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Physical Therapy Exercises for Lower Back Pain

Introduction to Lower Back

The lumbar section, also known as the low back, is that part of the back that begins just under the ribcage. The lumbar spine, also known as the low back, is a complex network of interconnected bones, joints, nerves, ligaments, and muscles that all function together in order to provide stability, resilience, and endurance. However, because of its intricate nature, the low back is prone to damage and discomfort.

There are some issues that can arise if you live a sedentary lifestyle. A complaint with the lower back is one of the most serious problems, and it can be terribly painful.

The lower back carries the upper body's weight which allows for regular movements like bending and rotating. Low back muscles are in charge of flexing and spinning the hips when walking, as well as protecting the spine. The muscles in the pelvis, knees, and feet are supplied with stimulation and strength by nerves in the low back.

Causes of Lower Back Pain

The most common cause of severe low back pain is damage to the nerves, connective tissue, joints, or discs. The body also mobilizes an inflammation soothing reflex in response to injury. Although inflammation can seem to be mild, it may cause excruciating pain.

Spasms and injuries are caused by a variety of factors which cause lower back pain including:

  • Trying to lift a large weight or bending the spine while doing so are both dangerous
  • Jerking motions, such as a slip, put too much tension on the low back
  • A bad posture for prolonged period of time
  • Sports accidents, particularly those involving twist or massive forces of impact, are common.

Chronic pain is described as pain that lasts more than three months and outlasts the body's natural process of healing. A disc problem, a joint problem, and/or an aggravated nerve root are also common causes of chronic low back pain. Among the most common reasons are:

  • Herniated disc in the lumbar area. As proteins from the herniated part of the disc enter a nerve root, they cause inflammation, which, along with nerve compression, triggers nerve root pain. Nerve fibers abound in the disc surface, and a break in the wall will result in excruciating pain.
     
  • Degenerative disc disease. Intervertebral discs are full of water and at their healthiest when you are born. Discs lose hydration and break down as people get older. If the disc lacks hydration, it becomes less able to withstand pressures and passes force to the disc wall, which can cause tears and discomfort, as well as fracturing, which can lead to a herniation. The disc can also collapse, resulting in stenosis.
     
  • Dysfunction of the facet joints. Each motion section in the lumbar spine has two facet joints behind each disc. These joints are surrounded by a capsular connective tissue that is densely perforated by nerves which provide cartilage between the bones. These joints can be sore on their own or when they're combined with disc pain.
     
  • Spinal Stenosis. This disease induces damage by narrowing the spinal canal, which comprises the nerve roots. The narrowing of the lower back may be primary, forminal, or both, and it can occur at a single or multiple stages.
     
  • Osteoarthritis. The disc and facet joints wear out with time, resulting in this condition. It may occur at a single level or several levels of the lower spine, causing discomfort, irritation, instability, and stenosis of varying degrees. Spinal osteoarthritis is a slow-progressing condition that is linked to ageing. Spondylosis, or degenerative joint disorder, is another name for it.
     
  • Trauma. Acute spine injuries or dislocations may cause pain. Lower back pain that occurs following a traumatic event, such as a car crash or a fall, should be evaluated by a doctor.

Symptoms of Lower Back Pain

An ache or stiffness somewhere in the back, and occasionally all the way down to the buttocks and thighs, is the most common symptom of lower back pain. Your reflexes and reactions to certain stimuli can also be tested by your doctor. This decides how your nerves are being affected by your low back pain.

When you have alarming or incapacitating signs or neurologic loss, the doctor will most likely keep an eye on your health for a few weeks before recommending testing. This is because the majority of low back pain can be treated with basic self-care techniques.

Certain signs necessitate further investigation, such as:

  • loss of bowel regulation
  • weakening of the immune system
  • fever
  • weight loss

Your doctor can order imaging tests such as X-rays, CT scans, ultrasounds, and MRIs to search for:

  • problems with the bones
  • problems with the disc
  • problems of the back's ligaments and tendons

Physical Therapy Exercises to Reduce Lower Back Pain

According to a research “A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain”, physical exercise is typically used with a low back pain treatment plan. Most people with back problems find that performing certain movement’s helps them feel better.

Lower back pain exercises will help you improve your back, abdominal, and leg muscles. They provide back pain relief by supporting the spine. Before engaging in some back-pain-relieving workout, consult the doctor. Any workouts cannot be recommended or even dangerous depending on the cause and severity of the discomfort.

Some people like to sit (their back and hips are flexed). Others are most comfortable standing (back and hips are extended). Exercises to help you get into a more relaxed posture are normally more effective at managing back pain.

Most physical therapy treatments for low back pain and any radicular pain (pain that radiates down the leg) will involve a variation of the exercises mentioned below (Exercise in the Management of Chronic Back Pain):

Following are the exercises by which you can reduced lower Back pain.

  • Stretching.
  • Exercises for dynamic stabilization
  • Core strengthening exercises
  • Sit-ups, crunches, abdominal devices, and leg lifts
  • Lower back exercises (hyperextensions)
  • Good-mornings Exercise 
  • Moderate aerobic exercise
  1. Stretching.
    Stretching exercise for abck pain relief
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    Stretching and vigorous movement can help preserve normal range of motion and provide relaxation for muscles that are prone to disuse atrophy (muscle shrinkage due to lack usability) or spasm as a result of poor posture or nerve discomfort. Low back pain patients should stretch their lower back muscles, stomach muscles, hips, and legs as a general rule. During stretching, the patient should never jump, and all stretches should be steady and deliberate.

