Low back pain is one of the most common causes of work-related disability and the reason some people miss work. It is also the second most common neurological condition in the United States, after headaches. In fact, about 80% of adults in Western countries have experienced lower back pain.
For some lucky people, we can resolve lower back pain on its own or with medication in two to four weeks. However, some cases of low back pain can last longer than a few weeks, in which case we refer the condition to as “chronic” and “progressive,” meaning it can only get worse.
In addition, 60-80% of patients who suffer from a first episode of low back pain may experience recurrent pain within a year.
Current research shows that certain muscles in the back stabilize the spine. When the spine or back is injured, these muscles are reflexively inhibited or closed. Even worse, these muscles do not recover spontaneously, even though patients are pain free to resume normal activity.
Inhibition of these muscles, called the lumbar multifidus and transversus abdominis, leads to low back pain. However, there are steps you can take to prevent the same thing from happening to you.
Low back pain and physical therapy
One way to prevent inhibition of the lumbar multifidus and transversus abdominis is to do a series of physical therapy exercises.
Designed to strengthen the muscles of the lower back and keep the spine healthy, these physical therapy exercises can range from back stabilization exercises to muscle strength development to a wide variety of techniques.
In addition, a physical therapist may also recommend methods such as heat therapy, ultrasound, massage, mobilization, and education on posture and body mechanics to prevent the recurrence of low back pain.
We will discuss some of these methods below. You will also find practical self-help tips provided by the experts to help you avoid low back pain or prevent it from getting worse.
However, before learning how to treat low back pain with physical therapy, it is important to understand the causes of low back pain.
Low back pain: CAUSES
There are actually many types of back pain, but the most common is lower back pain. Why? You may ask. The reason is simple: you carry most of your weight on your lower back. Therefore, it is likely that a person is suffering from pain in this area.
There is no definitive cause for lower back pain. Sometimes the causes of this condition are so complex that it is difficult to identify a single cause.
However, physical therapists and other health professionals have observed that low back pain is often the result of strain on the muscles and ligaments of the back due to:
o poor posture,
o heavy lifting
o sudden, awkward movement
o Muscle spasm
o Stress
We can all be guilty of the above activities. We may not be suffering from back pain at the moment, but it is likely that as we age and inhibition of our back muscles from these activities increases, back pain will become a very distinct possibility.
Besides these common activities, back pain can also result from specific conditions, such as
o Herniated discs (when the disc material presses on a nerve)
o Sciatica (when a herniated disc puts pressure on the sciatic nerve. This condition causes a sharp, shooting pain in the buttocks and back of the leg).
o Spinal stenosis (when the space around the spinal cord and nerve roots becomes narrower. Arthritis and bone overgrowth, with pain resulting from a pinched nerve in this narrow space) causes this condition.
o Spondylosis (a type of arthritis affecting the spine because of degenerative changes caused by aging),
o Spondylolisthesis (when one vertebra in the spine slides forward over another)
Low back pain: TREATMENT
Treatment for low back pain depends on several factors, including the specific type of low back pain (chronic or acute) and its suspected cause.
For example, acute low back pain is usually treated with pain medication, such as painkillers, or exercises that relax the muscles.
In contrast, an underlying condition may cause chronic back pain - or pain that lasts longer than two weeks and is progressive, in which case the treatment plan may be to resolve the underlying condition to treat the back pain.
Low back pain and physical therapy exercises
Physical therapy exercises are one of the most common methods of treating low back pain. In fact, many home remedies for low back pain involve exercise, as the general theory is that if you stay active, you stay healthy. This is true in most cases.
However, for this article, the exercises presented here will be those performed by physical therapists to treat patients with low back pain.
In physical therapy exercises, the exercise program for back pain should include a combination of stretching exercises, strengthening exercises, and low-affected aerobics. Read below to learn more about these exercises:
-Stretching
A person’s back comprises the spine, contiguous muscles, ligaments, and tendons. These elements move in harmony with each other, so any limitation between motion of these back components results in back pain.
Stretching for low back pain specifically targets the soft tissues, such as muscles, ligaments and tendons, that are found in the back and around the spine. By stretching, we mobilize the spine and soft tissues, which increases movement and thus relieves pain.
There are many types of stretching exercises used by physical therapists. One of these is the hamstring stretch, which relaxes tight hamstrings, a common symptom of low back pain. This exercise is said to help decrease the intensity of low back pain in sufferers.
-Muscle Strengthening
Physical therapists use two forms of exercises to strengthen and relieve back pain, depending on the specific condition of the patient. These are McKenzie exercises and dynamic lumbar stabilization exercises. However, the two forms of strengthening exercises can also be combined if the therapist deems it appropriate.
-McKenzie Exercises
Named after a New Zealand physical therapist, McKenzie exercises are primarily extension exercises that may help reduce pain generated by the disc space and may also help reduce symptoms of disc herniation by reducing pressure on a nerve root.
In cases of acute pain, we should perform frequently McKenzie exercises, at least once every two hours. In addition, we advise patients to avoid flexing the spine during the exercises.
-Dynamic Lumbar Stabilization Exercises
When using this back exercise technique, the first thing the physical therapist does is to look for the patient’s “neutral” spine. This is the position that allows the patient to feel most comfortable.
Then, when the patient is in this position, the therapist works the back muscles to “teach” the spine to stay in this position.
Regular practice of these exercises can help strengthen the back muscles and keep the spine in an excellent position.
Low-affected Aerobic Exercises
The goal of low-affected aerobic exercise is to recondition the back. Patients who undergo back reconditioning through low-affected aerobic exercise will have fewer episodes of low back pain.
In addition, when an episode of low back pain occurs, the pain is less intense and lasts only a short time.
Another benefit of low-affected aerobic exercise is that patients remain functional, meaning they can continue their usual work and leisure activities. In contrast, patients who do not engage in low-affected aerobic exercise experience a gradual decline in their functional abilities.
For low-affected aerobic exercise to work, it must be continuous. This will raise the heart rate and keep it elevated, while increasing the production of endorphins, which are pain-fighting hormones released by the body.
Here are some examples of low-affected aerobic exercises you can try to ease or reduce lower back pain:
-Walking
One of the simplest forms of aerobic exercise, walking, is considered being very gentle on the back. To get the most out of walking as a low-affected aerobic exercise, walk 2 to 3 miles three times a week.
-Stationary Bike
This form of aerobic exercise is less painful for the back because of the lower impact. It is beneficial for patients with low back pain who may find walking too painful.
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-Water Therapy
Sometimes called aqua therapy, water therapy simply involves doing exercises in water. The buoyancy allows for effective conditioning while reducing pressure on the back.
