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Interview: lower back pain – what can you do about it?

20-1-2026

Translation: Natalie McKay

Every second person in Switzerland regularly suffers from back pain. Are you one of them? Find out what you can do about it in this interview with physiotherapist and osteopath Paul Ahne.

You probably know the feeling: you’ve been helping with a house move, been sitting down for too long, or have run around all day - and suddenly there it is, this diffuse pain in your lower back. If you’re lucky, this feeling will go away again after a few days. In the worst-case scenario, however, it’s here to stay. What now? How can you get rid of the pain? Paul Ahne, physiotherapist and lecturer at the German School of Osteopathy, has answered these and other questions for you.

**If I were to complain to you about back pain, what would be the first questions you’d ask?

Was there a specific trigger? Did you do any heavy lifting at the weekend, even though you don’t usually do much physical work?
Is the pain acute, or has it been going on for some time (chronic)?
Does the pain radiate?
Do you also have neurological problems such as tingling, numbness or loss of strength? If so, you should always consult a doctor.
Does the pain tend to get worse throughout the day if you do a lot of physical activity?
Or is it worse in the morning, and gets better when you move?

Lower back pain is a huge problem in our society (every third person in Germany is affected according to the AOK Health Atlas (linked page in German)), yet it’s often not easy to pinpoint the exact cause. In people over 25, MRI scans regularly reveal minor changes (wear and tear and slight displacements), which is normal and doesn’t automatically mean this is the source of discomfort. That’s why it’s usually difficult to diagnose or treat back pain yourself.

If the pain moves from the lower back to the legs or buttocks, this may indicate neurological issues such as nerve compression syndrome (piriformis) or disc problems. If you also experience sensory disturbances such as tingling or numbness, loss of strength or reflexes, you should always consult a doctor.

But even if the pain radiates, this isn’t a clear indication of a nerve problem. Trigger points (muscle stiffness) can also cause pain to radiate from the lower back.

That’s not acceptable. What would you advise people with back pain to do first?

In the case of acute problems, for example because you cleared things off the balcony at the weekend and normally hardly do any physical activity, we’ll wait and see how the symptoms develop over the first three days. It’s usually a temporary irritation rather than anything crazy. With a little heat and adequate movement – which shouldn’t be painful and actually does you good – the pain should be gone after 72 to 96 hours.

If you have long-term complaints without a specific trigger, it makes sense to look at your lifestyle. Nowadays, many people spend most of the day sitting down – in the office, on the train or on the couch. This can lead to restricted movement in the lumbopelvic hip region. In this case, it makes sense to incorporate specific movements that are normally overlooked. If you sit a lot, your hips are in fact always at an angle, meaning your hip extensors are hardly ever used. It’s worth practising movements that are the exact opposite of this posture. (Editor’s note: you can find specific exercises at the end of this interview.)

However, it’s not only passive but also monotonous workloads – for example if you work at a checkout or as a painter, or spend a lot of time driving a company car – that can cause issues. It’s important to recognise the main cause of the exertion and counteract it with targeted movements which compensate for it.

Sitting for long periods or monotonous everyday activities are among the typical triggers of lower back pain.
Source: Shutterstock

How do you go about treating lower back pain?

The approach can vary greatly from case to case. It’s always patient-centred: for example, if a person already exercises three times a week, the plan can be more challenging. If, on the other hand, someone has a predominantly sedentary job and does little exercise, we start with a simple routine.

It’s important to find out what people enjoy doing. If I say strength training is best, but you prefer swimming, then stick to swimming. The important thing is that you do it regularly, and we provide targeted therapeutic support for this training.

Especially with existing pain, it’s not enough to attend a few physiotherapy appointments and then leave it at that. People have to take personal responsibility for their everyday behaviour. If you don’t do anything, it won’t get better.

**Are there any cases of lower back pain where you would advise against certain movements altogether?

If neurological symptoms occur, you should definitely consult a doctor. If certain movements cause numbness or weakness, you should avoid them for the time being. Patients with disc problems often find lying down uncomfortable, especially at night. After getting up, the symptoms usually subside, but return during the course of the day as the patient moves around more. Still, it’s rarely advisable to simply lie down and take it easy. Exercise is almost never a bad idea – unless you have a broken bone or a fever.

Even in the case of a slipped disc, there’s extreme inflammation at first, but it actually heals well. As soon as the neurological problems subside, you can get moving again as quickly as possible.

What exercises do you recommend for lower back pain?

It’s particularly beneficial to train the deep core muscles. In other words, the muscles that stabilise the spine. Exercises involving pelvic circles or tilting your pelvis forwards or backwards are highly effective at targeting these muscles.

Many people find it helpful to work on the trigger points in the gluteal muscles with a fascia roller, a fascia ball or a tennis ball for rapid symptom relief. Stretching exercises, for example when you cross your leg over your knee (figure 4 stretch), are also helpful. Once the pain starts to subside, it also motivates you to become more active again.

Even if all you have at home is a rug, you can start with glute bridges – i.e. raising your pelvis when lying on your back. First on two legs, then on one leg, you can train the extension of the hip flexors.

Although this doesn’t solve the issues immediately or by doing only this, it’s a good first step in 99 per cent of cases.

Fascia rollers, the figure 4 stretch (pictured) or glute bridges can offer you initial relief for acute lower back pain.
Source: Shutterstock

Thanks for the interview!

Header image: Shutterstock

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Ronja Magdziak

Freie Autorin

ronja.magdziak@gmail.com

Freelance writer, biologist and yoga teacher. Fascinated by nature, body and mind, I love spending time outdoors and being active. More than anything, I enjoy writing about things that make us feel good!

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