Lower back pain sucks, but when you have lower back pain on one side only it can be even worse because you may feel crooked, like one hip is too high or one leg is too long. This can make it even tougher to walk or get your chores done.
Keep reading to get details about one sided back pain, some exercises to even things out, and when you should go get checked out.
Contents
- Potential causes
- Assessment strategies
- Side-specific exercises
- When to seek help
- Rehab template
Disclaimer:
You should consult with a healthcare provider before starting any new physical activity. This article is for educational purposes and is not meant to replace an assessment, diagnosis, or treatment from a qualified professional. Note; no doctor patient relationship has been formed.
Potential Causes
The list of things that cause lower back pain on one side overlaps with the causes of pain on both sides, but has some extras. So it could be one of several things, but it helps to classify into two categories first; acute and chronic.
Acute low back pain is most likely from an injury like a ligament sprain, muscle strain, muscle spasm or cramp. Less common than those would be a disc injury like an annular tear or herniation. A disc herniation would have pain shooting down one leg that is worse than the back pain, or even numbness/tingling or muscle weakness in the leg.
Even less likely still would be some sort of fracture which would require significant trauma for most, excluding elderly/osteoporotic individuals. Lower back pain on one side could also be ‘referred pain’ from the abdomen on the same side from something like a kidney stone. The least likely would be some sort of disease process that causes spinal pain like cancer.
Chronic lower back pain is more likely to be from a disc injury, or from advanced osteoarthritis of the spine than other issues mentioned above. But chronic lower back pain is more complex and often does not correlate with a specific tissue injury. Again, in rare cases, chronic low back pain could be stemming from some sort of disease process in the back or abdomen.
Outside of the serious conditions listed below, the specific source of the pain is actually not very important for treating lower back pain. What is more important is what hurts and what helps which varies greatly among individuals with the same condition. Here is how to find that out.
Self Assessment
A basic self assessment can be simple back and hip movements in each direction to see if any are uncomfortable or painful. Try touching your toes (flexion), leaning backwards (extension), leaning to each side (lateral flexion), and twisting in each direction (rotation).
You should also do some ‘functional movements’ which just means movements that you have to do during your daily activities. Getting in or out of a chair, lifting things or reaching overhead are all examples of things you could test. If you can identify movements or patterns that reliably cause discomfort, then you can modify them to have less pain.
The LBPfix program has an assessment and categorization built-in, and gives you activity modification strategies and exercise recommendations based on your assessment results. Click here to learn more about the program.
We strongly recommend keeping a journal for lower back pain that has been going on for a while or keeps coming back. This can help you identify the triggers that perpetuate it. Relying solely on memory just will not be effective for more than a few hours.
Side Specific Exercises
There are plenty of exercises you can do to work one side of the body more than the other, for the abdominal/core muscles, but also the lower body. These will build muscular endurance and/or strength depending on how difficult they are, how many sets and reps you do etc.
Core
- Side plank
- Palloff Press
- Suitcase Carry
- Cable/Band chop
Lower body
- Lunge/Split squat
- Copenhagen Plank
- Single leg deadlift/RDL
- Single leg glute bridge
When to seek help
These signs and symptoms – also known as red flags are a cause for concern. If you have any of these, you should seek medical evaluation immediately:
- Progressive loss of strength in your hips and/or legs
- Numbness/tingling in the genital/anal region
- Loss of bowel or bladder control
- redness/swelling over spine
- Unintentional weight loss and/or loss of appetite
- Pain worse at night
In addition to these red flags, it is a good idea to go see a healthcare professional for lower back pain if you also have significant known health issues like cancer, cardiovascular disease, kidney disease, autoimmune disease, inflammatory arthritis, or if you use intravenous drugs.
Rehab Template
There is no one size fits all template for lower back pain relief, or any other goal for that matter. Everyone will have their own path to walk depending on their specific circumstance. Here are the general strategies that comprise the rehab process. Apply the principles to your specific context and stick with it. It can take a long time to fully recover, but you will be so happy when you do.
Assessment
As mentioned above, doing a variety of movements under controlled conditions is the first step. Figure out what is bothering you so you can reduce the frequency and/or intensity of aggravation. Bending your back in different ways, lifting things, crouching, sitting, walking are all possible examples to be checked.
Activity Modification
Now it is time to modify the problem movements or postures in some way to make them less painful. For example, if bending forward or lifting is the worst (very common), try bending forward from your hips while keeping your back straighter or arched backwards slightly. See video below for demonstration.
Sitting too much is another common issue, click here to read our article about lower back pain from sitting. The best thing to do for this is just alternate sitting with standing. If you don’t have that option at work, or you are driving, use extra lumbar support, or try to change your posture in some way every 30-60 min.
Pain relief
There are several options for pain relief, several of which you may have tried already. Things like ice, heat or topical pain relievers can provide some relief. The real heavy hitter, however, is movement.
If you can find a movement that you tolerate well that is likely to help much more than passive therapies. Walking is a great option for many people. It is simple and can be very effective. Click here to read our article about walking and lower back pain.
Sometimes there are specific dynamic stretches that can be very helpful. For example repeated arching of the back while standing or while laying on your stomach. This movement (extension) is often very helpful for those who have pain from bending forward.
The LBPfix program has a self assessment step which categorizes your back pain pattern. The program then delivers exercises and recommendations for your pain category. So you can be confident that you will be doing things that will be helpful.
Strength and conditioning
There is a whole world of possibility here, far too much to cover in one short paragraph. Everyone will have specific preferences and tolerance, so it will be important to do some experimentation. Try some different strength exercises, some different forms of cardiovascular exercise and choose which one you think you can stick to for the long term.
Start with just a little bit when you are adding in new exercise. For cardio just start with 10-20 minutes. For resistance training, do 1-2 sets of a few exercises per body part. You will very likely get sore when you are just starting out, that’s why it is better to just start with a little.
As you get used to the exercises you won’t get as sore. Start with a couple times per week and just get consistent. It is no use doing something every day for a week or two and then quitting because you got too tired or sore.
Consistency > perfection.
If you want to take the guesswork out of it, take the quiz now to see if you qualify for the LBPfix program. Then you will get the exercises you need delivered straight to your inbox.
Our Framework: How LBPfix Can Help
1. Identify Your Pain Driver: We classify your pain into one of four movement intolerance types
2. Prescribe the Right Movement Strategy: Once we know your pain type, we match it with corrective movements
3. Build Long-Term Resilience: As pain settles, we help you:
Move confidently without flaring up
Rebuild core control and lifting mechanics
Return to work, sport, or life without setbacks
Ready to Fix Your Low Back Pain?
Take our 2-minute quiz to find out if you’re a good candidate to our program – no strings attached!
