Easing Low Back Pain

Back pain? You and everybody else. At any given time, 25% of the population reports having some sort of back pain in the last three months. What you might not know is that the number one recommendation by doctors for low back pain is at-home treatment. Low back pain can come from a wide variety of places, including muscle strains and overuse, poor posture, poor sitting or sleeping surfaces, compensation for weakness or stiffness, spinal stenosis, arthritis, and disk degeneration or herniation. Oftentimes it’s some combination of all of the above.
Nobody’s perfect, and we all have subtle imbalances in our body. The problem is, over time these imbalances worsen, postural and positional habits become ingrained, and our body starts to move in ways to adjust for poor alignment. Your body is a master compensator, and when you ask it to do a task, it’s going to get it done — just not necessarily in the right way. That means when you lean over to lift that bag of groceries, a decade of poor movement patterns is going to come into play, and suddenly you’re lifting those apples with all of the force coming from your lumbar spine (low back), and none from your abs, legs, and glutes. The more times you stress your body in these abnormal ways, the more cranky those joints, muscles, and ligaments are going to get.
One of the most important things with any type of low back pain is to keep moving! It’s tempting to remain in bed when your back is aching, but it’s actually the worst thing you can do. Getting moving helps to ease stiffness, improve blood flow, and increase the flow of endorphins to decrease pain, all of which are at the heart of why we have pain in the first place. Exercise might seem daunting, and that’s okay — here are six easy moves you can do to improve mobility, regain core control, and ease back pain.
1. Half Kneeling Hip Flexor Stretch

• Get into a half kneeling position on the floor. Push your hips forward and make sure to keep your back straight.
• At this point you should begin to feel a stretch in the front of your thigh and hip on leg that is behind you.
• Advanced: Prop your back foot onto a box or the wall to incorporate more quad stretch.

2. Hamstring Release

• Sit on a firm surface with knees and feet dangling off edge. Be sure to have enough room to be able to kick the foot out and straighten the knee.
• Place a lacrosse ball/trigger point ball behind the knee on one of the hamstring muscles just above the knee.
• Kick the foot up and down, straightening the knee.
• Move the ball up and down to different parts of the muscle, focusing on spots that feel tight.
• Repeat on other side, as often as needed until the hamstrings feel released.

3. Supine Twist/Low Back Rotational Stretch

•  Lie on your back on the floor with your hips and knees bent to 90 degrees, feet flat.
•  Draw your navel towards your spine to engage your lower abs.
• Slowly rotate knees down towards one side, keeping hips on the ground.
• Keep your low belly in and use your obliques to bring your legs back up to center.
• Repeat on the other side. Repeat 10-20 times.
• Variation: If you’re craving more of a stretch: Start on your back with your legs straight and arms out to the side. Bring one knee up and twist it over to the opposite side of your chest.

4. Cat-Cow: This is a great beginning level spine and pelvic warm up.

• Begin on your hands and knees. Make sure your knees are directly under your hips and your wrists are directly under your shoulders.
• Cat Pose: Inhale and slowly round your spine toward the ceiling. Focus on pushing up between the shoulder blades while tucking pelvis underneath you, like you’re drawing your pubic bone towards your chest.
• Exhale and return to neutral. Slowly reverse into cow pose.
• Cow Pose: Inhale and draw your chest forward while pulling your tailbone to the ceiling, gently arching your back. Look high and forward, but don’t force your neck backwards.
• Repeat 10-20 times.
• Variation: If you want to add some more movement and spine stretching, try child’s pose after 10 cat-cows.
• Childs Pose: Start in neutral, then exhale as you sit back onto your heels, tucking your chin and lowering your head. Reach your arms straight out in front of you. In this position, you can walk the hands to either direction to feel a nice stretch throughout your side body.

5. Kegel Squeeze Three Ways

• This is a great beginner exercise to start working on your deep core muscles, which protect the spine like a corset when you move.
• Lie on your back with your knees bent and your feet flat on the ground.
• • Place a small medicine ball, pillow, or towel in between knees. Your back should remain flat throughout this exercise.
• First draw in your lower abdominals, pulling the navel towards your spine. Then contract your pelvic floor muscles, or kegel, and squeeze the ball, holding for five seconds.
• Varations: Perform this stable base, then use abdominals to draw both knees to chest. Alternately, perform stable base, then squeeze glutes to lift hips off the floor in a bridge.
•  Tip: Not sure how to kegel? Imagine the muscles you would contract if you were trying to stop the flow of urine.

6. Bird Dog

• Begin on your hands and knees.
• To prepare: squeeze your glutes, draw your stomach in, pull your shoulder blades down toward your glutes and keep head in line with spine.
• Holding this stable base, lift one arm.
• Hold 3 seconds, then replace it. Repeat with other arm.
• Repeat 10 times. Then try lifting one leg straight back, then replacing it. Repeat with other leg. Do this ten times.
• Advanced: Lift the right arm and left leg so that each is straight (as shown).

Bottom line: Numerous published guidelines on the management of acute low back pain (pain that you’ve had for less than 4 weeks) indicate conservative treatment as the standard of care, which begins with at-home treatment including exercises such as those above and over-the-counter medications such as ibuprofen and acetaminophen. If treating your back pain yourself isn’t working, the next step is to consult a physical therapist for a trial of therapy. Also, if back pain lingers, worsens, or develops more serious symptoms such as radiating leg pain, changes in bowel and bladder, or numbness and tingling in the legs or feet, consult your primary care doctor.
Reference: Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society | Annals of Internal Medicine http://annals.org/article.aspx?