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Lower Back Pain Can't Stand Up Straight

Lower Back Pain Can't Stand Up Straight

Back pain is a frustrating issue that many adults occasionally suffer from. In most cases, a distinct injury to ligaments or muscles in the lower back are the cause. This type of injury can be extremely painful but may also be temporary unless major damage occurred.

Lower back pain that hinders an individual from standing up straight can be particularly devastating. Fortunately, proper care and physical therapy can help individuals quickly recover from minor injuries. For people with more serious cases of lower back pain, even that which may require surgery, physical therapy is still a highly recommended approach by physicians due to the positive outcomes. However, the first step involves identifying the cause of the lower back pain as this can help a physician determine the best line of treatment.

Potential Reasons for Lower Back Pain When You Can’t Stand Up Straight

Although there are a number of reasons that back problems may develop, three of the most common causes of lower back pain that makes it difficult to stand up straight are back sprains or strains, sciatica, and a herniated disc.

Back Sprains or Strains

A back strain occurs when ligaments or muscles in the back tear due to intense physical stress on the back (e.g., excess weight, repetitive activities). Ligaments help hold spinal bones (vertebrae) together, while muscles provide support for the spine. Although a muscle or ligament may become strained, a back sprain refers to a painful injury that develops if a ligament is stretched in an abnormal manner. Both types of injuries may cause extreme lower back pain, and in some cases, it may be hard to distinguish a strain from a sprain.

Strains and sprains are quite common, especially in people who engage in forceful, repetitive movements or who perform a lot of lifting, twisting, and bending. However, inactive individuals who rarely exercise are also prone to back strains or sprains because muscles and ligaments that are not used regularly become weak. Accordingly, when a person who lives a sedentary life decides to do a strenuous activity such as move furniture or lift heavy weights, a sudden back injury may occur.

The symptoms of a back sprain or strain include sharp pain in the lower back that may be localized to one side. The pain may also make it hard to bend over or stand up completely straight. In addition, occasional muscle spasms may develop during movement or even while sleeping. Spasms can create hard, painful knots in the back.

Most back strains or sprains resolve on their own after a few weeks, especially for individuals who remain active by performing careful movements. If the injury is serious, an individual may be unable to work for a short period or may need to be reassigned if their job duties require heavy lifting, repetitive actions, or other strenuous movements. Furthermore, people who experience this type of injury often may benefit from working with a physical therapist who can demonstrate safe lifting and strength-training techniques that lower the risk of back problems.


Sciatica is characterized by intense pain that is the result of sciatic nerve inflammation. It typically develops when nerves in the lower portion of the spine become compressed (squeezed). The sciatic nerve is easily affected because it is the longest and widest nerve in the body. It is located in the lower back and extends down the hips, buttocks, and legs. Sciatica-related pain may be mild, moderate, or severe. Due to the length of the sciatic nerve, the pain is usually felt throughout the lower body.

Although nerve compression is believed to be the main cause of sciatica, it is also associated with muscle spasms. The muscles that tend to spasm as a result of sciatic nerve damage are the larger muscles in the lower back. Spasms are easily felt due to the large size of these muscles. A painful muscle spasm can prevent an individual from standing up completely straight or cause the back to remain in a bent position until the spasm ceases.

Sciatica is often a symptom of another health issue that is causing sciatic nerve irritation. For example, sciatica typically develops due to a ruptured, bulging, or herniated disc that squeezes the sciatic nerve. Although the underlying cause of sciatica may vary, the following signs are often observed:

  • Muscle weakness in the back or legs
  • Sharp pain that shoots down the lower back, hips, buttocks, or legs
  • Pain with fluctuating degrees of severity, particularly with movement
  • Pain that worsens when in a sitting position or while standing for extended periods
  • Tingling, numbness, pins and needles, or burning sensations in the lower extremities

Long-term sciatica can make it difficult to stand, walk, or even work if it is not properly addressed. Several useful approaches that may be recommended by a physical therapist to help target sciatica include: strength-training exercises, therapeutic stretching techniques, hot and cold therapy, and over-the-counter pain medication.

Herniated Disc

A herniated disc, also known as a protruding, bulging, or ruptured disc, develops when the thick, gel-like fluid inside of the disc protrudes through a tear in the protective outer layer of the disc. This can lead to extreme pain because the bulge places pressure on the spinal cord and nerves in the lower back. Substances that are released from the torn disc also contain irritants that further aggravate inflamed nerves.

A ruptured disc may occur anywhere along the spine, but the pain most often develops in the lower region of the spine. This condition is also associated with chronic lower back pain and sciatica. The pain that may be experienced due to a herniated or ruptured disc typically spreads from the back to the hips, buttocks, thighs, and the calves, especially after sitting.

Discomfort that is associated with a herniated disc generally worsens during activity, although it may subside while an individual is resting. The discomfort often makes it hard to stand up straight as well. Even subtle movements such as sneezing, coughing, or the sitting position can make the symptoms worse by putting excess pressure on pinched nerves. In addition to struggling to move around or stand up straight, a herniated disc may cause numbness or tingling. The muscles in the affected region of the back may also become weak.

Certain factors increase the risk of developing a herniated disc. These include long-distance driving, a sedentary lifestyle, smoking, being obese or overweight, lifting items improperly, or performing repetitive movements that may strain the spine. People who experience this issue typically respond well to physical therapy and may notice improvement after a few weeks of treatment.

