Importance of exercise for lower back pain

Lower back pain

Author: Alex Jeffkins

About 85% of episodes of back pain are considered non-specific, as the pain cannot be attributed to a specific cause, such as a spinal fracture or infection. In acute cases of back pain, the muscles around the spine and hips will often tense up to prevent painful movements of the spine, which can lead to stiffness of the spine. Having a stiff spine and tense muscles can make all your usual movements painful.

Common contributors to lower back pain:

· Muscle guarding of the muscle around the lower back – tense muscles restricting your movement can be sore when you try to move them, particularly quick movements

· Low grade damage and inflammation of the soft tissues of the lower back – this damage is usually nothing to be concerned about, but can cause sore additional soreness

· Stiffness joints of the lower back – trying to move while stiff can be sore in the lower back

First steps for acute back pain:

· Gentle movement – walking and completing your usual light housework can make the back feel better by increasing blood flow to the back and easing off muscle guarding

· Avoid sitting or laying in one position for a protracted period – being in one position for a long time can increase the stiffness of the joints and increase muscle guarding of the back – take small breaks to stand, stretch and move

· Massage – can relax muscles that are guarding against movement, relieving pain as you move

Your physiotherapist may also prescribe gentle movements of the spine to keep the spine and lower back muscles moving and active.

Gentle spinal movements for relief of back pain:

· Side-to-side knee rocks – this movement will get the spine twisting gently while supported

· Pelvic tilts – as you move your pelvis, your lower back will arch and round gently

Vigorous exercise is not recommended while your pain is high during acute back pain, however you can begin with gentle strengthening exercises for the core and hip muscles which both support the spine. The level of intensity of these exercises depends on your current fitness and pain levels, and your physiotherapist can guide you as to the appropriate level of exercise to start with.

Strengthening exercises of the core and hip muscles to support the spine:

· Glute bridges – Works the buttocks which support the spine from below

· Heel taps – Works the abdominal muscles, which form a supportive ring for the spine

· Side lying clamshells – Works the side of the buttocks which stabilises the pelvis while walking, preventing the spine from tipping and twisting

People who have acute back pain are at a higher risk of developing chronic back pain. It is important to increase your core strength and hip strength with the above exercises; and continuing to develop your strength by performing harder variations over time. This can help prevent chronic back pain or reduce pre-existing chronic back pain.

Beyond these beginning exercises, you can continue to develop your strength in the gym with free-weights or with Pilates exercise.

Please note it is IMPORTANT to seek specific advice from your Physiotherapist to ensure you are doing the correct exercises, based on what your specific diagnosis is.