The majority of lower back pain exercises are created through therapy programs. These therapy programs are designed to treat not only low back pain, but also pain that radiates down the leg, medically acknowledged as radicular. These lower back pain exercises consist of a combination of practices of which we will we discuss in this article.

Stretching

StretchingThrough practising the correct stretching of the muscles along with active exercise will help the patient to maintain a normal range of motion. As well as this, it will provide a period of rest for the muscles that are suffering from disuse atrophy (shrinking of the muscles due to lack of use) or any muscles that are in spasm due to incorrect posture or through nerve irritation.

For the majority of patients, it’s best to follow a routine of stretching that has been designed specifically for them by a physiotherapist or a spine physician. Usually, patients that are suffering from lower back pain should focus on stretching the abdominal muscles, lower back muscles, hips, and legs.

The patient should not bounce during stretching, as well as this, stretching should be done slowly and gradually.

Dynamic stabilization exercises

Dynamic Stabilisation ExercisesThe main goal of dynamic stabilization exercises is to strengthen the secondary muscles of the spine; this is done through a variety of movements. Standard exercises usually include the use of exercise balls, balancing machines or particular stabilizing exercises.      

Core strengthening exercises

core strength exerciseIn order to build strength around the lower back region, it is necessary to work towards strengthening the abdominal muscles and lower back muscles, medically known as the erector spinae. This then leads to tightening the core region to build up what is referred to as the 'belt of muscle' around the spine which will provide support for the lower back.

These exercises usually include:

  • Exact abdominal strengthening, such as crunches, sit-ups, and leg raises and the use of abdominal machines.
  • Hyperextensions are low back exercises that can be performed on machines or by lying on the stomach whilst gradually raising the chest off the ground. This form of exercise uses the lower back muscles to 'hyperextend' the spine.
  • 'Good-mornings' these are a form of exercise that strengthen the lower back muscles. The patient will be required to stand with their legs straight and shoulders hip-width apart, holding a broom-stick or a weighted bar across the shoulder area. The patient is then required to bend forward slowly until their face is parallel to the floor and then rise back up. This is a similar movement to bending forwards and touching the toes, with the exception that the weight is distributed across the shoulders.

Physical Therapy for Lower Back Pain Relief

Different forms of physical therapy exercises may help with lower back pain relief. Aquatic water physical therapy water therapyHydro physiotherapy is also known as aquatic (water) physiotherapy. This type of therapy uses water to support the body and to minimize the effect of gravity, thus making it easier for patients to break into an exercise program.

Hydro physiotherapy is very useful for elderly and disabled patients who may not have the physical strength to practice some of the exercises outside the aquatic pool.

Lumbar traction

Lumbar traction involves a patient that lies on their back whilst being secured on certain table. At the foot end of the table is a cable that comes out and is attached to a strap that has been placed around the patient's hips.  

The cable is attached to weights that are placed at the foot-end of the table, and it is this that creates a continuous and mild pulling force on the hips toward the foot-end of the table. Lumbar TractionThe objective of traction is to unburden the space between the discs and muscles in the lumbar spine. This unburdening is to provide a period of rest which enables the muscles to rest and thus takes the pressure off the disc space. However, research that has been conducted on the efficiency of traction is controversial. Some studies have demonstrated that it adds value, whilst in opposition to this; other studies have shown that it is of little or no value for patients with low back pain.

When lower back exercises do not work

On some occasions, spine practitioners refer patients for physiotherapy and the patient’s then return to their GP stating that they have stopped the therapy because they felt that they were not getting ample lower back pain relief from the program.

Here is a list of reasons why on some rare occasions physiotherapy rehabilitation may not improve lower back pain:

The program does not involve active exercise
, if a patients physiotherapy program fails to include any form of exercise, and uses solely hot and cold packs along with stimulation therapy, it can sometimes provide some mild relief from the discomfort, but will not cure the problem. These forms of therapy work more effectively in combination with exercises

Patients failing to stick to the prescribed exercise program accordingly if a patient does not perform all of the prescribed exercises or does not set aside enough time to devote to the program it is unlikely to provide pain relief for the patient. Being consistent when performing these exercises is more likely to strengthen the back and help to maintain a better posture and stop recurring pain in the future.

