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Jordan Loewenstein, D.C. | La Jolla Chiropractor

Exercise & Stretch Library

Low Back Pain
By Location

Pick where your back pain sits. You’ll get the conditions that live there, the clues that tell them apart, and the specific stretches and exercises for each one.

Three Patterns Mapped
A Program For Each Diagnosis
UTC San Diego — Near UCSD
Movement Beats Rest
Bed rest lengthens recovery
Direction Matters Most
Bending vs arching changes the plan
Below The Knee Is Different
That means nerve, not joint
Know The Emergency Signs
Saddle numbness is a 999 moment
Start Here

Where Does It
Actually Hurt?

Low back pain sorts out less by exactly where it hurts and more by which direction makes it worse and how far it travels. Pain that hates bending forward needs a different plan from pain that hates arching backward, and anything going below the knee is a nerve conversation. Pick the pattern that fits you below.

A quick reassurance before you read on. The great majority of low back pain is not dangerous and improves within weeks, and imaging in the first six weeks rarely changes anything. What matters most is staying active, finding the direction that eases it, and building trunk and glute strength so it does not keep coming back. There is a short list of genuine warning signs and they are spelled out clearly further down.

The Low Back Map

Pick Your
Sore Spot

ClickTapWhere It Hurts

Pick the pattern that matches your back pain. You’ll get the likely diagnoses, the clues that tell them apart, and the stretches and exercises for each one.

Across the low back

Central and Belt-Line Back Pain

The great majority of low back pain lives here, and the great majority of it resolves. The single most useful question is not what structure is involved, it is which direction makes it worse. Pain that hates bending forward and pain that hates arching backward need close to opposite approaches.

Narrow It Down

Test the direction. Does bending forward or arching backward feel worse? That answer shapes the whole program.

1
Most common
Mechanical Low Back PainNon-specific low back pain
Across the belt lineStiff in the morningNo leg symptoms
Across the belt line, often on both sides, without travelling into the leg.
Most likely yours if
  • An aching, stiff band across the low back with no pain below the knee
  • Stiff after sitting or first thing in the morning, better once you get moving
  • It came on after a long drive, an awkward lift, or a stretch of desk work
  • No numbness, no tingling, no weakness
Stretches & mobility · daily
Strengthening · every other day
Do
  • Keep moving. Walking is one of the most effective things for ordinary back pain
  • Get back to normal activity sooner than feels natural. Guarding prolongs it
  • Build trunk and glute strength. That is what stops it recurring
Don’t
  • Go to bed with it. Bed rest makes back pain worse and lengthens recovery
  • Wait for it to be pain-free before you move
  • Assume you need a scan. Imaging in the first six weeks rarely changes anything and often finds harmless things that worry people
2
Disc-Related Back PainDiscogenic pain or disc bulge
Worse bending forwardWorse sittingBetter standing
Deep and central in the low back, sometimes spreading into the buttock but not down the leg.
Most likely yours if
  • Bending forward and sitting are the worst, and standing or walking feels better
  • Getting out of a chair or a car is the hardest moment
  • Coughing or sneezing can jolt it
  • Often worse in the morning and eases through the day
Stretches & mobility · daily
Strengthening · every other day
Do
  • Try prone press-ups. If they make the pain move toward your back and out of the leg, that is a good sign, keep going
  • Sit less, walk more. Use a lumbar roll in the car
  • Get up every 30 minutes
Don’t
  • Do repeated forward bending, sit-ups or toe touches while it is irritable
  • Sit for an hour straight
  • Continue any exercise that makes pain travel further down the leg. That is the wrong direction
3
Facet Joint PainLumbar facet joint syndrome
Worse arching backOne sideBetter bending forward
To one side of the spine, a couple of inches off the midline.
Most likely yours if
  • Arching backward and twisting are the worst, and bending forward feels like relief
  • Usually one-sided, and you can point fairly close to the spot
  • Stiff after standing still for a while, better sitting
  • Often in people over 40, or after heavy extension-based sport
Stretches & mobility · daily
Strengthening · every other day
Do
  • Favour flexion-based movement while it settles: knees to chest, child’s pose, cycling
  • Build core control so the joints are not taking the load
  • Hands-on care often helps this one noticeably
Don’t
  • Do repeated back extensions, cobra poses or overhead pressing while it is flared
  • Stand still for long stretches
  • Crack it repeatedly for temporary relief
4
Muscle StrainLumbar muscle strain
There was a momentSpasmTender to touch
The muscle either side of the spine, tender to press and often visibly tight.
Most likely yours if
  • It happened in a specific moment: a lift, a twist, a sneeze
  • The muscle went into spasm and may still feel like a tight rope
  • Tender when you press directly on the muscle
  • It is easing day by day rather than staying flat or worsening
Stretches & mobility · daily
Strengthening · every other day
Do
  • Keep moving gently. Heat helps more than ice after the first day or two
  • Expect meaningful improvement within one to two weeks
  • Return to normal activity progressively rather than waiting for zero pain
Don’t
  • Lie in bed for days
  • Test it with a heavy lift to see if it is better
  • Assume spasm means something is seriously damaged. Spasm is protective, not diagnostic
Self-checks you can do right now

