I had severe lower pack pain (L4-L5, and L5-S1) since age 16 when I had a ski racing injury (sudden flexion in a 40mph+ fall in a downhill event). In high school there were times I was debilitated for a week or more and it was excruciating.
The pain continued almost constantly, with occasional acute episodes for twenty years, despite physiotherapy, chiropractic, etc. I kept doing hard sports (mountaineering, skiing, tennis, sea kayaking, etc), but was tormented almost constantly by low back pain, punctuated by intensely debilitating acute episodes which acupuncture, therapy, infra-red, and pain medications could not resolve, only two weeks of flat out rest with tranquilizers/muscle relaxants could fix it (eventually).
One sports medicine therapist remarked that my quads (front of upper leg) were super-strong, and most sports I did favored that . . . while the back of my legs (hamstrings and back of upper leg) were tight and weak. He said he thought this made my pelvis tilt forward and put backward pressure on the lower back disks. I never really worked out what that meant, or how to remedy it, but I felt it made sense.
Finally, I went totally against what the physiotherapists said (they prescribed gentle extension exercises, stretching, etc, and no flexion), and I did intense flexion stretches (yoga), as well as intense hamstring stretches (yoga) on a regular basis. It felt great! Since that time, I have had no chronic lower back problems for thirteen years+. I have had occasional bouts of mild to moderate pain, but it went away with proper stretching.
The absolute key to balancing the problem and fixing it was when I added Kung Fu with intense stretching to my weekly schedule. The Kung Fu discipline involves a lot of stretching and preparation of the body structure. It also involves a lot of development of core strength and that is crucial.
What has solved my back pain problem forever, without surgery or drugs is: stretching and core strength. A sedentary lifestyle is the killer for anyone with back pain. My father is a doctor and he has always said, "Move it or lose it." Even when it feels totally against common sense, and totally against what your conservative lawsuit-scared doctors say, this wisdom is truth. Move it and flex it or you will lose it, along with your quality of life. But you can get it back. I did so in my 40s and I'm no health nut. I smoke, I drink, I chug espresso. But back pain , no way, no more.
Yoga and Kung Fu/Chi Gung, plus massage and activity = resolution.
Don't believe me? Think I didn't have serious back problems? Ha.
In 1998 at age 38 my back pain after a trip by car was so severe, that after sleeping off the car journey, I got up in the middle of the night, tried to stand up to go to the toilet, and the pain was so intense, I fell down and vomited violently. I spent the next month screaming in pain, literally screaming, had doctors, drugs, acupuncturists, even traditional Balinese healers (I live in Bali), but I was still screaming, and couldn't walk for two months, after which I could walk, but had lost sensation in the front of my right leg permanently (still you can drive a nail into that shin and I feel nothing). I first walked with a cane, and then walked without it, did the yoga stretches, and then went on to Kung Fu (Shao Lin White Crane lineage), starting at age 42. In Shao Lin Kung Fu, nobody is expected to do anything they cannot do, but they are always expected to do what they can and be the best and most honest and true person they are.
Really for all of you, I must say the key is stretching and core strength building. For those who are not athletic, just start in a simple (Iyengar) yoga group, and also do some natural, intuitive stretching, at least twice a day. It feels great. For low back sufferers, the hamstrings are crucial. If you can find a low back sufferer who doesn't have totally tight hamstrings, tell me. I won't believe you. It's the key.
And the whole back, especially the lower back is totally dependent on the core (torso) body tone. It doesn't matter if you are fat or skinny, lazy of hyper. You just gotta do it, and it's just as easy for a fatty who loves reading and couch potatoing as it is for a slim sports nut. We can all do this. The complex layers of muscles that support and move the torso are the key to all movement, and all balance of spinal and extremity activity (and rest positions).
Pilates is also excellent for this. I understand Pilates in theory but have never done it in practice.
Even for those of you who have more serious injuries than I did. t is something you can solve. Just try, you don't need to be a nut about it, just do it. Stretch those hamstrings, inner leg muscles and tendons, hips, lower back (flexion and extension), all of it. You don't need to kill yourself, just do it slowly and enjoy it. When I started out, I was an "athlete" but with killer back problems, and I could not sit down on the floor without falling over backwards because my legs were so stiff. I just went slowly slowly, and even me, the stiffest of the stiff, in a matter of a year or two, I am a gumby doll and I feel great. I was never flexible my whole life, neither was anyone in my family. But we all never tried. I just did it a bit for a bit of time, and now I am considered flexomatic, and I have no more back pain. After more than twenty years of killer back problems, it is over. No surgery, no drugs. No doctors. No therapies.
You really must try it. Just try. Try even if the doctors say no. I started this kind of activity in my 40s, and I'm no spring chicken. I just did it as much as I could, not pressuring myself, and it worked. The body can be well, if you just let it, and try it out.
Even though I don't carry on with regular yoga or kung fu, I am still free of back pain!!! Even when I'm lazy for months, or a year, and do no exercise. I still have the flexibility I gained, and it has saved my back. Also, whenever my back starts to give signals of impending trouble, I now naturally without thinking just stretch, and move and it does not become acute or ongoing. Even couch potatoes can change their bodies forever with proper stretching (yoga) and strengthening (kung fu/pilates). And don't be scared. Most Kung Fu lineages have a huge wealth of movements and training for non-athletic, mobility impaired, and elderly people. It's totally scientific and wholistic and no one is excluded.
I believe for the vast majority of low back pain sufferers, the flexibility and core strength route will resolve it absolutely.
Good luck and please be pain free. Nobody should have to go
through what I (we) have gone through. Back pain is invisible;
nobody can see what a horror you are living, nobody can see that just
bumping into you on the way into the elevator made you wince in pain. Nobody can see that every movement, every adjustment, every crack in
the sidewalk is a trauma. They think you're fine because you don't
have a crutch or a bandage or a bleeding flesh wound and so you
suffer more. Stretch, strengthen,
little by little, it doesn't take so much and you'll be surprised what
you can do if you do it day by day, little by little, no expectations,
just give it a go .