When lower back pain persists and continues to interfere with your quality of life, multiple treatment options may be needed for adequate relief. Below are some back pain treatments that are commonly overlooked or underused. Try one or more of these remedies to see which one, or combination, works best for you.

1. Release your inner endorphins

Endorphins are hormones made naturally in your body. What many people don’t know is that endorphins may help block pain signals from registering in your brain. Endorphins also help alleviate anxiety, stress, and depression, which are all associated with chronic back pain and often make the pain worse.

Certain activities may boost your endorphin levels, such as aerobic exercise, massage therapy, or meditation.

Watch Video: 4 Little-Known Natural Pain Relievers

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2. Get enough restorative sleep

Pain is a leading cause of insomnia—difficulty with falling asleep and/or staying asleep. Inadequate sleep can also make your back pain worse. This vicious cycle makes it more difficult for you to get restorative sleep.

See Restorative Sleep Brings Back Pain Relief

Getting enough restorative sleep is needed for the body’s tissues to heal and recharge energy levels. If you have trouble sleeping, it is important to address pain or other factors that are causing it. Your doctor might recommend lifestyle changes, medications, or other treatments depending on what is disrupting your sleep.

3. Exercise your core

The muscles in your abs and back play a critical role in supporting your lower spine. These muscles don't get a good workout during the course of a normal day—they need to be specifically targeted through exercise.

See Exercise and Back Pain

There are many simple exercises that can be performed in 20 to 30 minutes as part of your daily routine. If you are just starting out, even the simple act of sitting upright on an exercise ball for 30 minutes a day will engage your core muscles.

See Back Exercises and Abdominal Exercise Recommendations

4. Engage your brain

Pain specialists have long understood that pain is more complicated than just a sensation. The way your brain interprets and processes pain signals plays an important role in how you perceive your pain.

The good news is that you can develop skills for your brain to reduce or ignore some pain signals. Some strategies to try include:

  • Mindful pain management. Practicing mindfulness and meditation, which typically involves slow, controlled breathing and focusing the mind, may help reduce the pain sensation. It can also help with relaxation. To get started with mindfulness and relaxation techniques, many free videos are available online.
  • Cognitive behavioral therapy. This type of therapy may help you to think about your pain differently or learn new strategies for managing it.

Developing expertise in mind-body techniques may go a long way to help you have some degree of influence over your pain.

5. Find activities that make you happy

Ongoing back pain can wreak havoc on your life, affecting your cherished relationships, finances, and your ability to get stuff done at work and at home. Finding activities that make you happy can help reduce some stress and may relieve some pain.

Some people find that even doing just 3 things that make them feel good each day—such as enjoying a comforting cup of tea or coffee, calling an old friend, walking the dog, or receiving a longish 30-second hug from a loved one—can make pain more tolerable.

Even something as simple as laughter with a friend may stimulate feel-good endorphins. 1 Manninen S, Tuominen L, Dunbar RI et al. Social laughter triggers endogenous opioid release in humans. J Neurosci. 2017; 37(25):6125-6131. doi: 10.1523/JNEUROSCI.0688-16.2017. , 2 Dunbar RI, Baron R, Frangou A et al. Social laughter correlated with an elevated pain threshold. Proc Biol Sci. 2012; 279(1731):1161-7. doi: 10.1098/rspb.2011.1373.

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6. Stretch your hamstrings twice daily

One often overlooked contributor to lower back pain is tight hamstrings. If your hamstring muscles—located in the back of your thighs—are too tight hamstrings your lower back and sacroiliac joints will be stressed, leading to more pain. Hamstring stretching should be done carefully and at least twice per day for 15-30 seconds each time.

There are many gentle stretching exercises that should not hurt.

See Specific Hamstring Stretches for Back Pain Relief

Bonus tip: Soothe the pain with cold and/or hot

Don't underestimate the pain reduction of simply applying cold packs and/or hot packs to help reduce your lower back pain.

  • Cold therapy helps reduce inflammation and pain. Some examples include wrapping ice in a cloth, a pack of frozen peas from the freezer, or a cold gel pack. Always keep at least one layer between your skin and the ice/cold pack.
  • Heat therapy helps improve blood flow, relaxation, and pain relief. Heat therapy can come in many forms. It's best to try several to find what works best for you. Taking a warm bath or shower, soaking in a hot tub, or using a heating pad or heat wrap are all ways to bring warmth to your lower back.

Whether applying ice or a heat pack, limit applications to 15 or 20 minutes with at least 2 hours of rest in between to protect your skin. Never sleep with a heating pad or frozen pack as this can lead to permanent skin damage.

Hopefully these overlooked remedies can help you try some new approaches to better manage your lower back pain and find lasting relief.

Learn more:

Back Care for Lower Back Pain

Early Treatments for Lower Back Pain

  • 1 Manninen S, Tuominen L, Dunbar RI et al. Social laughter triggers endogenous opioid release in humans. J Neurosci. 2017; 37(25):6125-6131. doi: 10.1523/JNEUROSCI.0688-16.2017.
  • 2 Dunbar RI, Baron R, Frangou A et al. Social laughter correlated with an elevated pain threshold. Proc Biol Sci. 2012; 279(1731):1161-7. doi: 10.1098/rspb.2011.1373.

Dr. Scott Curtis is a sports medicine specialist at Princeton Spine and Joint Center, where he serves as the center’s Director of Sports Medicine, specializing in sports-related injuries and general musculoskeletal care.

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