Lower Back Pain

CAUSES OF LOWER BACK PAIN

A lot has been said about low back pain already and it is, together with neck problems, the most common problem or issue we see at Physio K. ​ The low back is a complex structure consisting of vertebrae, intervertebral joints, ligaments, muscles, nerves and discs. Most people with low back pain will have an issue with a few different structures together (e.g. tight muscle and a joint not moving well, or a disc issue with a muscle spasm). ​ In younger people, it is more common to have a joint that’s ‘stuck’ (meaning, not moving anymore) and muscle or fascia tightness. More progressed back issues will involve the discs and sometimes some nerve irritation as well. ​ Check the link to know more about disc issues in the lower back or sciatica. ​ "Physiotherapy can help with movement related issues in the low back. It can help reduce your pain and get you back to normal mobility. "

LOWER BACK PAIN TREATMENT

Early intervention will significantly reduce the length of treatment necessary to relieve your symptoms. If your problem is chronic: don’t worry, physiotherapy can still help. You will just require longer and different treatment. ​ In most cases, you do not need surgery! A combination of manual therapy, exercise prescription, dry needling and or visceral manipulation can ease your back pain and can get you back to your normal activities. ​

Watch a series of exercises made for lower back pain:

Lower back exercises

In the above video, Kenny from Physio K is showing an exercise program for people with lower back pain, tailored for people who have disc issues or sciatic nerve problems. Numbness in the bum or further down the leg or the feeling of pins and needles could be an indication of this problem.

1. Cat cow exercise.

On your hands and knees, in all four position, making sure that your hips are above your knees and your hands are underneath your shoulders. Try to tilt your pelvis forward and backwards. We're going to focus on the lower back, imagining tucking a tail in between your legs and then putting your tail up in the air. The curved up position is a bit like how a cat is rounding its back and the opposite, curved down position, is similar to the position of a cow. Make sure you stay mid range, don’t push all the way up or down if you have disc issues or sciatic nerve irritation. Do this for about a minute: 20 to 30 times and if possible multiple times a day.

2. McKenzie extension exercise

Laying on your tummy on a mat on the floor and putting your elbows underneath your shoulders (sphinx pose). Try to extend your lower back and look up with your head. You'll have a little bit of compression in the lower back which is great for your disc and you can also feel a little bit of stretch in the front so that's why you have to look up to have the maximum amount of stretch in the front.

Stay in that position for 20 - 25 seconds and go down again. Do that four to five times in a row. If this is too easy for you then you can go to the next step, which is trying to extend your elbows. Put your hands underneath your shoulders, extend your elbows totally and try to relax in your back and look up.

3. Stretch of the Piriformis

Laying on your back on a mat, pull up one leg and grab your knee with one hand and grab your heel with your other hand. The purpose is to try and pull your knee towards your opposite shoulder and make sure you leave your head relaxed on the table. You should feel a deep stretch under your glutes. The piriformis is a muscle that's laying in the pelvis, underneath your glutes. That's a very important muscle for your nerve health. If you have any kind of nerve issues make sure you do that stretch. Hold this position for 20 to 25 seconds, relax, do that four or five times in a row. Make sure you have a straight angle in your knee which is 90 degrees and pull across

4. Nerve glider

Laying on your back on a mat with your knees bent and feet flat on the floor. If the problem is on the right side, then you'll do the exercise with your right leg. Put your right knee on top of your left knee and then, in this position, relax your foot and try to extend your right knee up and down. Don't hold, don't try to stretch, we're trying to get a glide in the nerve. This is a good stand alone exercise, or could be used as a warm up. The next step is the same thing but at the same time, pull your toes towards your nose while you extend the knee and then go down again, leaving your knee on top of the other one. Try to do 20 to 30 repetitions each, a few times per day. ​ ​

Lower back mobility exercises

In the above video, Anthony from Physio K runs you through a couple of exercises to improve your lower back pain.

1. Lumbar rocking

Laying on your back, preferably on a mat, you're going to gently bring your knees up towards your chest, wrapping your hands around and grabbing onto the front of your knees.

Now gently pulling those up closer towards your chest and letting them back out again. When you're doing this exercise, it's important to remember to relax your chest, relax your core and relax your legs. The only thing that should be doing the movement is your arms.

Do this for about two minutes and three times a day.

2. Lumbar rotations

Laying on your back, you're just going to rock your knees gently from side to side, keeping your shoulders firmly pressed against the ground as you do so. It's important to remember with these ones to do them for two minutes and three times a day.

3. Cobra into child's pose stretch

You start off on your hands and knees and start by rocking your hips down towards the floor, holding for about five to ten seconds and then coming back up again and going down into child's pose, holding for 30 seconds.

We recommend repeating these three times for each one of these exercises and we're looking at doing them three times a day.

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Lower back exercises | Progression

In the above video, Anthony from Physio K runs you through a couple of lower back exercises that are really good if you're having pain or stiffness in that area. They are a progression of the previous exercise video, which you can find here

1. The crucifix

Laying down on a mat on the floor, you're going to start off with both of your hands out towards your side, and straighten your left leg to start off with. Bring your right one straight across, and then rock back doing the same thing the other way, straightening that outside leg and going straight over the other side. Try to do this one about 10 times each side.

2. Glute bridge

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Laying on your back on a mat on the floor, you're going to have both of your knees bent; roughly your feet are going to be placed about shoulder width apart and then you're going to push down through your heels lifting your hips up off the ground making one straight line from your knees all the way through to your shoulders, and then coming back down again.

If this exercise is too easy for you to start off with, you can do it single leg, so you're going to go up with both of your legs, straighten out your left one and hold straight up and slowly bring your hips back down again.

If that again is too easy for you, we're going to have you hold 1 leg up pushing down through the heels again, lifting your hips straight up, remembering to make a straight line from your knees all the way through to your shoulders the entire time.

For this exercise, we generally recommend about three sets of ten, as it is a really good strengthening exercise for the glutes, but also a really good lower back mobilisation exercise.

3. Dead bug

Laying on a mat on the floor, you’ll start off with both of your knees bent up about 90 degrees, and raise both of your hands straight up pointing directly towards the roof. As you do this exercise, you're going to lower one hand and the opposite leg at the same time and then coming back up towards the top, interchanging them, so it's important to remember whilst you're doing this exercise: you always want to have your legs at a 90 degree angle or a perpendicular angle with the body

4. The bird dog

On your hands and knees, you're going to raise your right hand with your left leg at the same time. Now when you're doing this, it's important to remain stable through the hips and through the core, and try to avoid any rotational movement. Try to maintain a straight line straight through the back and pelvis.

For both of these last exercises, we're going to have you do them for about three sets of 10 reps.