Low Back Pain: The PEACE + LOVE Approach

Caring for a New Back Pain Injury: The PEACE & LOVE Approach

Back pain is one of the most common musculoskeletal complaints worldwide. It doesn’t discriminate — it can affect anyone, regardless of age or fitness level. For women, back pain may arise from various factors, including hormonal changes, stress, exercise levels, occupational demands, or the physical toll of roles in everyday life.

Whether your back pain started from lifting something heavy, sitting too long, or an awkward twist during exercise, it’s important to respond with care. The PEACE & LOVE framework, a modern guide for managing acute injuries, offers a practical, holistic approach that aligns beautifully with women’s unique needs and busy lifestyles.

Here’s how to care for a new back pain injury using PEACE & LOVE principles, promoting healing and preventing future issues.

PEACE: Immediate Care for Back Pain (First 48–72 Hours)

The initial phase of care focuses on supporting your body’s natural healing process while avoiding actions that may delay recovery.

P – Protect
Protecting your back means avoiding activities that worsen the pain. This doesn’t mean complete rest, as prolonged immobility can lead to stiffness and slower recovery. Instead, limit activities that provoke discomfort and engage in gentle, pain-free movements to maintain circulation.

E – Elevate
While “elevation” traditionally applies to limb injuries, for back pain, think of it as creating optimal body positioning. Alternate between sitting, standing, and lying down throughout the day to avoid overloading any single structure. When resting, try lying on your back with a pillow under your knees or on your side with a pillow between your knees. These positions help reduce tension in the lower back and provide comfort.

A – Avoid Anti-inflammatories
It may be tempting to reach for anti-inflammatory medications or ice packs, but inflammation is a natural and necessary part of the healing process. If possible, avoid suppressing it unless directed by a healthcare professional, as the use of these medications may delay healing. Instead, manage discomfort with frequent position changes, gentle stretches and relaxation techniques, such as deep breathing.

C – Compress
Compression in back pain management involves external support, such as lumbar rolls or ergonomic chair cushions. These tools promote a more comfortable posture and reduce unnecessary strain. Avoid over-relying on supports, though, as your body also needs to strengthen naturally.

E – Educate
Knowledge is power. Acute back pain episodes are common and often resolve well with time. Fear or anxiety about the injury can amplify pain, so do your best to trust in your body’s resilience. Stay active within your limits and avoid bed rest, which can prolong recovery.

LOVE: The Recovery Phase

Once the acute pain starts to subside, typically after the first 72 hours, it’s time to focus on rebuilding strength and restoring confidence in your body.

L – Load
Gradually reintroducing movement is key to recovery. Start with gentle exercises and functional movements that help strengthen the back and surrounding muscles. Examples include:

Pelvic Tilts: Lie on your back with knees bent, gently tilting your pelvis to flatten your lower back against the floor.
Cat-Cow Stretch: On hands and knees, alternate between arching and rounding your back to promote mobility.
Bridges: Engage your glutes and core by lifting your hips off the floor while keeping your feet grounded. Progress slowly and listen to your body. If an activity increases pain, pause and consult a healthcare provider.

O – Optimism
Mindset matters. Trust in your body’s ability to heal and focus on what you can do, rather than what you can’t. Negative thoughts and fear can increase muscle tension and pain sensitivity which can increase the risk of developing chronic pain. Practices like mindfulness, journaling, or talking to a trusted friend can help you process emotions and stay positive. Celebrate small milestones, such as being able to move with less pain or return to daily tasks. Seeing a health professional for reassurance can also be helpful for this.

V – Vascularization
Promoting blood flow to the injured area aids recovery. Engage in gentle, low-impact activities like walking, swimming, cycling or stretches. These activities improve circulation without placing undue strain on the back. Regular movement not only supports healing but also boosts mood and reduces stress, both of which can indirectly ease pain.

E – Exercise
Building strength, flexibility, and endurance through exercise is the cornerstone of long-term recovery. Focus on exercises that strengthen all of the muscles around your back, including your core, glutes, leg and back muscles, as these areas provide crucial support for your spine. Some examples include:

Bird Dog: On hands and knees, extend one arm and the opposite leg while maintaining a neutral spine.
Planks: Engage your core by holding a straight-line position on your forearms and toes or knees.
Squats: From standing, lower yourself down as if you’re going to see on a chair, then return to standing.

A physiotherapist can help tailor a program to your needs.

A Holistic Perspective on Back Pain

Back pain isn’t just a physical experience — it’s influenced by emotional, social, and environmental factors. Adopting a holistic approach ensures a comprehensive recovery.

The Role of Hormones

Hormonal fluctuations, such as those during pregnancy, postpartum, menstruation or menopause, can affect joint and ligament stability, potentially contributing to back pain. Understanding these influences can help you adjust your care routine during these times.

The Impact of Stress

Chronic stress can lead to increased muscle tension, particularly in the shoulders and back due to the activation of the sympathetic nervous system. Some stress-reduction practices you could try are:

Breathing Exercises: Diaphragmatic breathing calms the nervous system and supports relaxation.
Meditation: Apps or guided sessions can help cultivate mindfulness and reduce tension.
Yoga: Gentle yoga practices, such as child’s pose or seated forward folds, can stretch and release tight back muscles.

Postural Awareness

Modern lifestyles often involve prolonged sitting, whether at a desk or scrolling on a phone. While there is no such things as “bad posture”, staying in one position for too long can be a problem. If you need to stay in the same position for a while, consider these points:

Use a supportive chair that you feel comfortable when sitting
Consider using a lumbar support when sitting if that relieves your pain
Set up your workstation to promote a posture that requires minimal effort to sustain
Take frequent breaks to stretch and move

Nutrition and Healing

Nutrition plays a vital role in tissue repair and reducing inflammation. To optimise healing ensure you are eating enough food to fuel your body, prioritising foods from wholefood sources, including anti-inflammatory foods such as:

Leafy greens, berries, and citrus fruits
Omega-3-rich sources like salmon, walnuts, and chia seeds
Whole grains and lean proteins

Staying hydrated is also very important, as dehydration can exacerbate muscle tension.

Sleep and Recovery

Rest is when your body repairs itself. You can optimise your sleep environment by:

Ensuring your mattress and pillow feel comfortable for you
Using additional pillows to sleep with when you’re particularly sore
Avoiding screens before bedtime to improve sleep quality
Experimenting with sleep positions that reduce back strain, such as side-lying with a pillow between your knees
Dim the lights before going to bed

When to Seek Professional Help

While most episodes of acute back pain resolve with self-care, certain symptoms warrant medical attention:

Severe or worsening pain
Pain radiating to the legs or causing numbness
Difficulty controlling your bladder or bowels
Pain persisting beyond a few weeks
If it’s taking a toll mentally and you’d like support from a professional during recovery

A physiotherapist can provide tailored care, including manual therapy, guided exercises, and advice on lifestyle adjustments.

A note on manual therapy: Hands-on work like massage and joint mobilisations are common treatments in episodes of new back pain. They often provide short-term relief which may aid in getting some mobility back. Just know that your body heals the injury, not the manual therapy itself.

Conclusion: PEACE & LOVE for Your Back

Acute back pain is a common experience — you are not alone. By following the principles of PEACE & LOVE, you can support your body’s natural healing processes, rebuild strength and confidence, and reduce the risk of future episodes.

Remember, recovery is a journey, and your body is resilient. With patience, optimism, and the right care, you can return to the activities you love —stronger and more aware of how to protect your back in the future.