The direction test. Slowly bend forward, then slowly arch back. Note which one reproduces it. Worse bending forward points toward the disc. Worse arching back points toward the facet joints. That distinction changes which exercises help.

The sitting-versus-standing test. If sitting is worse and standing or walking is relief, think disc. If standing still is worse and sitting is relief, think facet.

The leg question. Anything travelling below the knee, or any numbness, tingling or weakness, moves you to the down-the-leg tab, because it changes the plan.

In the meantime
  • Walk. It is the single most effective thing for ordinary low back pain, and it beats rest every time.
  • Do not go to bed with it. Bed rest measurably lengthens recovery.
  • Break up sitting. Every 30 minutes, even for a minute.
  • Skip the scan early on. Imaging in the first six weeks rarely changes treatment and often shows harmless findings that make people more fearful.
  • Build the trunk. Bird-dogs, dead bugs and side planks are what stop it coming back.
Stop and get it looked at if

Loss of bladder or bowel control, numbness in the saddle area, or progressive weakness in both legs. That is a medical emergency. Also get seen promptly for back pain with fever, unexplained weight loss, a history of cancer, or pain after significant trauma.

One side of the low back

One-Sided Low Back Pain

One-sided back pain narrows the field usefully, because a few specific structures sit off to the side. The most helpful thing you can do is try to point at it with one finger, then notice whether arching backward or bending forward is the problem.

Narrow It Down

Can you point to it with one finger, and does arching or bending make it worse? Those two answers cover most of this.

