Low back pain (LBP/sciatica) is a very painful and debilitating condition and is the single most common thing I see in practice every day. The following facts show just how seriously we should take this!
- Low back pain affects 80% of the population
- 84% chance of recurrence within one year!
- Close links with low back pain and neck pain (15 fold increased risk of neck pain)
- 50-80% recover within 4-6 weeks
- This is not uncommon – it may feel absolutely terrible and disabling but as long as you follow my recommendations below you have a good chance of recovering!
In most cases the majority of low back pain is not serious. What a lot of health professionals do not tell their patients is that 85% of low back pain is categorized as “Non-specific low back pain”. This means the pain and disability does not have a definitive cause or diagnosis. This non specific LBP is what we will be talking about today and I will be giving you the information and exercises to get you walking right and up straight again. Because 50-80% of people recover in 6 weeks the usual advice is to take painkillers and keep active – but the thing is there is more you can do! The period when the pain subsides is the critical time when you need to be actively rehabbing yourself in order to be one of the 16% that do not have multiple other flare ups and end up with back pain as part of your life!
First I need to say, yes there is the remaining 15% of back pain that is specific and does have a diagnosis so it is important to have these ruled out – especially if the pain is not improving.
Below I am going to outline a guideline for getting your back to the best it can be when you experience acute low back pain.
Phase 1. Initial inflammatory phase: This is the stage where most likely it is uncomfortable to walk, bend over etc and you just want to curl up in a ball and stay there (that will not help!). In this phase you need to abide by the Tips below:
- Number one rule is to keep moving, within reason. This prevents the structures around the spine such as the muscles in spasm from stiffening up too much. This is also very important in order to decrease loss of stabilizing muscle activity. Now you don’t need to continuously keep moving – just don’t stay in one position for a long period (more than 20 minutes). Bed rest is one of the worst things for back pain (The opposite of what they were telling everyone 20 years ago.)
- Gentle range of motion exercise: knee rocker – Lying on your back with your knees bent up and feet on the ground – slowly let your knees drop to one side, and then the other. This is a gentle exercise and not to be forced or pushed into pain. Little and often throughout the day.
- Safe sleeping position: the best position is in side lying with you knees bent up a little and a pillow between the knees. This position decrease the forces on the spine and allows muscles to relax.
- If you must sleep on your back then have a pillow under your knees to unload the spine.
- Stretch to straighten up: when in back pain your hip flexors tighten up and put a shear force through your spine and causes you to have a bent over, shuffling posture.
Tip: to get a good stretch “tuck your bum in” or draw your front hip bones towards the roof. You should feel it in the front of your thigh or hip.
Hold for 1 minute.
Phase 2. Recovery: In this phase the main things causing stiffness and pain are muscles that are tight and in spasm in your hips, gluts and low back.
- Glut stretch: To get into the below stretch, start in four point kneeling and bring one knee forward between your hands. then extend you other leg out behind you and across to the other side. Lean forward in this until you feel a stretch in your glut region. To add more of a stretch, walk your hands out in front of you. Hold for 1 minute each side
- Hip flexor stretch: as above in phase 1
- Bird-dog exercise: In four point kneeling slowly raise one arm and leg on opposite sides, making sure to keep your back straight (imagine your dinner is sitting on your hips – it is all about control). Lower down in a controlled manner and repeat, 10 times each side twice.
Beginners: Start by raising one leg only.
- Bridge, level one:
START POSITION: Lying on your back with your knees bent.
Stabilization: Tighten abdominals.
Squeeze your buttocks together and lift buttocks off the floor until your body is aligned. Hold for 5 seconds and then lower down. repeat 10 times twice.
Phase 3: Strengthening and back stability – and maintain!
To do this make it a routine to do my top five LBP exercises daily.
Maintaining core stability is important in preventing flare ups and ensuring you at your best if flare ups do happen, to speed up recovery.
Thanks for reading and remember looking after your back is ALWAYS important, not just when it is sore.