Relaxation techniques for back pain

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How we perceive pain and how well we cope with it is influenced by many factors, including our mind. Stress and psychological distress can also make pain worse. Relaxation and stress management techniques can help here.

Almost everyone experiences low back pain at some point in their lives. There is usually no clear cause, and the pain typically goes away on its own after a few days or weeks. But this "non-specific" low back pain may also last longer or keep returning after symptom-free periods. It is then referred to as chronic or recurrent low back pain.

People with non-specific low back pain are advised to stay as active as possible and do certain types of exercises. Relaxation techniques such as progressive muscle relaxation and autogenic training are often recommended too. These techniques can be learned in courses, for instance at an adult education center. Some statutory health insurers in Germany cover part of the costs. It is also possible to learn the techniques with the help of an app, CD or audio file.

A number of studies suggest that progressive muscle relaxation or mindfulness training can relieve low back pain and improve flexibility.

How does progressive muscle relaxation work?

Progressive muscle relaxation (PMR) is a widely used relaxation technique. It is sometimes called or deep muscle relaxation as well. This technique involves focusing on a specific group of muscles to start off with. The muscles are first actively relaxed, then tensed for a short while, and then fully relaxed again. These steps are repeated with other muscle groups until the entire body is relaxed.

The aim is to become more aware of your body and learn to consciously achieve physical and mental relaxation. A further goal is to reduce muscle tension that is caused by psychological stress. It is thought that relaxing in this way can help you cope better with stress.

What does mindfulness training involve?

Mindfulness training (mindfulness-based stress reduction, or MBSR) aims to help people pay more attention to their thoughts, feelings, and surroundings – without judging them or wanting to change them. This is meant to improve your self-awareness and allow you to experience events, activities or moments in a more intensive way and enjoy them more. It is also believed to help you recognize and let go of negative thoughts and feelings.

Mindfulness training can involve various exercises, such as trying to become more aware of everyday things like the taste of your food, or the wind in your face when you go on walks. Or you may try to avoid reacting immediately to what others say or do, and instead take a step back from the situation first. The overall idea is to stop automatically reacting to things in a certain way. Meditation and yoga exercises can be used in mindfulness training too.

Paying more attention to your own thoughts and feelings can sometimes be unpleasant too. For instance, if you are more aware of feelings such as grief, anger or fear, those feelings may become stronger at first. For this reason, mindfulness training isn't very suitable for people with certain mental illnesses. These include addiction problems, acute depression and psychosis.

There has not yet been enough research to tell whether mindfulness is effective against chronic back pain. The studies done so far have shown that the exercises can provide temporary pain relief.

Anheyer D, Haller H, Barth J et al. Mindfulness-Based Stress Reduction for Treating Low Back Pain: A Systematic Review and Meta-analysis. Ann Intern Med 2017; 166(11): 799-807.

Chou R, Deyo R, Friedly J et al. Noninvasive Treatments for Low Back Pain. (AHRQ Comparative Effectiveness Reviews; No. 169). 2016.

Chou R, Deyo R, Friedly J et al. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med 2017; 166(7): 493-505.

Skelly AC, Chou R, Dettori JR et al. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review. 2018.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on December 5, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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