  2. Exercises for dynamic stabilization.
    Exercises for dynamic stabilization
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    These exercises may include the use of exercise balls, balance machines, or certain stabilization exercises. Dynamic stability exercises are designed to reinforce the secondary muscles of the spine and aid in the support of the spine across a variety of ranges of motion.

  3. Core strengthening exercises.
    Core strengthening exercises
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    According to a research “Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial”, these are movements specifically designed to reinforce the abdominal and low back muscles (erector spinae) in order to create the specified 'chain of muscle' across the spine. The following are examples of standard exercises:
  • Sit-ups, crunches, abdominal, and leg lifts:

    Source


    These are one of the examples of specific abdominal strengthening exercises that can reduce lower back pain. 
     
  • Lower back exercises (hyperextensions) 
    hyperextensions
    These can be done by using any equipment or simply by laying down on your stomach and gently lifting your chest off the ground. The lower back muscles are used to 'hyperextend' the spine in this workout.
     
  • Good-mornings exercise: 
    Good mornings exercise 
    Source

    These are also a lower-back muscle-strengthening workout. The patient must stand with his or her legs straight and shoulder wide apart, with a metal pole or weighted bar over his or her shoulders. The patient then raises back up by slowly bending over so his forehead is parallel to the surface. It's close to just leaning to meet your toes, only there's more weight on one hand.
     
  • Moderate aerobic exercise:
    Moderate aerobic exercise
    Source

    Improves blood supply and promotes injury recovery without jarring the spine. Stationary bikes, elliptical or step machines, swimming, and water exercise are also examples of low-impact aerobics. People with low back pain who exercise daily have less recurring pain episodes and are more likely to remain active and functional while their pain flares up.

Don't push yourself to work out despite the pain

A research “Diagnosis and treatment of low back pain” states that  pressing into an uncomfortable position will result in further tissue damage as well as exacerbate existing damage. If the exercises are hurting you, researchers recommends focusing on stabilization exercises and planks. Perform 3 to 5 repetitions of 10- to 20-second stays.

Don't just lay on the bed

It's easy to lie down before the pain goes away, but the National Institutes of Health warns that staying in bed for longer than a day or two will make the back pain symptoms worse. When you're just starting to feel a bit better, simple activities are best. Walking is an ideal way to begin. At a gentle speed, walk for 10 to 15 minutes twice a day.

Don't forget to warm up your body

Many back pain problems arise as we apply pressure to the spine without first warming up your body. Perform any basic stretches before trying tasks such as strength drills or gardening. Warm up for 5 to 10 minutes with a low-level aerobic workout before any workout (for example walking). This increases blood flow and can help you prevent injuries or worsened back problems in the long run.

Don’t lift large and heavy objects or engage in high-impact moves

According to Ian Armstrong, MD, founder and medical director of the Southern California Spine Institute in Westlake Village, CA, pain-causing movements should be avoided at or directly after exercise. Mild muscular pain and swelling occurring in 24 to 48 hours after an exercise is common and can subside on its own. Replace them for low-impact exercises like cycling or using an elliptical machine or a recumbent static bicycle.

Avoid lifting weights overhead or on the shoulders

Shoulder pressures and other overhead lifting moves put a strain on the spine and can be avoided if you're suffering from back pain. The strain on the spinal discs increases as you lift weights overhead. Exercising with a weight on the shoulders, such as weighted squats, is also a big no.

Exercising on the ground isn't the only choice.

According to a study published in the journal Clinical Rehabilitation, water aerobics and other pool exercises can help you get back on your pain faster (The effect of aquatic exercise program on low-back pain disability in obese women).

When in a research, 49 sedentary patients with severe low back pain were randomly assigned to either aquatic exercise or no sport, people in the pool programme improved further. It's a great low-impact aerobic workout that won't strain your back (Aquatic therapy improves pain, disability, quality of life, body composition and fitness in sedentary adults with chronic low back pain. A controlled clinical trial).

Don't dismiss the pain.

Most back pain problems are self-limiting, meaning that if you don't aggravate them, they'll go away in a matter of days or weeks. If the pain does not go down on its own, don't neglect it and keep working out. This could result into more damage.

Furthermore, excessive exercise may only serve to exacerbate the movement patterns that contributed to your back pain in the first place. So reconsider the back workout you're doing. Is it a little too strenuous? Is it possible that the motions are exacerbating the back problems? When these problems are resolved, chronic pain should go away. If it doesn't, consult a physician.



Conclusion

Regular exercise aids in the development of stamina and the management of body weight. Low-impact physical exercises that are guided will help to improve heart function without straining or jerking the back. In patients with non-specific low back pain, core stabilization exercise is more effective than normal physical therapy exercise in terms of pain relief. Exercise is useful for low back pain, although not all workouts are.

When muscles get stronger, any slight pain feeling at the start of these exercises can fade away. Patients should avoid exercising and call a doctor if discomfort is more than moderate and lasts longer than 15 minutes after exercise. Any workouts can make pain worse. Elderly and disabled patients who lack the strength to perform any of the exercises outside of the aquatic pool can benefit greatly from aquatic therapy.