Spine experts agree that physical activity is important for people with low back pain. This leaflet will show you how to stay active while controlling your pain, and how appropriate activity can protect you against a recurrence of low back pain.
When your healthcare provider treats your low back pain, they aim to:
Communicate well;
To explain and reassure you of your situation;
Reducing your fears;
Increasing physical activity;
Teaching appropriate exercise;
Correcting body mechanics and
Avoiding long-term use of passive treatments
WHAT KIND OF EXERCISE SHOULD BE DONE?
So how do you stay physically active without worsening your pain? Most people are surprised to learn that carefully selected exercises can reduce pain. Some of the exercises in this brochure can speed recovery and provide immediate and significant relief.
When pain subsides or disappears, other exercises may help to restore and restore back motion and back muscle strength. These will help you achieve a full recovery and prevent pain from reappearing. Most doctors do not consider the increase in pain during activity significant unless it continues after activity. So try to stay active.
Please note that this is a guide only. Not all exercises are suitable for everyone. If your pain becomes much worse while exercising, stop exercising and notify your healthcare provider.
Observe your pain when choosing your exercise
To avoid worsening your low back pain, it is important to choose your exercises carefully. One way to know if your lower back is getting worse is if the symptoms spread as follows:
Spread to areas farther from your waist;
Spread to the hips;
Spread down legs.
This can occur during exercise and activity and even in certain positions.
The good news is that the reverse is also true! Symptoms may disappear from your hips and legs and are felt closer to the center of your lower back (called “centralization of pain”). This usually means you are improving and moving towards recovery! You can find exercises and positions that will provide this. When all of the symptoms return to the center of your lower back, they will usually improve and disappear with continued exercise.
The four most common exercises for centering and alleviating symptoms are:
Flat terrain walking
Bending back while standing
Prone stance on elbows
Hands on the prone position
Observe your pain while doing these exercises and other activities. Does it centralize or does it not worsen, at least stay the same?
Body posture is also important
Along with proper exercise, good posture when standing or sitting is essential. When sitting, avoid sitting for too long and hunching over. If your symptoms get worse while sitting (and may even go down to your hip and leg), check your posture. Sitting upright can also help with centralization and reduce pain for many people. To increase muscle strength and develop better sitting habits, it helps to think of sitting upright as an exercise. Sitting upright and painless often prevents symptoms from coming back. If you have to sit for a long time, it can be very helpful to place a firm support behind your lower back and keep your hips slightly higher than your knees to deepen the natural indentation of your lower back.
WHAT KIND OF EXERCISE SHOULD BE DONE?
Exercise when pain subsides
In most cases, it only takes a day or two to control or eliminate symptoms. If your pain is much better or gone, start with some simple forward bending exercises and gradually and carefully increase your range of motion. Continue until your symptoms return, get worse, and move away from the centre.
Continuing to sit upright is very helpful for most people.
Strength training
Many people with low back pain have weak back muscles. Strengthening exercises protect you from future problems. Posture and body movement all (including sitting upright) require adequate muscle strength and flexibility, which requires some stretching along with strengthening work. Moderate strength training is one of the most valuable things you can do for your overall health and is especially important if you have low back pain.
Low back strengthening is beneficial in two ways:
It helps to repair injury by increasing blood flow.
Improves function in daily life by increasing strength and endurance.
Necessary nutrients should be brought to the injured area with good blood flow to heal and repair injuries. Strengthening work for the lower back muscles increases blood flow to the worked muscles and adjacent tissues. This is also true for aerobic exercise (eg, walking, swimming, cycling), but especially so for strength training.
Building strong muscles also increases your strength to work throughout the day. In addition to strengthening the waist, it is necessary to pay attention to the large muscles in the upper and lower parts of the trunk and legs. These muscles provide significant endurance and stability to the back and trunk by improving balance and walking. This gives you greater convenience in doing your daily activities and reduces your chances of falling.
Special equipment and gyms can be helpful; but there are also good, inexpensive ways to strengthen your lower back muscles at home. Putting a pillow or two under your waist increases strength. Two frequently used and very useful exercise tools are the Swiss balls and the Roman Chair.
Summary
Good low back treatment consists of pain-relieving exercises and moderate strengthening exercises followed by appropriate stretching. Taking care of yourself using these techniques is a good defense to prevent symptoms later on, but can also help you heal.
WHERE TO START?
Walking: Start with 10 minutes and work your way up to 30 minutes or more. Increase the distance and walking speed as much as you can.
Standing Stretch: Place your hands with your fingers behind your waist. Bend back as far as you can, pressing inward with your fingers. Hold that for a second or two. Repeat 10 times, trying to bend more each time. Repeat every 2 hours unless your pain gets worse.
Prone, Elbows Pose: Get up on elbows and arch your lower back. Stay like this for 10 seconds. Repeat 3 times. Repeat every 2 hours unless pain worsens.
Prone, Hands-On Pose: Get up on your hands and arch your lower back. Hold this position for 1-2 seconds. Return to the prone position. Repeat 10 times, each time making your lower back a little more hollow. Repeat every 2 hours unless pain worsens.
Standing Posture: Pull head back keeping chin in, ears and shoulders aligned with hips and feet balanced (good posture shown on left, poor posture shown on right).
Posture While Sitting: Ears and shoulders should be on the hips and in line, the dimple formed in the waist while standing should also be present when sitting (poor posture shown on the left, good posture on the right).
Supine, Single Knee Pull: Pull through a series of ribs and continue to pull gently for 10 seconds without breaking the position. Repeat 3 times. Do this for each leg.
Supine, Two-Knee Pull: Pull both knees to the ribcage and continue to pull gently for 10 seconds without breaking the position. Repeat 3 times. Do this 2-3 times a day, unless the pain gets worse.
Prone, Head and Shoulders Raise: Join hands behind back and lift head and shoulders off floor. Hold this position for 5 to 10 seconds. Repeat 3 times.
Prone, Topile Exercise: Clasp hands behind back and raise head and shoulders up. Hold this position for 5 to 10 seconds. Repeat 3 times.
Prone, RomanChairleExercise: This is a more advanced exercise and may not be suitable for everyone. The hip pad is placed at the level of the protrusions of the hip bones. Lean forward as much as possible and lift your torso using your lower back muscles. Do this exercise slowly (count to 3 as you stand up and to 4 as you bend down). Repeat 5 to 10 times.
Supine, Bend: Extend arms towards knees. Tilt the pelvis until the waist is straight. Lift your head and shoulders off the ground. Hold this position for 5 to 10 seconds. Repeat 3 times.
Cat/Camel: Stand in a crawling position. Place hands at shoulder level and knees in line with hips. 1) Raise your torso by contracting the abdominal muscles. Hold like this for 5-10 seconds. 2) Relax, your back is hollow.
Supine, Topile Exercise: Place hands on floor and lift hips off floor. Stay like this for 5-10 seconds. Repeat 3 times.
Getting up from a chair: Sit with arms crossed over chest, slowly get up and slowly return to sitting position (count to 3 while getting up and sitting).
Prone, Ball Resting Takeoff: Stand with knees straight and back flat on ball. Slowly bend your knees (count to 3). Hold for 5 seconds with your knees in this fully bent position. Slowly return to a standing position (count to 3). Repeat 5-10 times.
