The pain in my lower back has lasted longer than a month

In brief

In brief

  • For back problems that last longer than 1 month, your GP can make a step-by-step plan with you.
  • This helps you expand your activities step by step.
  • Make sure you keep moving, even if you’re in pain.
  • Sports (such as swimming, cycling, jogging and doing exercises) can help make your body stronger and more flexible, improve your physical condition and reduce stress.
  • If necessary, a physiotherapist or exercise therapist can support you in building up your activities.


What is it

Becoming active again with lower back pain

Have you been unable to resume your normal activities after 3 to 4 weeks of back pain? Then your GP can make a step-by-step plan (file in Dutch) with you. This plan states which activities you are going to start again, and when. This helps to expand your activities. 

Sometimes people are afraid to move because of the pain and/or they need guidance or support. In that case, a physiotherapist or exercise therapist can support you in building up your activities.

Moving and exercising

Advice for staying active and exercising with lower back pain

Pay attention to your posture and movements

  • Are you unable to find a comfortable position at night because of the pain? Then try lying on your back with some pillows under your knees, or on your side with your legs pulled halfway up.
  • To get out of bed, roll onto your side first. Move your legs over the edge of the bed and push yourself up sideways with both arms. To lie down, make the same movements in reverse order.
  • Sit on a straight chair, preferably with armrests, so that you can stand up more easily. Sit with your back straight and your stomach pulled in. When getting up, place your hands on the armrests and slide forward to the edge of the seat. Place one foot directly under the chair and the other foot slightly in front of you. Try keeping your back straight while you stand up.
  • Use a swivel chair when you sit at a desk, so that you can turn around with the chair when you want to grab something behind you or when you want to stand up.
  • When you have to lift something, bend your knees and lift with your back straight. Keep the object you are lifting close to your body (don’t lift with your arms stretched out in front of you).
  • Don’t lift too much at once. Don’t lift heavy things over long distances, but make stops in between.
  • Avoid twisting and bending your back at the same time.
    • If you want to pick up something next to you or behind you, stand up first, turn around and then bend down with your knees.
    • When you get out of the car, make sure you turn your body and legs a quarter turn at the same time. Place your feet on the ground and support yourself with your hands before you stand up.
  • Preferably wear flat shoes.


Exercises will not help lower back pain clear up any faster. But some people find it pleasant to do some stretching exercises. As a reaction to the pain, your muscles tend to tighten. In that case, stretching exercises can help these muscles to relax again.

Stretching exercises

  • Pull up your knees
    Lie on your back with your knees bent and your feet flat on the ground. Use your hands to slowly pull your knee up towards your chest. Hold this position for 30 seconds. Then slowly lower your leg. Repeat the exercise with your other knee.
  • Tilt your pelvis
    Arch your back as much as you can by pushing your buttocks back and your stomach forward. Then gradually straighten your lower back by pulling your lower abdomen in and tightening your buttocks. You can do this exercise lying down, sitting down, standing, or on your hands and knees. You can combine this exercise with your breathing: breathe in while your back is arched, and breathe out while your back is straight.
  • Twist your lower back
    Lie on your back with your knees bent and your feet flat on the ground. From this position, slowly move both knees to the left and then to the right. Keep both shoulders on the ground. Repeat the exercise.

Strengthening your muscles

  • Abdominal muscles
    Lie on your back with your knees bent and your feet flat on the ground. Touch your knees with your fingers and hold this position as long as you can. Relax for a minute and then repeat the exercise.
  • Back muscles
    Lie on your stomach with your arms and legs stretched. Then raise your arms and legs and hold this position for as long as you can. Relax for a minute and then repeat the exercise.

Stay active and get plenty of exercise

  • Make sure you get plenty of exercise. Sports such as swimming, cycling and jogging can help you get stronger, more flexible and fit.
  • Swimming and walking are also recommended in case of severe pain.

Avoid cooling down

Some people with back problems find it pleasant to keep the lower back warm. People with back problems also say that their back becomes stiffer or more painful if their back cools down quickly after exercising or heavy work. This cooling down can be caused by wet sportswear or work clothing sticking to the back. Cooling down can be prevented by quickly changing into dry clothes after sports or heavy work.

What happens next

What happens next if you keep having lower back pain?

You discuss with your GP whether the step-by-step plan has helped.

Getting enough exercise remains important for people who sometimes have back problems. See Healthy exercise (in Dutch) for exercise tips. 

Have you noticed that problems and stress affect your back? In that case, make sure you deal with your problems and stress in time. See psychosocial problems and stress (in Dutch) to find out how to do this. 

For long-term (chronic) symptoms, it can help to learn to deal with the symptoms. This way you expand your activities further despite your back problems. This is called behavioural therapy. A specialised physiotherapist, exercise therapist or psychologist can provide this treatment. 
Long-term symptoms for which no cause can be found are called medically unexplained physical symptoms (MUPS). See ‘medically unexplained physical symptoms’ (onvoldoende verklaarde lichamelijke klachten) (in Dutch) for information and advice. 

Do you still have severe symptoms, despite the treatments? Then your GP can refer you to a rehabilitation centre.

If you have chronic back problems, you will have a back consultant. This can be your GP or another healthcare provider, such as a physiotherapist. He or she coordinates the treatment and can answer your questions.

When to call

When should I contact my GP for lower back pain?

Urgent: Call your GP or the out-of-hours service immediately if you have 1 or more of the following symptoms:

  • you are dizzy and sweating, and feel like you might faint
  • you can no longer pee (urinate) even though you feel you need to
  • your bottom and groin feel numb 
  • you suddenly lose strength in your leg (you are unable to stand on your toes or heels)

Call your GP or make an appointment (during office hours): 

  • if you have pain in your back after a fall
  • if you have recently had back surgery or an injection in your back
  • if you have (or have had) cancer
  • if the symptoms have not decreased after 4 weeks. 
More information

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