Lower back pain is one of the most common reasons for people to see either a physician or a physical therapist. In a 1 year time span, about 65% of the population will experience back pain at least once and between 70-84% of people will experience lower back pain at some point in their life. That’s a fairly high number and, as I’m sure some of you know, back pain is not an easy thing to deal with. Pain can range from mild, low-level chronic annoyance to an extremely debilitating, exhausting pain that disrupts your ability to perform normal tasks.

On the bright side, for acute pain (pain lasting <3 months), the majority of people have complete recovery of their symptoms within a year of diagnosis. But the recurrence rate of low back pain can range between 64-84% within 1-3 years. This means that almost all of us will be dealing with some form of lower back pain on/off throughout our lifespan, which is fairly normal.

Now the question that most of us are asking, if it’s “normal” to be dealing with lower back pain at times, how do I make it so that it’s not as debilitating or disruptive to my day to day activities?

That’s a great question. I always phrase it to my clients that physical therapy should not be viewed as a “fix” for lower back pain. It should be viewed as a way to help teach you strategies, tools, and exercises that you can perform to help you manage your symptoms whenever the need arises. And this varies a lot from person to person. For some, performance is daily to help prevent symptoms from occurring. For others, those strategies need only be employed on an as-needed basis when they have an acute bout of lower back pain.

Now, let’s get into the real reason you’re here and talk about exercise. In general, the research on lower back pain shows that there is no consensus on the BEST type of exercise but all signs point to movement! Whether that be a walking program, swimming, strengthening, pilates, yoga, tai chi, you name it. It’s all beneficial for the lower back to help reduce pain and disability. For those with more chronic lower back pain (>3 months duration), a recent literature review done by The Journal of Orthopedics and Sports Physical Therapy (2022) found “The most effective interventions for reducing pain were Pilates, mind-body, and core-based exercises. The most effective interventions for reducing disability were Pilates, strength, and core-based exercises.”

 

In the acute phases of lower back pain however, the focus of exercise is typically on improving range of motion and reducing tissue irritability. This helps to reduce muscle tension, improve joint mobility, and reduce inflammation. This allows you to be able to get back to more challenging activities that will improve your strength and muscle endurance such as those mentioned above. There are a ton of different range of motion exercises out there but I’m going to direct you on four quick and easy ones that I typically give to most of my patients with lower back pain to get them started.

 

1. Single Knee to Chest

Begin lying on your back with your legs bent and feet resting on the ground. Place your hands around one thigh, then slowly pull your knee toward your chest until you feel a gentle stretch in your lower back. Hold for 1-2 seconds, then release and perform on your other side. Alternate side to side for 10-20 repetitions.

 

2. Lower Trunk Rotation

Begin lying on your back with your knees bent and feet resting on the floor. Keeping your back flat, slowly rotate your knees down towards the floor until you feel a stretch in your trunk. Hold for 1-2 seconds, then release and perform on your other side. Make sure that your shoulders stay in contact with the floor. Alternate side to side for 10-20 repetitions.

 

3. Cat/Cow (or Cat/Camel as some refer to it)

Begin on all fours with your arms directly under your shoulders and knees bent 90 degrees. Slowly round your back up toward the ceiling, then let it sag down to the floor while looking up, and repeat. Alternate back and forth for 10-20 repetitions.

 

4. Quadruped Sidebending

Begin on your hands and knees with your spine in a neutral position. Bend your spine to the right, then to the left, as if you are trying to make your shoulder and hip touch on each side. Sometimes I’ll cue people to “try to look at your shoe on that side”. Repeat, alternating left and right for 10-20 repetitions.

 

If you’re dealing with lower back pain, please feel free to try out some of these exercises but don’t hesitate to give us a call. We are not all created equal and sometimes you might need a slightly more tailored approach. We are here to help you feel good again!

 

 

Written by: Rachael Wheeler, DPT, OCS