Lower Back Pain Causes, Treatments & Exercises

 

With back pain being so prevalent in our society, often recurrent, and potentially disabling, it is no wonder there are a lot of questions surrounding the role of exercise with back pain. Part of this comes from the vast unknown when it comes to causes of back pain. Often, patients don’t know what has happened, why it happened, and what to do. Studies looking at what patients believe is happening when they have back pain paint images of discs sliding out of the spine, or crumbling into nothing (Spondylolisthesis), bones grinding together, nerves being pinched or vertebra popping out of place. Terrifying images that often result in fear, stress, and avoidance of exercise.

The Australian Bureau of Statistics estimates that up to 90% of people in Australia will experience lower back pain at least once in their lives.

But the reality of back pain is that is only the 1-5% of back pain that is related to a serious problem like a fracture, inflammatory disease or malignancy. For the vast majority of back pain conditions, there can be no identifiable structure as being the cause. Now, this thought process goes against the common medical model of pain being that if there is an “issue with the tissues” then that would explain the pain. But more and more we are beginning to realise that changes in the body’s structure are not a good predictor of pain or what causes back aches.

Causes of Lower Back Pain

For example, in the lower back in a pain-free population, 90% of people will show signs of degeneration, 56% will show disc bulges, a further 30% will show signs of a disc prolapse, all without symptoms. And this isn’t exclusive to the back, shoulder scans revile the 90% of people over the age of 40 will have tears in the rotator cuff muscles with full function and no pain. In the knee, the severity of osteoarthritis is an extremely poor predictor of knee pain.

Why Does it Hurt?

Now, this prompts health professions to ask the question “Why does it hurt then?”. Research tells us that the structures in the body are only a small part of the puzzle what are the things that make our bodies sore?

For lower back pain patients, some of the strongest predictors of pain are things like stress, anxiety, sleep, fear of injury and fear of movement. Also, thought processes like “I will never recover”, “Exercise is dangerous for me” and “If it hurts I’ll stop” all have links to prolonged recovery times.

The mechanism of all these psychosocial and cognitive aspects of pain is not entirely understood, but there is plenty of evidence to suggest that part of the process is the “sensitisation” of the nervous system. Imagine a knob that can be dialled up and down increasing the amplification effect of the nervous system resulting in an activity that didn’t hurt before, now being painful. It has less to do with the structures of the body being damaged or out of place, and more to do with how sensitive that body part is.

Which brings us back to the question, “Should I Exercise with Back Pain?”. The short answer is yes. In persistent back pain, the likely hood of it being the result of a serious problem is very low, and the risk of causing more damage by exercising is virtually zero. But understanding the reasons why exercise is important for back pain is just as important as doing it.

5 Exercises for Lower Back Pain

Exercise is a great way of desensitising the nervous system in the body. When done in a gradual, progressive manner exercise will improve the resiliency of the spinal tissues to tolerate load, and in turn dial down the amplification effect of the nervous system. Exercise is linked to improved mood, better sleep, and lower stress. All of which are linked to a sensitive nervous system. And lastly, exercise can be fun!. Enjoyment levels of patients with back pain a considerably lower. So engaging in something that stimulates some good vibes, has a bit of laughter, and is an appropriate challenge can certainly bring more joy to our lives and in turn, decrease our pain.

Check out what Sum Of Us physiotherapist Leon Green has to say about the reasons for low back pain.

 

Here are some more effective exercises that can help relieve back pain and improve your overall spinal health:

1. Cat-Cow Stretch

The Cat-Cow stretch is a gentle way to warm up your spine and alleviate tension.

How to do it:

• Start on your hands and knees in a tabletop position.
• Inhale, arch your back, and lift your head and tailbone towards the ceiling (Cow pose).
• Exhale, round your spine, and tuck your chin towards your chest (Cat pose).
• Repeat for 10-15 reps.

2. Child’s Pose

Child’s Pose is a restful position that helps stretch the lower back and relieve tension.

How to do it:

• Start on your hands and knees.
• Sit back on your heels and stretch your arms forward, lowering your forehead to the floor.
• Hold for 30 seconds to a minute, breathing deeply.

3. Bridge Pose

Bridge Pose helps strengthen the back muscles and glutes, providing support for your spine.

How to do it:

• Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
• Press your feet into the floor and lift your hips towards the ceiling.
• Hold for 10-15 seconds, then lower your hips back down.
• Repeat for 10-15 reps.

4. Bird-Dog

Bird-Dog is an excellent exercise for improving balance and strengthening the back muscles.

How to do it:

• Start on your hands and knees in a tabletop position.
• Extend your right arm forward and your left leg back, keeping your spine neutral.
• Hold for a few seconds, then return to the starting position.
• Repeat on the opposite side.
• Perform 10-15 reps on each side.

5. Pelvic Tilts

Pelvic tilts help to engage and strengthen the lower abdominal muscles, supporting the lower back.

How to do it:

• Lie on your back with your knees bent and feet flat on the floor.
• Tighten your abdominal muscles and push your lower back into the floor.
• Hold for a few seconds, then release.
• Repeat for 10-15 reps.

Tips for Exercising with Back Pain

• Consult a Professional: Before starting any new exercise routine, it’s important to consult with a healthcare professional, especially if you have a history of back pain.
• Warm-Up: Always warm up your muscles before exercising to prevent injury.
• Stay Consistent: Regular exercise is key to maintaining a healthy back. Aim to incorporate these exercises into your routine several times a week.
• Listen to Your Body: If an exercise causes pain or discomfort, stop immediately and consult with a healthcare professional.

By incorporating these exercises into your routine, you can help alleviate back pain and improve your overall spinal health. Remember, consistency and proper form are key to reaping the benefits of these exercises.

But finding what is the right type of exercise is different for everybody. Some things will be more appropriate than others depending on your current fitness, exercise history, general health, and style of movement. Contact us for an expert opinion.