Spinal Stenosis

Spinal stenosis, which is another cause of sciatica, is described as the narrowing of the space where nerve roots are located (foraminal stenosis) or pressure that is placed on the spinal cord due to the narrowing of the spine (canal stenosis). This condition often develops in the lower back (lumbar region). It is associated with back pain while standing or walking, as an upright position increases pressure on nerve roots by decreasing spinal space. Additional symptoms include:

  • Muscle weakness in the legs   
  • Stabbing pain that spreads down the legs    
  • Numbness or tingling in the lower back, legs, or buttocks  

Stenosis may be caused by arthritis, aging, a spinal injury, degenerative changes of a disc or vertebral body, or spondylolisthesis (forward slippage of a vertebra). If this condition is not treated properly, it can lead to bladder or bowel problems along with sexual dysfunction. 

Additional health problems such as postural stress, degenerative disc disease, and lumbar (lower back) arthritis may also cause debilitating back pain that stops people from standing up straight. However, back injuries (e.g., sprains, strains), sciatica, a herniated disc, or spinal stenosis are common underlying causes of this particular type of back pain.



Several strategies offer relief and prevention of painful back problems. One of the first strategies that is often recommended to help relieve pain is nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen (Advil, Motrin). However, NSAIDs should not be taken for long periods of time as this increases the risk of side effects that include gastrointestinal issues. Individuals who need to take NSAIDs for more than a few days to reduce back pain should speak with a doctor.

Most people who have minor back issues typically report substantial relief from back pain after about 3-4 weeks, and in some cases recovery is much shorter. Individuals who do not notice any improvement after about three days, develop a fever, or only experience minimal relief from over-the-counter pain medication should schedule an appointment with a doctor who can conduct a thorough evaluation.

A doctor should also be promptly contacted if:

  • A serious injury caused the back pain
  • The pain gradually intensifies or spreads down the legs
  • Muscle weakness or numbness in the legs develops
  • There is any loss of bowel or bladder control

These signs indicate that a serious issue is causing back problems, especially if an individual cannot stand up straight.

Hot and Cold Packs

Another beneficial strategy involves alternating hot and cold applications on the back. More specifically, a cold pack or bag of ice that is wrapped in a cloth can be placed on the affected area shortly after the pain begins. The cold pack can be used throughout the day for about 20 minutes each time. Cold temperatures target muscle spasms, pain, inflammation, and swelling by slowing down blood circulation.

As the pain starts to subside, a heating pad can then be placed on the back for 20 minutes to loosen and soothe tense muscles, improve flexibility, reduce pain, and boost circulation. Enhanced circulation improves oxygen and nutrient transfer to inflamed tissue. Heightened blood flow also helps the body remove irritants that accumulate at the affected area. This is an important part of the healing process as harmful waste can worsen inflammation if it builds up.

Physical Therapy

If NSAIDS and hot-cold applications do not offer significant relief, a physician may recommend physical therapy. The therapeutic routine focuses on promoting recovery as well as restoring mobility and a full range of motion. It also involves designing a program that can be followed at home to support long-term improvement. A therapist can also monitor whether progress is being made and adjust the regimen if it is deemed necessary. Although lower back pain episodes often resolve on their own, therapeutic exercise effectively targets persistent pain for people who can’t stand up straight. Strict adherence to a physical therapy routine also reduces the incidence and severity of future lower back pain problems.

A highly skilled physical therapist may use manual, physical, and soft tissue mobilization in combination with back exercises to treat strains or sprains, sciatica, a herniated disc, or other issues that may be causing lower back pain. Specific therapeutic techniques include:

  • Supine core strengthening
  • Functional retraining
  • Gait training
  • Extension and flexion back exercises
  • Active assisted range of motion
  • Strengthening exercises (e.g., isotonic or isometric exercise)
  • Spinal joint mobilizations/manipulations
  • The McKenzie Method of Mechanical Diagnosis and Therapy (MDT)

When these exercises are carefully demonstrated they help relieve frustrating lower back pain. The therapeutic regimen also promotes enhanced fitness and improved overall health, which helps prevent back issues from recurring. By strengthening weak muscles or ligaments, proper balance and mobility can be restored as well.

In addition, a physical therapy regimen may include therapeutic massage. This particular approach is more effective for some people who have persistent lower back pain than exercises alone. Accordingly, the combination of therapeutic massage, back exercises, and education regarding preventive strategies is especially beneficial for people with acute (4 to 12 weeks) or chronic back pain (longer than 12 weeks).


Struggling with back pain that prevents an individual from standing up straight can make it hard to enjoy life or even engage is normal day-to-day activities. Understanding the potential cause is an important way to ensure that the appropriate form of treatment is received. A Physical Therapist can conduct a physical examination that should provide an indication of the proper management approach, which may include a referral to a physician, if necessary. In addition to supporting a quicker recovery, adherence to a physical therapy regimen can help reduce the incidence of future back pain episodes.

Overall, individuals with lower back pain who can’t stand up straight need to address this issue quickly to prevent it from becoming a long-term problem that can disrupt work or family life. Working closely with one of the physical therapists at FYZICAL may be the key to returning to a normal routine in a short amount of time.

FYZICAL offers a wide variety of physical therapy services by qualified providers across the U.S. To find a FYZICAL Therapy & Balance Center near you, visit our website at Our highly skilled therapy providers are 100% focused on your optimal health so you can Love Your Life®!

To learn more about how FYZICAL Therapy & Balance Centers can help you, download our free e-book.