1
Most common one-sided
SI Joint PainSacroiliac joint dysfunction
One dimplePoint with one fingerRolling over in bed
Right on the dimple at the top of the buttock, just off the midline, almost always one side only.
Most likely yours if
  • You can point to it with one finger, and that finger lands on the dimple
  • Rolling over in bed, standing up from a chair, or standing on one leg aggravates it
  • Often after pregnancy, a fall onto the buttock, or a lot of one-sided loading
  • Rarely travels below the knee
Stretches & mobility · daily
Strengthening · every other day
Do
  • Load both legs evenly. Stop standing hanging on one hip
  • Build glute and trunk control. Stability is the aim, not more flexibility
  • Pillow between the knees at night
Don’t
  • Repeatedly stretch or crack it for short-lived relief
  • Do heavy single-leg work while it is irritable
  • Assume asymmetry means something is out of place. It usually means one side is working harder
2
Quadratus Lumborum PainQuadratus lumborum strain or overload
Side of the low backWorse leaning awayCarrying a bag
The side of the low back, between the last rib and the top of the pelvis.
Most likely yours if
  • An aching band on one side, above the belt line and off to the side
  • Worse after carrying a bag on one shoulder, or a child on one hip
  • Bending away from the sore side pulls
  • Often accompanies a leg-length difference or one-sided habits
Stretches & mobility · daily
Strengthening · every other day
Do
  • Switch which side you carry things on, or use a backpack
  • Build side-plank strength. This muscle responds well to being strengthened
  • Watch for standing habitually on one leg
Don’t
  • Keep carrying the bag on the same shoulder
  • Only massage it. It comes straight back without the strength work
  • Ignore a persistent one-sided pattern for months
3
Facet Joint Pain, One SideUnilateral lumbar facet syndrome
Just off the spineWorse archingBetter bending forward
An inch or two off the midline, on one side, right beside the spine.
Most likely yours if
  • Arching backward or twisting toward that side reproduces it
  • Bending forward gives relief
  • Stiff after standing or walking, better sitting
  • You can point close to the spot, and it does not travel far
Stretches & mobility · daily
Strengthening · every other day
Do
  • Favour forward-bending movements while it settles
  • Build core control so the joints share less of the load
  • Hands-on care tends to help this one
Don’t
  • Do repeated extensions, cobras or overhead pressing while flared
  • Stand still for long periods
  • Twist under load
4
Under 25 or extension sport
Stress Fracture Of The SpineSpondylolysis
Young athleteWorse archingOne side
One side of the low back in a young athlete, worse with arching backward.
Most likely yours if
  • Under about 25, and in a sport with lots of extension: gymnastics, cricket, diving, dance, football linemen
  • Arching backward, especially standing on one leg and arching, reproduces it
  • It has been building over weeks and is not settling
  • One-sided and fairly localized
Stretches & mobility · daily
Strengthening · every other day
Do
  • Get imaged. In a young athlete with extension-based back pain this needs ruling out properly
  • Stop the extension-heavy activity until it is cleared
  • Build deep core control in neutral, avoiding extension
Don’t
  • Keep training through it because it is only sore during sport
  • Do repeated back extensions
  • Assume young age means it must be a simple muscle strain. The opposite is true here
Self-checks you can do right now

The one-finger test. Landing on the dimple at the top of the buttock points at the SI joint. An inch or two beside the spine points at a facet joint. Out on the side above the pelvis points at the QL muscle.

The direction test. Worse arching backward, better bending forward, points at the facet joints. The reverse points toward the disc.

The stork test. Stand on one leg and arch backward. Sharp one-sided pain in a young athlete in an extension sport should be imaged rather than trained through.

In the meantime
  • Even out your load. Backpack instead of shoulder bag. Stop standing on one hip.
  • Pillow between the knees. Especially for SI joint pain.
  • Strengthen sideways. Side planks are the most underused exercise for one-sided back pain.
  • Stop chasing the crack. Repeated self-manipulation gives twenty minutes of relief and no lasting change.
  • Young athlete, arching pain, get it imaged. That combination is the one exception to wait-and-see.
Stop and get it looked at if

A young athlete in an extension-based sport with one-sided back pain that is not settling. Also get seen for back pain with fever, unexplained weight loss, a history of cancer, or pain that is worse at night and not relieved by position changes.

Down the leg

Pain That Travels Down The Leg

Once pain travels below the knee, or brings numbness and tingling with it, you are dealing with a nerve rather than a joint or a muscle, and the rules change. There are also a small number of signs here that mean stop reading and go to hospital, so those come first.

Narrow It Down

Two questions: does it go past the knee, and does leaning forward help or hurt? Those two answers separate almost everything below.

