If there is one ailment that almost everyone can identify with, it’s lower back pain. A 2007 study in the journal Neurologic Clinics found that up to 80% of the population will experience back pain at some point in their lives.
Doctors field more complaints about aching backs than just about any other health problem — and it’s no wonder. Nearly 65 million Americans report suffering back pain at any given moment, says Georgetown University’s Health Policy Institute. About 16 million adults, or 8% of the adult population, have persistent or chronic back pain that limits everyday activities.
As a result of all these backaches, back pain is a leading cause of work-loss days, resulting in more than 264 million lost workdays in one year, says the American Chiropractic Association. That’s equal to two workdays for every full-time worker in the country. A 2016 analysis by the Journal of the American Medical Association found that low back and neck pain accounted for the third highest amount of health care spending in the U.S. at $87.6 billion.
Yet, even though back pain often makes the thought of moving at all dreadful, exercise is perhaps the best thing one can do to treat it. “Patients with low back pain are encouraged to stay active, and for most back pain, exercise does not cause any harm, even if it’s somewhat painful at first,” says Eric Robertson, doctor of physical therapy, clinical specialist in orthopedic physical therapy and associate professor of clinical physical therapy at the University of Utah and University of Southern California.
In fact, the worst thing one can do for back pain is nothing at all. “Bed rest has been shown to lead to poor outcomes with back pain, as has avoiding daily activities and work,” Robertson says. “Our bodies prefer moving, even when our backs hurt.”
What Causes Lower Back Pain
Back pain can take many forms, the National Institutes of Health reports, from a dull, constant ache to a sudden sharp or shooting pain. It can start after an accident, from lifting a heavy object, twisting wrong, working out too hard or simply from growing older.
The NIH describes two types of back pain.
— Acute: short-term back pain that lasts a few days to a few weeks. Most low back pain is acute. It often gets better on its own within a few days or weeks.
— Chronic: pain that continues for 12 weeks or longer, even after the cause of acute low back pain has been treated. About 20% of people see their acute low back pain progress to chronic low back pain, with symptoms one year later.
Most back pain occurs in the lower back, defined as the five vertebrae in the lumbar region of the spine. It is usually caused by a mechanical breakdown in the structures of the lower back, including the discs, muscles and nerves that make up the spine. The NIH says mechanical breakdowns can be related to:
— Skeletal irregularities such as scoliosis (a curvature of the spine), lordosis (an abnormally exaggerated arch in the lower back), kyphosis (excessive outward arch of the spine) and other congenital anomalies of the spine.
— Spina bifida.
— Sprains, strains and spasms.
— Injury from playing sports, car accidents, a fall or other trauma.
— Degenerative problems such as disc and spinal degeneration, arthritis or other inflammatory diseases.
— Spinal stenosis.
However, Robertson adds, “Low back pain is complex and multifactorial in nature, and while some causes of low back pain relate to bone or joint problems, up to 90% of low back pain is referred to as nonspecific, meaning it’s not possible to pin down a specific cause.”
The good news, he says, is that because these cases of nonspecific back pain often do not need specific medical treatments, “clinicians like physical therapists rely on an individualized assessment of strength, flexibility and movement to determine a treatment plan.” And that means exercise.
[READ: Tips for Managing Back Pain.]
Exercises for Low Back Pain
Walking, as simple as it is, is a phenomenal exercise for low back pain, Robertson says. General stretching and mobility exercises can also be beneficial. “Some patients with back pain prefer exercises that promote flexion to reduce their pain, patients with spinal stenosis for example. Other patients with low back pain find that exercises that promote extension are more beneficial,” he says.
Below are eight specific exercises that may help with low back pain, from the American Physical Therapy Association’s consumer website ChoosePT.com. (Robertson is a spokesperson for the APTA.) Some are easier, for beginners, and some are more advanced. Do as many as feel comfortable. However, talk to your doctor before starting any new exercise to be sure it is safe for you.
— Stand straight with your feet hip-width apart.
— Lower your buttocks down and backward, as if you beginning to sit in a chair. Stop when your knees reach about a 90-degree angle. Try not to lean forward more than a few inches. For balance, you can move your arms forward stand next to a wall, counter or other support.
— Straighten your legs to stand upright. Build slowly until you can do sets of 10.
Bridge Exercise for Hip Extensors (Easy)
— Lie on your back with knees bent, feet flat on the floor and hands palm-side down at your side.
— Press into the floor from your hips through your feet and lift your buttocks. Count out loud one-two to get to this bridge position.
— Hold this position for five seconds, then count one-two-three-four as you return to the starting position. It should take you longer to return to your starting position than to get to your bridge position. Control is important.
— Repeat as many times as you can depending on your fitness level.
Standing Hip Abductor Exercise (Easy)
— Stand upright, facing a counter or a sturdy piece of furniture for balance or stability, if needed.
— Standing upright, lift your leg up and out to the side (counting one-two). Do not lean. Let your leg do the work.
— Hold this position for 15 seconds, then lower your leg to the starting position. Repeat as many times as you feel matches your fitness level.
— Repeat on the other side.
Standing Wall Abductor Exercise (Easy)
— Stand upright — keep good posture — with your left shoulder touching a wall. Then bend your left knee.
— Push your bent left knee toward or into the wall without letting your body move.
— You should feel the muscles of both hips work. The muscles of one hip will work to push you against the wall, and the muscles of the other work to keep you in an upright position.
— Hold this position for 15 seconds. Repeat as many times as you feel comfortable for your fitness level.
— Repeat on the other, right side.
Sit-to-Stand Exercise for Quad Strength (Easy)
— Sit on the front half of a stable, heavy chair that will not tip over backward, or place the back of a lighter chair against a wall.
— Stand up using a one-two count.
— Slowly lower yourself back down into a sitting position using a one-two-three-four count. It should take you longer to return to your seated position. Controlled movement is important. Do not plop down onto the seat. Repeat as many times as you can for your fitness level.
Pelvic Tilts for Abdominal Strength (Easy)
— Lie on your back with your legs straight out in front of you.
— Pull your navel inward and down toward your spine, and flatten or press your lower back against the floor.
— Hold for 15 seconds. Repeat as many times as you feel matches your fitness level.
Side-Lying Leg Lift for Hip Abductors (Advanced)
— Lie on your side with the bottom leg bent. Roll your hips forward about 30 degrees.
— Lift your upper leg slowly to the count of one-two.
— Then, slowly return your leg to the start position with a count of one-two-three-four. Remember that control is important.
— Repeat as many times as you feel matches your fitness level.
Back-Lying Abdominal Exercises (Advanced)
— Lie on your back with your hips and knees bent to 90 degrees and your feet off the floor.
— Pull your navel inward and down toward your spine, and flatten your lower back against the floor.
— Slowly extend your legs out until you feel your pelvis start to rock forward. When you feel this, bring your knees back toward you by about 1/8 to a 1/4 inch.
— Hold this position for 15 seconds, making sure to count out loud, so you do not hold your breath.
— To release, bring your knees toward the chest, then lower your feet to the floor.
— Repeat as many times as you feel matches your fitness level.
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