numbness, or weakness in your legs
Pain combined with loss of bladder or bowel control
Pain following an injury or fall
Pain that worsens rather than improves with rest
There are many possible causes of back pain - from muscle spasm to SI joint dysfunction to more serious issues like lumbar disc problems (dehydration, prolapse, herniation). If you're in doubt, get it checked. Better to feel silly about seeing a doctor for something minor than to ignore something serious.
This article addresses the most common type of mild-to-moderate lower back pain. But if your situation doesn't match what I'm describing here, or if you're uncertain, please consult a medical professional.
The Type of Back Pain I'm Talking About
The complaints I hear most often from clients sound like this:
Dull, achy pain across the lower back, right where the pelvis meets the spine (around the sacrum)
Mild to medium intensity (not sharp or severe)
Worse in the morning, improves slightly with movement throughout the day
Makes standing for long periods uncomfortable
Makes standing up or changing position briefly painful (that moment when you go from sitting to standing and have to wait for your back to "unlock")
Sometimes feels like your back is gripping or tight
Does this sound familiar?
If so, you're probably dealing with the most common culprit: anterior pelvic tilt.
What's Actually Happening: The Pelvis-as-Bowl Analogy
Think of your pelvis as a bowl of water.
Ideally, you want to hold that bowl level so the water doesn't spill over the edges. That's a neutral pelvis - the position where your spine and hips can function most efficiently without creating strain.
But in anterior pelvic tilt, the front of your pelvis tips forward. Imagine the bowl tilting so water would spill over the front edge.
When your pelvis tips forward like this, it creates an exaggerated curve in your lower back (lordosis). This "scrunches up" the muscles and tissues in your lower back, compressing them and creating that characteristic dull, achy pain.
Your lower back isn't really the problem - it's the consequence of your pelvis being chronically tilted out of neutral position.
Why This Happens (And Why Stretching Alone Won't Fix It)
Many people instinctively stretch their hip flexors when their lower back hurts, and it often provides short-term relief. That's because tight hip flexors do contribute to pulling your pelvis into that forward tilt.
But here's the thing: tight doesn't automatically mean strong.
Often, the hip flexors are tight because they're chronically overworking to compensate for weakness elsewhere. And stretching them might give you 20 minutes of relief, but it doesn't address the underlying cause.
The real issue is usually a combination of:
Tight (and often weak) hip flexors pulling the front of the pelvis down
Weak gluteal muscles failing to support the back of the pelvis
Weak deep abdominal muscles failing to provide core stability
When your glutes and abs aren't doing their job properly, your hip flexors work overtime and your pelvis tips forward. Your lower back pays the price.
This is why you need to strengthen, not just stretch.
What Actually Helps
Once your pain has lessened to mild (not in the very acute phase), here are four exercises that address the root cause:
1. Cat-Cow (Gentle Spinal Mobility & Assessment)
This is a lovely way to gently wake up your spine and assess how your back is feeling today.
Start on your hands and knees (all fours) with your hands under your shoulders and knees under your hips
Cow pose: Slowly arch your back, letting your belly drop toward the floor and your head lift gently (don't force your neck back)
Cat pose: Slowly round your back, tucking your pelvis under and letting your head drop gently
Move slowly between these two positions, spending 3-5 breaths in each
Let your breath guide the movement: inhale as you arch (cow), exhale as you round (cat)
Do 5-8 slow, mindful repetitions
Why this helps: Gently mobilises your entire spine, helps you assess where you're stiff or uncomfortable, and encourages natural movement of the pelvis. This is also a good indicator of how your back is feeling - if this hurts, save the other exercises for another day.
2. Knee to Chest (Gentle Hip Flexor Lengthening)
Lie on your back with both legs extended
Slowly pull one knee toward your chest, holding it with your hands
Keep the other leg extended along the floor (you should feel a gentle stretch in that hip)
Hold for 20-30 seconds, breathing calmly
Slowly release and repeat on the other side
Do 2-3 repetitions per side
Optional progression (only if it feels comfortable): Once you've pulled your knee to your chest, you can gently let that knee fall across your body for a mild spinal rotation. This can feel lovely, but skip it if it causes any discomfort.