!
Emergency signs first
Cauda Equina SyndromeCauda equina compression
Saddle numbnessBladder changesBoth legs
Back and leg pain accompanied by numbness where you would sit on a saddle, and changes in bladder or bowel control.
Get this checked if
  • Numbness in the groin, genitals or inner thighs, the saddle area
  • Difficulty starting or stopping urination, or any loss of bowel control
  • Weakness in both legs, or rapidly worsening weakness in one
  • New sexual dysfunction alongside back pain
Do
  • Go to an emergency department now. Do not wait for an appointment
  • Say the words cauda equina when you arrive. It shortens the path to imaging
  • Treat this as time-critical. Delays can cause permanent damage
Don’t
  • Wait until morning to see how it goes
  • Try stretches or exercises
  • Assume it is just a bad flare-up because the back pain itself is familiar
1
Most common
Sciatica From A DiscLumbar disc herniation with radiculopathy
Past the kneeTinglingWorse sitting
Pain travelling from the back or buttock down the leg, past the knee, often into the calf or foot.
Most likely yours if
  • The pain goes below the knee, often with numbness or tingling in a strip
  • Coughing, sneezing or straining makes the leg pain worse
  • Sitting is usually the worst position, standing and walking better
  • Sometimes the back barely hurts at all and it is all leg
Stretches & mobility · daily
Strengthening · every other day
Do
  • Watch for centralization. If a movement pulls the pain out of the leg and back toward the spine, that is the movement you want, even if the back hurts a bit more
  • Use nerve glides rather than hard hamstring stretches
  • Keep walking. Most disc-related sciatica improves substantially over six to twelve weeks
Don’t
  • Do any exercise that sends the pain further down the leg
  • Force hamstring or piriformis stretches. They tension an already irritated nerve
  • Ignore progressive weakness, a dragging foot, or spreading numbness
2
Spinal StenosisLumbar spinal stenosis
Worse walkingBetter leaning forwardOver 60
Buttock and leg heaviness, aching or cramping that comes on with walking and eases when you sit or lean forward.
Most likely yours if
  • Walking a predictable distance brings it on, and sitting down relieves it within minutes
  • Leaning forward helps. You may find pushing a shopping trolley comfortable when walking is not
  • Usually over 60, and it has come on gradually over years
  • Often both legs, with heaviness more than sharp pain
Stretches & mobility · daily
Strengthening · every other day
Do
  • Use a stationary bike. Leaning forward opens the space, so cycling is usually comfortable when walking is not
  • Do flexion-based stretches: knees to chest, child’s pose
  • Build up walking in intervals: walk to just before symptoms, sit, repeat
Don’t
  • Do repeated back extensions or press-ups. Arching narrows the space further
  • Push through increasing leg heaviness on a long walk
  • Assume surgery is inevitable. Many people manage well with the right program
3
Deep Gluteal SciaticaPiriformis or deep gluteal syndrome
Stops at the kneeWorse sittingSore to press
Deep in the buttock, sometimes down the back of the thigh but usually not past the knee.
Most likely yours if
  • Deep buttock pain, worse the longer you sit, especially on something hard
  • Pressing deep into the middle of the buttock reproduces it
  • Referred pain usually stops around the knee
  • No coughing or sneezing aggravation, which separates it from a disc
Stretches & mobility · daily
Strengthening · every other day
Do
  • Break up sitting every 30 to 45 minutes
  • Take the wallet out of that back pocket
  • Strengthen the glutes. A weak glute makes the deep rotators overwork and stay irritable
Don’t
  • Dig into it with a ball for ten minutes
  • Only stretch. The relief fades fast without strength work
  • Assume all buttock and leg pain is a disc
Self-checks you can do right now

Check the emergency signs first. Numbness in the saddle area, changes in bladder or bowel control, or weakness in both legs. Any of those means an emergency department today, not an appointment next week.

The centralization test. Try prone press-ups. If the pain retreats out of the leg and back toward the spine, that is the direction you want, even if the back itself briefly hurts more. If pain travels further down, stop.

The shopping trolley test. If walking brings on leg heaviness but leaning on a trolley or a bike lets you go much further, that pattern is typical of spinal stenosis.

In the meantime
  • Chase centralization. Pain moving out of the leg and toward the spine is progress, even if the back is briefly sorer.
  • Glide, do not stretch. Nerve glides rather than aggressive hamstring stretching.
  • Keep walking within tolerance. Most disc-related sciatica improves over six to twelve weeks with movement.
  • Sit less. Sitting raises disc pressure more than standing does.
  • Track weakness, not just pain. Pain is uncomfortable. Progressive weakness is the thing that actually needs urgent review.
Stop and get it looked at if

Numbness in the saddle area, loss of bladder or bowel control, or weakness in both legs. Go to an emergency department. Also get seen promptly for a foot that drags, weakness that is worsening, or numbness that keeps spreading.

The Movements

Stretches &
Exercises

Every movement referenced above, in one place, with a video demo. Nothing here should reproduce sharp pain. Work in the range that feels clean and let it expand week by week. Two rules govern all of it, and they are spelled out right after this section.

Stretches and mobility

Daily is fine. Stop any movement that sends pain further down the leg.

