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Lower back pain is extremely common – estimated to affect more than half of the adult population annually with more than 10% experiencing frequent episodes. Recurrent lower back pain can be extremely frustrating but there are a number of things you can do to speed up your recovery and bring relief to your lower back pain.
1) Active rest
One of the most important things to do after injury is to keep mobile. Movement is key for proper healing and has been shown to:
- Accelerate tendon, ligament, muscle and bone healing.
- Increase strength of recovering tissues.
- Induce more rapid and intensive blood vessel growth into the injured area leading to enhanced blood flow and improved healing.
However, excessive or uncontrolled movement will disrupt tissue repair and may cause further damage. We need to limit the strain on the lower back enough to reduce pain and sensitivty but keep it moving sufficiently to encourage proper healing = active rest. The intensity of movement must be scaled according to the type, degree and stage of injury. The sections below details how to safely introduce movement in cases of acute lower back pain.
NB: In some severe cases, a day or two of rest may be warranted. However, movement and loading should still be performed as soon as possible but this should never result in an increase in pain.
Particularly important for lower back recovery is minimising sitting time. A good rule of thumb is not to sit for more than 20-30 minutes without getting up. With severe back injuries you may want to get up even more regularly this this. Microbreaks are a perfect way to break up periods of sitting and get the low back moving again.
For more information on creating a healthy, movement friendly, workspace take a look at the Ergonomic Solution eBook.
Walking is an easy and convenient form of active rest. It is safe and generally well tolerated even for those with acute lower back pain and is therefore a useful tool for lower back pain recovery. In order not to overload the back try to get out for a few short walks throughout the day rather than one long walk.
Your walking posture is also important. Walking slumped, with short strides and not swinging your arms will lead to more load on your spine and possibly exacerbate pain. Instead, walk with a tall posture, at a brisk but comfortable pace, swinging your arms from your shoulders.
Specific exercises can also be incorporated to help safely mobilise the spine and hips.
The cat camel is a great way to gently move the spine but with very low load making it extremely safe. Most low back pain patients, even those with severe pain, are able to perform the cat camel immediately. To perform:
- Start on all fours.
- Slowly move from position (A) to position (B) moving the whole spine including the neck but only go as far as you can pain free.
- Perform 8-12 reps as often as once per hour.
Restriction in the hips is a common problem for low back pain sufferers. Gentle stretching exercises can help improve hip mobility unloading the lower back and reducing pain:
- Lie on your back with one foot against a wall with the knee bent at 90° (see image).
- Cross your other foot onto your knee and use both hands to gently pull that knee towards your opposite shoulder.
- You should feel the stretch in the back of the hip being pulled. You should not feel pain, discomfort or tightness in the lower back.
- Hold this position for up to 2 minutes and repeat 2-5 times a day.
- Common mistakes
- Holding your breath.
- Rounding your lower back (if needed, you can place a small cushion or folded towel in the small of your back to prevent it rounding).
- Kneel in a lunge position with your spine upright but without overextending through the lower back. If your lower back is over-arching, hinge forward slightly from the hips.
- Tilt your pelvis backwards (without squeezing your buttocks) until you start to feel a slight pull in the front of your thigh
- If needed, gently push your thigh forwards to increase the stretch.
- You should feel the stretch in the front of the rear thigh. You should not feel pain, discomfort or tightness in the lower back.
- Hold for up to 2 minutes and repeat 2-5 times a day.
- This can also be performed in a standing position.
- Common mistakes
- Not tilting the pelvis backwards
- Over-extending the lower back.
- Squeezing your gluts or stomach
- Holding your breath
- Active rest is key for complete healing and recovery from lower back pain.
- Walking is an easy, conveinent way to keep the spine moving and is well tolerated by most lower back patients.
- Specific exercises such as the cat camel, lunge and figure four stretches can be added to your active rest protocol.
Look out for upcoming posts on other strategies to enhance lower back pain relief and recovery.
Liebenson. C., Journal of Bodywork and Movement Therapies
This post was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey, Channel Islands. For more information about Steffen click here.