Low back pain is one of the most common musculoskeletal diagnoses in the world. Low back pain can persist for many years and become a chronic condition if not treated.

Common contributors:

  • excessive sitting, especially in poor posture positions (desk chairs, couches, car seats, airplanes).
  • work duties that require heavy lifting or repetitive movements of bending and twisting.
  • lifting heavy objects with poor posture (example: moving furniture or heavy boxes, bending over without squatting down to engage the glutes and abdominals).
  • increasing age- as you get older, the spine degenerates and you can develop arthritis and bone spur of the vertebrae, and narrowing of the canal that the spinal cord runs through. The discs between the vertebrae also may degenerate and lose their fluid, which decreases the amount of cushion between each vertebrae, which can then lead to increased pain.

What it feels like:

  • pain van vary, as there are a few different sources of pain that can originate from the low back:
    • sharp, “twinge”–> this can be due to a muscle strain of a muscle in the low back, or a facet joint irritation (joints in the vertebrae that keep each vertebrae “on track”).
    • dull, aching–> this feeling can be due to sore and tired muscles in the low back.
    • numbness, tingling, burning, shooting pain down the leg, or weakness in the leg–> this can be due to irritation of a nerve, which can be caused by disc herniation of varying degrees in the lumbar spine, or irritation of a nerve root by other sources of inflammation occurring in the spine.

Risk factors in developing back pain:

  • weak abdominal and glute muscles
  • poor flexibility of hamstrings and hip flexors
  • overweight- excessive weight causes strain on the spine and the muscles that are trying to support the spine.
  • job duties- excessive sitting, repetitive movements that require bending/twisting/lifting, heavy labor.

How physical therapy can help:

  • improve strength of the deep abdominal muscles, specifically the transverse abdominis
    • these muscles act as a girdle, which help support your spine and pelvis, providing the lumbar region with stability.
  • increased flexibility of the hamstrings
    • the hamstrings attach to the bottom of the pelvis, and if tight, can create more stress to the low back.
  • increase hip mobility
    • to perform daily movements such as squatting to use the toilet, sit in a low chair, or pick items off the floor, your hips need a certain degree of flexibility.  If your hips are tight, your lumbar spine is forced to perform the movement, causing undue stresses on it.
  • improve strength of the glute muscles
    • these are powerful muscles that work to absorb the shock of your body weight.
  • increase joint mobility of the spine- stiffness in one area of the spine may contribute to excessive motion at another area, which can lead to muscle strains or irritation at the hypermobile joints.

Exercises:

  • Figure 4 stretch- stretches the muscles in the glutes which help keep the pelvis in proper alignment.
    • 2 x 30″, 2x daily
  • Abdominal brace with alternate leg marching- this exercise activates the transverse abdominis and requires it to keep your lower abdominals/pelvis/spine stable during the exercise.
    • attempt as many as you can, with good form (do not let back arch or let hips move side to side, also make sure to breath during the exercise!)
  • Sidelying clams- improves glute medius strength, which is an important muscle of the glutes that maintains a level pelvis during all single leg stance activities (walking, running, stairs all require a single leg stance for a brief moment).
    • 2 x 10 reps with a 5 second hold position, 2x daily
  • Bridges- improves glute max strength, which acts as a shock absorber.
    • 2 x 10 reps with a 5″ hold at the top, 2x daily
  • Hamstring stretch- improves flexibility of hamstrings, which if tight, can pull on the pelvis creating extra tension on the low back.
    • 2 x 30″, 2x daily
  • Hip flexor stretch- improves flexibility of the hip flexors, which if tight, can pull the pelvis into an anterior pelvic tilt, which creates extra stress on the low back.
    • 2 x 30″, 2x daily

Other ways to find relief:

  • Change positions frequently- don’t sit or stand in one position for too long, use body pillows while sleeping for better positioning. Often times, light movement and activity can be helpful.
  • Ergonomic set up at work- have your workplace adjust your workspace (adjust keyboard and monitor height, supportive desk chair, standing desk).
  • Heat pack- apply for 15-20 mins to relax the muscles that may be in spasm.
  • Ice pack- apply for 15-20 mins to reduce inflammation and block pain sensations.