Low back pain doesn’t care about your calendar. It barges in before a deadline, after a move, or mid-commute on the 405. Across 37 years and 500,000+ patient visits, I’ve learned that the best plans are simple, staged, and measurable. This guide gives you a clear at-home sequence: calm the flare, restore motion, rebuild control, then protect against relapses. It’s not a substitute for an exam—seek urgent care for red flags like trauma, fever, night pain, new weakness/numbness, or bowel/bladder changes.
Phase 1 (0–72 Hours): Settle the Fire
- Positions of relief: Supine with knees on a pillow; or side-lying with a pillow between knees. Find the shape that softens symptoms and use it often.
- Micro-walks: 3–5 minutes, 3–6x/day. Motion beats bed rest for most uncomplicated strains.
- Breath work: 4 cycles of slow nasal breathing, hands on belly; exhale longer than inhale to dial down guarding.
- Comfort care: Heat or cold—whichever feels better—for 10–15 minutes. Hydrate.
Phase 2: Restore Motion (Gentle)
- Pelvic Tilts: 8–10 slow reps, pain-free range.
- Prone on Elbows: 5–8 breaths if comfortable; stop if pain centralizes nicely, continue; if it peripheralizes (shoots down), stop and reassess.
- Hip Flexor Stretch: 30–40s/side—tight hip flexors amplify lumbar tension.
Phase 3: Rebuild Control
- Glute Bridge: 2×8–10 with a 2-second hold; ribs down.
- Dead Bug: 6–8/side, slow, breathing steady.
- Hip Hinge Practice: Hips back, spine long, light dowel along back for feedback.
Phase 4: Daily Guardrails (LA Edition)
- Desk rhythm: 25/5 work/move; screen at eye level; feet flat.
- Commute: Seat slightly higher, hips above knees; plan one stand/walk on long trips.
- Training: Increase volume by 10–15% weekly; hinge > round.
When to Get Checked
Red flags (listed above) need medical evaluation. If you’re not better across 2–6 visits or two weeks of solid self-care, get assessed—good care adjusts the plan, not your expectations alone.
CTA: Want a back plan tailored to your job and gym? Book with Dr. Edward Komberg in Los Angeles—clear milestones, simple home drills, and coaching you’ll keep.