Muscular lower back pain: management

Patient : Hello, I have lower back pain (close to my tailbone) when I sneeze and sometimes when I cough. I also get a shot of pain there if I gag (on my toothbrush when I brush my tongue) and lately (past year or two) when I get up from sitting on a cough my lower back is very stiff. This happens especially if I'm sitting cross-legged or lying on a couch propped up (not flat). I'm 28, I work in an office but I'm in and out of my chair all day. I'm not terribly athletic and generally lazy, but not overweight and I do live in a 5th floor walk-up apt building. I feel like an old lady whenever I get up and I hold my back like the old man in the attached pic. Should I stretch it more? Strengthen my core? Work on my posture? Help me not be so old and broken! Thanks, Britt
Doctor :   I understand your concern. It seems that you may have stiff muscles due to the lack of exercise and desk job which can l ead to the muscles going into spasm. You could try working out a bit more concentrating on strenghtening you back muscles. Try to improve your posture and use an ergonomic desk while working. Also avoid sitting propped up in bed as that is the worst posture for the back. You could also use some heat compress to relax the back muscles and some antiinflammatory gel like voltaren. However if the pain does not subside please see your GP for a complete physical examination.All the best.

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