Single Knee-to-Chest demonstrationWatch demo
01
Single Knee-to-Chest
On your back, draw one knee toward your chest. Gentle, and usually the safest place to start when the back is angry.
Hold 30s · 3x each side
Cat-Cow demonstrationWatch demo
02
Cat-Cow
On hands and knees, alternate arching and rounding the spine. Moves every segment without loading it.
2 sets of 10 slow reps
Child’s Pose demonstrationWatch demo
03
Child’s Pose
Sit back onto the heels with the arms reaching forward. Opens the low back. Very useful if bending forward feels better than arching.
Hold 45s · 3x
Lying Knee Twist demonstrationWatch demo
04
Lying Knee Twist
On your back, drop both knees to one side. A gentle rotation for a stiff low back. Keep both shoulders down.
Hold 30s · 3x each side
Figure-4 Glute Stretch demonstrationWatch demo
05
Figure-4 Glute Stretch
Ankle across the opposite knee, draw both legs in. A tight, weak glute is behind a lot of low back pain.
Hold 45s · 2x each side
Prone Press-Up demonstrationWatch demo
06
Prone Press-Up
Lying face down, press the chest up while the hips stay down. The key movement if your pain centralizes when you arch backward. Stop if it sends pain further down the leg.
2 sets of 10 · several times daily
Sciatic Nerve Glide demonstrationWatch demo
07
Sciatic Nerve Glide
Seated, straighten the knee and flex the ankle, then release. A glide, not a stretch. Should never leave lasting numbness.
10 reps · 2 to 3x daily

Strengthening

Every other day. Quality of control matters far more than reps or speed here.

Pelvic Tilt demonstrationWatch demo
01
Pelvic Tilt
On your back, flatten the low back into the floor by tilting the pelvis, then release. Teaches the control everything else is built on.
2 sets of 12
Glute Bridge demonstrationWatch demo
02
Glute Bridge
Feet flat, drive through the heels, squeeze at the top. Strong glutes take load off the low back with every step.
3 sets of 12
Bird-Dog demonstrationWatch demo
03
Bird-Dog
Opposite arm and leg extended on hands and knees. Trains the trunk to stay still while the limbs move, which is exactly what a back needs.
3 sets of 8 each side
Dead Bug demonstrationWatch demo
04
Dead Bug
On your back, lower the opposite arm and leg while keeping the low back flat. Core control without loading the spine.
3 sets of 8 each side
Modified Side Plank demonstrationWatch demo
05
Modified Side Plank
On your side propped on a forearm with knees bent. Builds the lateral trunk strength that stabilizes the whole low back.
3 holds of 20 to 30s each side
Two Rules

How To Know If
You’re Doing Too Much

These two rules apply to every program on this page, wherever your pain is. They are the same ones I give patients in the office, and they replace the guesswork about whether to push through something.

1
The 3 out of 10 rule

Some discomfort during these exercises is normal and even useful. Pain above about a 3 out of 10 is not. If an exercise pushes past that, reduce the range, the weight, or the number of reps.

2
The 24-hour rule

You should be back to your normal baseline within 24 hours. If it is more sore the next morning, you did too much. Cut the volume roughly in half and build back from there.

Most backs get better, and then need maintaining
Most acute low back pain improves substantially within two to six weeks, and disc-related sciatica typically takes six to twelve. The harder problem is not the first episode, it is the recurrence, because roughly half of people have another episode within a year. That is why the strength work matters more than the stretching. Stretching feels good in the moment; bird-dogs, dead bugs and side planks are what actually change the odds. If you are eight weeks in with no improvement, or there is progressive weakness, stop waiting and get examined.
Don’t Wait On These

Signs You Should
Skip the Exercises

The overwhelming majority of low back pain is not dangerous. This short list is the exception, and the first item is a medical emergency.

