Is Regular Exercise the Key to Preventing Low Back Pain?

It is estimated that 80% of individuals in the western world will experience back pain at some point. Back pain is preventable and according to a recent article in the New York Times, exercise is the key component for a healthy back. Exercise alone or in combination with education has the highest level of evidence for preventing low back pain. Other interventions, including education alone, back belts and orthotics do not appear to help in preventing low back pain. Psychosocial factors, self-confidence and perceived ability to cope are also predictors of recovery from low back pain. In addition, most individuals who have an episode of acute pain will have at least one reoccurrence, which makes a proactive approach more sensible.

As a physical therapist treating low back pain and complicated lumbopelvic conditions for almost 25 years, I am going to highlight my top three recommendations for a healthy back.

1. Stretch the low back

Pain from a displaced or deranged disc could cause pain in the low back, buttock, one or both sides, a deformity or stuck posture, inability to straighten up and is often self-limiting (goes away on its own over time). The individual often has a history of episodic back pain or multiple times his/her back has "gone out" over the past several years. Stretching backwards, not forwards, and interrupting prolonged periods of sitting can help. As a general rule, if you are going to be bending or sitting a lot, bend backwards or lie on your stomach propped on your elbows beforehand. Sciatica, or pain in one leg below the knee, most likely will not improve by bending backwards alone and requires further intervention and evaluation by a skilled physical therapist or provider.

2. Strengthen The Core and Glute Muscles

Any injury to the back or having a h/o back pain disrupts the function of the multifidus muscle, one of four deep core muscles that stabilize the spine and pelvis. The deep core is comprised of four muscles and poor timing and sequencing of this muscle system can result in compensations from other spine and pelvic muscles that leads to pain and dysfunction. Core muscle weakness can also be caused by adhesions and gut inflammation that inhibit the muscles from working.

3. Seek help from a physical therapist with experience in treating low back pain and orthopedic conditions who can customize an exercise program for you. Hamstring tightness, lumbosacral mechanics and muscle imbalances can affect posture and the ability to exercise. The function of the lumbar area is stabilization and mobility above (thoracic spine) and below (hips and pelvis) is essential. A recent study in the Journal of Physical Therapy Science looks at the thoracic spine as a culprit in back pain and stiffness in the thoracic spine can lead to excessive movement in the lumbar spine. This is one reason we assess the thoracic spine in all our back pain patients and include exercise to address this lack of mobility. Click here for the American Physical Therapy Guidelines (APTA) guidelines on preventing and treating low back pain. At Healthy Core, we utilize multiple treatment methods including Integrative Dry Needling, Instrument Assisted Soft Tissue Mobilization, visceral mobilization, kinesiology tape and therapeutic exercise to keep you healthy beyond an "episode of care." We will teach you how to take care of your back to decrease pain and prevent it from returning. Kick back pain to the curb and maintain a healthy lifestyle into the new year! Call 330-528-0034 to learn more and to schedule a FREE consultation.

Reference:

Steffens D, Mayer CG, Pereira LS, Stevens ML, Oliviera VC, Chapple M, Teixeira-Salmela LF & Hancock MJ (2016). Prevention of Low Back Pain: A Systematic Review and Meta-Analysis. JAMA Internal Medicine, 176 (2): 199-208.

Yang S, Kim K, and Park S (2015). The effect of thoracic spine mobilization and stabilization exercise on the muscular strength and flexibility of the trunk of chronic low back pain patients. Journal of Physical Therapy Science, 27 (3851-3854).