Movement Lab Journal

First aid for low back pain: what’s actually going on, and what you can try

The honest version, not “here’s your six-week fix”

It usually shows up the same way. You bend to pick something up, or you get off your board after a long paddle, or you stand up from your desk after a long day, and something in your low back grabs. Sometimes it’s a dull ache that sits there all day. Sometimes it’s sharp enough that you notice every single movement.

The instinct most people have is to rest it. Lie down, avoid bending, wait it out. Here’s the honest version: rest is rarely the fix, and the muscle that’s actually sore is often not the muscle that started the problem.

That’s not wrong, exactly, to want to protect it. It’s just incomplete, and the incomplete part is usually why it keeps coming back.

Why your back is sore, and why “worn out” probably isn’t the reason

If you’ve ever had a scan or imaging done on your back and been told there’s some wear and tear, a bulge, or “degeneration,” it’s worth knowing this: that kind of finding is extremely common in people who have no back pain at all. Your spine changing with age isn’t the same as your spine being broken, and it doesn’t decide whether you’re in pain. Your back is a genuinely strong, adaptable structure, not a fragile one that needs to be protected from movement.

So if it’s not “wear and tear” doing the damage, what is it? Most low back pain that shows up like this is mechanical, meaning it’s about how your low back is being loaded, not a structural problem underneath it. And a large part of that load usually isn’t coming from your low back at all.

Two targets here, not one lever: how your nervous system is controlling the area, and how much capacity the muscles around it actually have to do their job. When one part of that system, often your hips, isn’t pulling its weight, your low back quietly picks up the slack. It compensates. Your body’s genuinely smart about this: it keeps you moving even when something upstream isn’t doing its job properly, which is exactly why the sore spot and the actual problem are often in two different places.

What’s often involved

If you surf, this is the tightness you feel through your hips after a heavy session of paddling and pop-ups. If you lift, it’s the hip flexors that never really let go after a big leg day. If you’re at a desk most of the day, it’s the same muscles shortened from sitting instead of training.

The areas commonly tight or underworking when low back pain shows up this way:

• Your hip flexors, especially the deep one that runs from your spine to the front of your hip. Sitting for long periods shortens this one more than almost anything else.
• Your glutes, which are meant to be doing a lot of the work of holding your hips stable. When they’re not pulling their weight, your low back often ends up doing it instead.
• The muscles at the side of your low back, which get overworked stabilising a pelvis that isn’t well supported from the front or the back.

This is the actual content behind “your tight hips are why your back hurts.” It’s not the whole story for every case, but it’s a genuinely common one.

What you can try for relief

This is the same ball-release technique I use on myself daily, applied here, plus one stretch that’s about as standard and safe as it gets.

1. Glute release with a ball. Sit on a firm ball (a lacrosse or similar-sized ball works better than a foam roller here) and find the tight spot in your glute on one side. Roll slowly, don’t assume where it is.

2. Park on it, don’t grind. Once you find the tender point, hold steady pressure or use small slow circles.

3. Stay on the edge of discomfort, never deep into pain. Same cue as everywhere else, and it’s the one people get wrong most. Push through pain and your body braces, and nothing settles. Sit right at the edge where you can still breathe easily.

4. Follow it as it eases. After 10 to 20 seconds it usually softens. Follow it a little deeper to the new edge, repeat, then swap sides.

5. A gentle hip flexor stretch. Kneel on one knee (cushion under it if needed), the other foot flat in front. Gently shift your weight forward until you feel a stretch at the front of the hip of the kneeling leg, keeping your back tall, not arched. Hold it easy, breathing, well short of anything sharp. This one’s genuinely low-risk and worth doing daily if your hips spend a lot of time sitting.

Keep moving. This matters as much as the release work. Gentle movement, walking, easy daily activity, generally helps a sore back more than lying still does. Avoid anything that sharply reproduces the pain, but staying still for long periods tends to make it feel worse, not better.

One honest note on how this works. The ball work isn’t “releasing” anything structurally. It’s your nervous system letting an overworked muscle calm down, and it’s a real but temporary effect. That’s why doing it regularly matters more than one big session when it’s already bad.

🔴 When this isn’t something to self-treat

Most low back pain that shows up like this is ordinary and settles with movement, the release work above, and time. A small number of cases aren’t ordinary, and this list is the honest line. See a doctor, or go to emergency care, if:

• You notice new numbness around your inner thighs, groin, or the area you’d sit on a bike seat (sometimes called “saddle” numbness).
• You have new bladder or bowel changes, difficulty going, or losing control.
• You have progressive weakness in one or both legs, or a leg that keeps giving way.
• You notice new pain, numbness, or pins and needles down both legs at once, not just one side.
• You notice any new sexual difficulty: trouble getting or keeping an erection, a change in genital sensation, or being unable to climax.
• The pain followed a significant fall, accident, or trauma.
• It comes with unexplained weight loss, fever, or night sweats.
• You have a history of cancer.
• The pain is worse lying down or wakes you at night, and doesn’t ease with rest.
• It spreads down your leg past the knee, with numbness, tingling, or pins and needles.

None of that is meant to alarm you. Most back pain never touches this list. It’s meant to be the honest line between “try the hip work” and “get this looked at properly, today.”

The short version

• Rest isn’t usually the fix. Gentle movement generally helps more than lying still.
• “Wear and tear” on a scan doesn’t decide whether you’re in pain; plenty of pain-free people have the same finding.
• The sore spot in your low back is often downstream of tight hip flexors and underworking glutes, not the actual source.
• Stay on the edge of discomfort, never deep into pain, on any release work.
• If you notice any of the red-flag signs above, that’s not a self-treat situation. Get it checked.

Where this leaves you

If the hip work and staying gently active settle it down, that’s a genuinely good sign. Keep doing it, not just when it flares.

If it keeps coming back, or it never really eases, that’s worth a proper look. You can feel where it hurts, but you can’t always work out on your own why that area keeps getting overloaded in the first place, especially if it’s not actually your low back doing the compensating. That’s what an assessment is for; it finds the “why,” and builds a plan from there.

No pressure, no packages. My job is to help you need this guide less over time, not to keep you coming back to it.

Keegan · Keegans Movement Lab · Live Better, Longer.

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