Numbness in the saddle area (groin, genitals, inner thighs), or trouble starting or stopping urination, or loss of bowel control. Go to an emergency department today
Weakness in both legs, or weakness that is getting worse
A foot that drags or slaps when you walk
Back pain with fever, chills, or a recent infection
Unexplained weight loss, or a history of cancer
Pain that is worse at night and not relieved by changing position
Significant trauma, or any fall in someone with osteoporosis
A young athlete in an extension-based sport with one-sided back pain that is not settling
Not sure which one you’ve got? That is exactly what a first visit is for.
Book an Exam
Common Questions

Low Back Pain
Questions

Should I rest or move with low back pain?

Move. Bed rest was standard advice decades ago and the evidence now clearly shows it lengthens recovery. Walking is one of the most effective things you can do for ordinary low back pain. Return to normal activity a little sooner than feels natural, adjusting intensity rather than stopping altogether.

Do I need an MRI for my back pain?

Usually not, at least not early. For back pain without red flags, imaging in the first six weeks rarely changes treatment. It also frequently shows disc bulges and degeneration in people with no pain at all, which can make you more fearful and more cautious than you need to be. Imaging is indicated if there are red flags, progressive weakness, or no improvement after six to eight weeks.

What is the difference between sciatica and piriformis pain?

The most useful clue is how far the pain travels. True sciatica from a disc typically goes below the knee, often with numbness or tingling, and coughing or sneezing makes it worse. Deep gluteal or piriformis pain usually stops around the knee, is worse the longer you sit, and is tender when you press deep into the middle of the buttock.

Why does my back hurt more when I sit?

Sitting raises pressure inside the discs more than standing does, and it puts the low back into a flexed position. Pain that is worse sitting and better standing or walking is a fairly typical disc pattern. Prone press-ups often help this presentation, and the sign you are looking for is the pain retreating out of the leg and back toward the spine.

When is back pain an emergency?

Numbness in the saddle area, meaning the groin, genitals or inner thighs, difficulty starting or stopping urination, loss of bowel control, or weakness in both legs. Any of those means going to an emergency department the same day. Also get prompt review for back pain with fever, unexplained weight loss, a history of cancer, or pain that is worse at night and unrelieved by changing position.

What does it mean if a stretch makes the leg pain move up toward my back?

That is called centralization and it is a good sign. Pain retreating out of the leg and back toward the spine means you have found a movement direction that is unloading the nerve, even if the back itself briefly feels a bit sorer. The opposite, pain travelling further down the leg, means stop that movement.

Is it bad that my back cracks?

No. Joint cavitation is just gas releasing in the joint fluid and it is not damaging. What is worth noticing is if you feel the need to crack it repeatedly for twenty minutes of relief, because that usually means the underlying stability issue is not being addressed. Strengthening tends to reduce that urge.

How long does low back pain take to get better?

Most acute episodes improve substantially within two to six weeks. Disc-related sciatica typically takes six to twelve weeks. Recurrence is common, which is why the strength work matters more than the stretching. If you are eight weeks in with no improvement, or you have progressive weakness, that is the point to get examined rather than keep waiting.

Can a chiropractor help with low back pain?

Yes, and it is one of the best-supported uses of chiropractic care. Dr. Loewenstein examines the back alongside the hips and the way you load and move, uses hands-on care to restore motion and calm irritated tissue, and builds the trunk and glute strength that keeps it from returning. Treatment starts on the first visit at the UTC San Diego office.

UTC San Diego · Mon–Fri 9am–7pm · Sun 10am–4pm

Find Out What’s
Actually Going On

Narrowing it down by location gets you most of the way there. A hands-on exam gets you the rest of the way, and treatment starts on visit one.

Book an Appointment(858) 558-3111
5151 Shoreham Place, Suite 175 · UTC San Diego, CA 92122 · Near UCSD
JL
Dr. Jordan Loewenstein, D.C.
D.C. · M.S. Nutrition · ART Certified · Webster Certified · sdspinecare.com
Clinically reviewed August 2026
Related Pages
Foam Rolling: How to Do It RightFull Low Back ProgramSciatica ExercisesHip Pain by LocationExercise & Stretch LibraryAbout Dr. Loewenstein
This page is general educational information and is not a substitute for a professional diagnosis or individualized medical advice. Stop any exercise that increases pain travelling down the leg. If you develop numbness in the saddle area, loss of bladder or bowel control, or weakness in both legs, seek emergency medical care immediately.