April 11th, 2023/ Dr. Sisson

What Does The Term "Small of Back" Mean?

The small of your back is the narrow part or your back right above your waist, where the spine kind of curves inwards a little bit.

This is usually around the L5-S1 area, or for some people, it's L4-L5.  It's the part where your spine dips inward, and it has a narrow curve, and it looks smaller than the rest. That's why it's called the small of your back.

What Causes Pain In Small The Small Of Your Back?

Since the spine is dipping in at the small if your back, that sharp dip usually means you're compressing the joints together more in that area than you are at the joints above and below it.

Therefore, people often tend to develop central pain in their spine, right in the small of their back.

That's most common when people are standing and walking.

When you're standing or walking, that's a really common time to have pain in the small of your back because you're in an upright position where your spine is extended.

That further jams the joints in the small of your back together.

How To Relieving Pain in the Small of Your Back When Standing

What can you do to relieve pain in the small of your back when you're standing?

Well, largely, you don't want the curve in your back to be super sharp at one area.

Normally, the curve in the lumbar spine, the lordosis, should be kind of a smooth curve. It looks more like a "C," and it shouldn't look like a sideways "V".

So, the less hinging you can get at one segment, the better you're probably going to feel.

What that means is instead of standing with a lot of arch at one point in your back, you want to try to roll your pelvis underneath and flatten your spine.

Conversely, if you're sitting down or if you're bending, you may feel more muscle pain.

That pain is usually not centrally in the small of your back though. Instead, you may tend to feel forward bending activities in the muscles on the sides of your spine.

Now, some people have the habit of standing with their back arched where they're kind of hanging back on their hip ligaments. Their backs are a little bit hyperextended, and if they've stood that way for years, it may even feel normal.

The good news about correcting your posture to eliminate back hyperextension is that it can actually make you look a little bit thinner.

When you lean back, it looks like your belly pushes out versus when you stand more upright, it pulls your abs in and makes you look a little bit trimmer.

The other good news is that the small of your back doesn't hurt quite as much when you are standing.

How Else Can You Relieve Pain In The Small Of Your Back?

If you have difficulty rolling your pelvis under you when standing, or if you need to bend your knees in order to do so, you probably have some stiff hip flexors.

Stretching your hip flexors can help

1. Stand with one leg forward and one leg backward.
2. Tuck your pelvis underneath so that you flatten your spine.
3. Push your pelvis forward until you feel a stretch in the front of your back thigh.
4. Hold for 30 seconds - 1 minute

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