Low Back Pain

Lower back pain is a common condition that affects about 80% of the population. Pain may vary from a dull aching to a sharp shooting pain. The onset of pain may be sudden or acute.

Lower back pain can occur from lifting a heavy object, following a sports injury, or could result from prolonged or repeated stress on the lower back. It may also result from trauma, wear-and-tear due to increased age, inactivity, poor posture or tumors. Some conditions can also lead to back pain:

  • Sprain or strain of the muscles of the lower back
  • Degeneration (arthritis) or inflammation (spondylitis) of the joints between the vertebral bones
  • Degeneration, rupture or herniation of the intervertebral discs
  • Slipping of a vertebral bone out of position (spondylolisthesis)
  • Thickening of the ligaments that connect the vertebral bones (spinal stenosis)

Most of these conditions cause pain by compressing spinal nerves that pass through and exit from the spine in the lower back. Lower back pain may sometimes be accompanied by pain, numbness or weakness in the legs.

Most cases of lower back pain resolve with time, but if it lasts for more than 3 months, it is considered chronic. You should visit your doctor if your lower back pain is severe or lasts more than 72 hours.

Exercise is necessary to keep the lower back healthy. It can also alleviate back pain and prevent future episodes. A good exercise program for lower back pain should focus on the back, stomach and leg muscles as they play a part in stabilizing the spine during various movements. Before starting any exercise program for lower back pain, it is necessary to consult a doctor, as some exercises can stress your back muscles and are best avoided.

Exercises for back pain

Some of the exercises that are good for relieving back pain include:

  • Hamstring stretches:Lie down on your back and lift one leg up with the knee bent. Loop a towel under your foot and straighten the bent knee, while pulling on the towel. Hold for 15 to 30 seconds, feeling the stretch in the back of your leg.
  • Partial crunches:While lying on your back, keep your knees bent with your feet on the floor. Exhale as you raise your shoulders off the floor. Hold for a second then repeat the movement about 8-12 times. Use your stomach muscles instead of your hands to pull yourself up.
  • Bottom to heels stretch:Kneel on all fours and lower your buttocks to your heels. Hold the stretch for a deep breath then return to the initial position.
  • Knee rolls:Lie on your back with a small rest under your head and your knees bent. Keeping both your shoulders on the floor and your knees together, roll your hips to the side, lowering both knees down, breathing deeply. Perform the same movement on the other side. Repeat alternatively, 8-10 times.
  • Back extensions:Lie on your stomach while resting on your elbows and forearms on the ground. Push back and lift your shoulders off the ground, arching your back. Hold the stretch for 5-10 seconds before returning back to the ground. Repeat this movement 8-10 times.
  • Cardio exercises:Walking, biking and swimming also help alleviate lower back pain.
  • Pilates:This type of exercise involves strengthening, stretching and core abdominal exercises that can help with your back pain.

Mild discomfort may be felt at the start of an exercise, which usually disappears as you continue. If pain intensifies or persists longer than 15 minutes, you should stop and consult your doctor or physical therapist who will modify or suggest other exercises.

Exercises to avoid during back pain

Exercises involving lifting of both legs off the ground while lying on your back, full sit-ups and standing toe touches, put a lot of strain on your spinal discs and may aggravate lower back pain.

Low back pain can be disabling; however, most cases heal with time (2-12 weeks) and with conservative therapy. Surgery is suggested when symptoms persist and begin to affect daily activities. Low back surgery may be indicated for treating various underlying causes of back pain such as spinal fractures, degenerative disc disease, nerve compression, stenosis (narrowing of the spinal canal), tumors, infection, instability or bowel and bladder difficulties.

Surgery is usually suggested by your doctor once conservative measures have failed to relieve pain. In rare cases, such as cauda equina syndrome, where there is a high risk of developing permanent paralysis, or bowel and bladder difficulties, surgery may need to be performed on an emergency basis.

Some low back surgeries include:

  • Discectomy:The herniated soft interior of an intervertebral disc (spongy discs of tissue that cushion the bones in the spinal cord) is removed to release pressure on a compressed nerve.
  • Laminectomy:Bone and/or thickened tissue narrowing the spinal canal is removed to release pressure on a compressed nerve.
  • Spinal fusion:Spine movement is reduced by fusion of the vertebral segments.
  • Removalof spinal tumors
  • Debridement of the spine:Infected, abnormal or dead tissue is removed.

Many low back surgeries are performed through minimal invasive techniques to reduce pain and the hospital stay. Recovery after low back surgery may take 3-12 months. Physical therapy is recommended following surgery to improve flexibility, strengthen the back and stomach muscles, and help you return to your regular activities.