When people seek guidance on managing or preventing lower back pain, they often receive information on strengthening their core muscles, stretching their hamstrings and even changing their mattresses.

Despite the prevalence of such suggestions, a little-known piece of advice may be even more critical. It is insightful, backed by research, and can decrease the frequency of a symptom dubbed the common cold of musculoskeletal pain.

The advice is to limit the amount we bend forward during the morning.

Our lower backs are particularly prone to injury in the morning, more so than at any other time of day. That vulnerability is primarily due to our discs, the cartilage pads between our vertebrae, and a common cause of low back pain. While we sleep, our bodies are recumbent, with no vertical force of gravity acting on our spines. That positioning causes fluid to be drawn into our discs, making them more pressurized when we wake up.

When you combine that increased morning pressure with activities that involve forward bending, the result is an increased susceptibility to injury. Such activities include, but are not limited to: gardening, mopping floors, toe touch stretches, and lifting objects from the ground.

The connection between low back pain and AM forward bending was demonstrated recently in a randomized controlled trial. In that study, researchers randomized participants into two groups. In the intervention group, people were instructed to limit the amount they bent forward in the morning. In contrast, the control group received nonspecific exercises without advice on controlling early morning bending.

The intervention group reported significant reductions in low back pain, while the control group did not.

Because of that, the study’s author stated that controlling early morning forward bending is a form of self-care that can help develop a sense of control or mastery over low back pain, and thereby build confidence and improve outcomes.

As the day progresses and we walk and move about, our spines are subjected to the compressive forces of gravity. As a result, fluid is slowly pushed out of our discs, leaving them less susceptible to injury. Therefore, postponing activities that involve bending and lifting for the afternoon and evening hours can go a long way in decreasing the incidence of low back pain.

Dr. Jordan Duncan is from Kitsap County and writes a monthly health column for Kitsap News Group. He is the owner of Silverdale Sport & Spine.