Patients that do not keep up with exercise long term, it is best for patients to continue with the prescribed physical therapy exercises and/or a self-directed exercise program following the initial course of physical therapy. Typically, it is recommended that the patient maintain the basic core and dynamic stabilization exercises and slowly shift into a more extensive exercise program, including low impact aerobic exercise and specific weight-lifting exercises that will not load the spine.

Patients do the exercises incorrectly, patients may not have a clear understanding of how their exercises should be performed to bring about the needed benefits. If this is the case, then the patient may benefit from a more thorough explanation on how to perform the exercise by a spine specialist as well as guidance by a qualified physical therapist who could correct possible errors in exercise performance.

Often patients suffering from low back pain are treated successfully with physiotherapy only to discover a year or more later that their condition has returned. The majority of the time, during physiotherapy sessions, the patient strengthens their abdominal and lower back muscles, this then takes the stress off the lower back. However, after physiotherapy, the patient fails to continue with the abdominal and lower back exercise program at home, which leads to a steady loss of fitness in the trained muscles and subsequently low back pain ensues.

Therefore, it is suggested that once a patient is treated successfully with physiotherapy, he/she should create an exercise maintenance program at home in order to sustain the muscle mass and strength that was developed in the physiotherapy sessions.

The importance of lower back pain exercises

Failing to exercise and keep active can aggravate the pain Whilst pain in the lower back could put us off from exercising, a lack of exercise can aggravate the pain, causing stiffness and weakness. It is necessary to keep moving in order to ensure that the discs, muscles, ligaments, and joints are all kept healthy.

Keeping active through physical activity ensures that nutrients are distributed into the affected disk space and helps to keep it healthy. Significant immobility deprives the injured disc of the nourishment it needs, which can result in further deterioration and discomfort. Furthermore, through keeping active and exercising regularly ensures that the fluids in the spinal structures exchange accordingly and thus reduce swelling that occurs naturally in the tissues that surround the affected/injured disc.

Rehabilitation and Exercise can help with healing A natural method for the healing of the lower back is to exercise, but it must be done in a controlled, steady, and progressive way. Even though other forms of treatment such as injections and medication can help in the healing process, they are limited in what they can do.

Strengthening, stretching and Aerobic Exercises are significant in rehabilitation A rehabilitation program that is wide-ranging consisting of stretching, strengthening, and aerobic conditioning of the back and body are vital in recovering. Participating in stretching exercises help due to the fact that inactivity is usually accompanied with stiffness and by stretching out the lower back area you ensure that you are keeping active.

Often patients that are suffering from chronic pain find that it can take weeks or even months of stretching to mobilize the spine and soft tissues; however, they will find that by keeping active and increasing motion provides relief from back pain. Aerobic conditioning exercises are equally as important due to the fact that aerobically fit patients have fewer lapses of low back pain.  

As well as this, patients that are well-conditioned tend to be more likely to sustain their regular routine,  whereas in contrast to this,  patients that are suffering from chronic low back pain, that do not work on aerobic conditioning, are more likely to lose their capability to perform daily activities over time.

Managing Anxiety about Exercising

Whilst it is normal to feel worried about exercising, it is equally as important to manage your anxiety and fear of injuring yourself again; this is in order to regain normal muscle function. The foundation for feeling apprehension about lower back pain lies in the central nervous system, and this responds to pain by instructing the muscles that are based around the affected area to protect against additional injury. Therefore, only the correct physical training that makes the muscles recover their function can overcome this neurological barrier.

Visit a fully trained and accredited Health Professional for Rehabilitation

It is recommended, for all forms of exercise, to seek the advice of a trained and licensed spine specialist, such as a physiotherapist, occupational therapist, doctor or chiropractic. However, the patient and exercise program will differ significantly depending upon your diagnosis and level of pain. Spine specialists are fully trained to develop a suitable rehabilitation program and provide instruction on correct technique and form. 

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