Why this helps: Gently lengthens hip flexors without forcing them, while the extended leg actively works to maintain length.
3. Modified Dead Bugs (Core Strengthening)
This is a gentler version of the traditional dead bug exercise, perfect when your back is sensitive.
Lie on your back and extend your arms straight to the ceiling
Lift your legs to tabletop position with your shins parallel to the ceiling
Consider placing a small folded towel under your lower back (not a high stack) - this gives you something to press into, which improves proprioception and helps you maintain alignment
Slowly tap one foot down to the floor while keeping the other leg in tabletop position
The key: keep your lower back pressed gently into the floor (or towel) the entire time - don't let it arch up
Return to start position and repeat on the other side
Do 8-10 repetitions per side
Why this helps: Teaches your deep core muscles to stabilise your pelvis and spine without straining your back. The bent-knee, toe-tap version is much gentler than extending the full leg.
4. Pelvic Tilts (Learning Neutral)
This might seem simple, but good form is absolutely key here.
Lie on your back with knees bent, feet flat on the floor about hip-width apart
Imagine placing a marble between your belly button and your pubic bone
Gently tilt your pelvis to "roll the marble" toward your belly button - you should feel your abs engage, your glutes slightly squeeze, and your lower back press into the floor
Hold for 3-5 seconds, then release back to neutral (not into an arch, just neutral)
Repeat 10-15 times
Why this helps: This exercise teaches your body what a neutral pelvis feels like, strengthens your glutes, and engages the core muscles that should be supporting your pelvis. Over time, this motor pattern becomes more natural.
Important Notes About These Exercises:
Start gently. If any exercise increases your pain, stop and rest.
Consistency matters more than intensity. Better to do these exercises for 5-10 minutes every day than to do a heroic 30-minute session once a week.
Pain should decrease, not increase. Some muscular effort is fine, but sharp pain or increased back pain means stop.
This takes time. You're retraining movement patterns that have likely been established for years. Be patient with yourself.
Lifestyle Adjustments That Help
Beyond exercises, small changes in how you sit and move throughout the day can make a significant difference:
Sitting:
Avoid deep, slouchy sofas that let your pelvis tip backward
Sit on chairs where your pelvis is slightly higher than your knees (this naturally encourages a more neutral spine)
Consider a small wedge cushion that tips your pelvis slightly forward when sitting
Don't stay in any position too long - change positions regularly
Standing:
Avoid locking your knees when standing for long periods
Try to distribute weight evenly on both feet
If standing for a long time, occasionally place one foot on a small step or curb (alternating feet)
Movement:
The Encouraging Bit
Here's what I want you to remember: This is something you can work on and improve.
Anterior pelvic tilt and the resulting lower back pain aren't a life sentence. With consistent work on strengthening the right muscles, learning what neutral pelvis feels like, and making small adjustments to your daily habits, most people see significant improvement.
It won't happen overnight. You're retraining patterns that have likely been established for years, possibly decades. But improvement is genuinely possible.
The Realistic Bit
I've focused on anterior pelvic tilt because it's the most common cause of the type of lower back pain I see in my clients. But it's not the only cause.
If you've tried these approaches for a few weeks and aren't seeing improvement, or if your pain pattern doesn't match what I've described here, please see a medical professional. There are many other conditions that can cause lower back pain, and some require different approaches or treatment.
And even if anterior pelvic tilt is your issue, sometimes you need personalised guidance to learn these exercises properly and to address your specific movement patterns.
If You Need Support
This is exactly the type of work I do with clients - not just giving exercises, but helping you understand what's happening in your body, teaching you to move in ways that support rather than strain you, and building sustainable practices that actually create change.
If you'd like guidance working on this (or any other movement challenge), I'd be happy to help.
Anja Dobler Integrated Movement & Breathwork Specialist Based in Berlin | Teaching internationally online www.anjadobler.com
