The human back is a tricky thing; it’s both incredibly strong and also incredibly easy to hurt.
Back pain is the number one type of pain that we treat at Integrative Pain Specialists and that’s not just at our practice; it’s everywhere. Back pain is not only the most common types of pain in the nation, it’s one of the most common health conditions period. According to the American Chiropractic Association, about 80 percent of the population experiences back pain at some point.
Back pain is not only the most common types of pain in the nation, it’s one of the most common health conditions period. According to the American Chiropractic Association, about 80 percent of the population experiences back pain at some point.
Your back needs both exercise and care to stay healthy. And the moment it begins to hurt, it needs special attention – and more exercise. It sounds counterintuitive and that’s one of the obstacles to treatment; if your back hurts, you instinctively try to avoid using it. You don’t move much, you don’t exercise, you don’t stretch. And so it gets worse, not better.
Non-specific chronic low back pain
There are different types of back pain and different treatments and exercise programs for each person, depending on where the pain is and what’s causing it. One of the most common back problems though, is “non-specific chronic low back pain,” sometimes shortened to NSCLBP. Non-specific chronic low back pain is exactly what it sounds like – your lower back hurts and there’s no obvious cause.
This type of back pain is so prevalent and is responsible for so much time taken off of work, that it has become a major topic of study in the national health departments of most first-world countries. So over the last few years, there has been quite a bit of new research to support the idea that exercise, rather than bed rest, is the most effective treatment for non-specific chronic low back pain.
How do you spell back pain relief? S -T – R – E – T – C – H – I – N – G
When I say “exercise,” I don’t necessarily mean bench presses and marathon-running. If you’re in my office for pain relief, most of what I’m going to focus on is stretching. Stretching helps to make your muscles more flexible and that flexibility is needed to maintain your range of motion. If you don’t stretch, your muscles actually get shorter, in addition to getting tight. Then when you try to use them, they’re weak and unable to extend as much as they should. That puts you at risk for muscle damage and pain if you aren’t already in pain. If you are already in pain, it just makes the pain worse, so you do less, then the muscles get even tighter and shorter and weaker, and so you hurt more. It’s a downward spiral.
So where should you start? If you’re in chronic pain – pain that lasts for more than six months – make sure you see a physical therapist for a stretching routine; you don’t want to injure yourself by doing something that’s not right for the type of pain you have. But don’t put it off – get up and get moving and see a professional right away to get an assessment. Each of my patients is different so I assess each person’s problems, abilities and needs before prescribing a stretching routine, but there are a few that work for almost everyone.
When you wake up in the morning, before you even get out of bed, get your blood flowing and your muscles and joints lubricated by doing some stretches from bed. Lying on your back, bring one knee up to your chest and hold it for 20 seconds. Then do the same with the other knee. Do each side three times, holding for 20 seconds each time. You should then be able to get up and start walking without that typical morning stiffness and limping.
At your desk
The seated forward flexion stretch puts a nice bend into your spine, but gently. I don’t recommend it for everyone – depending on the type of back pain, some patients should do a similar exercise while lying down instead. But for most, the chair position works well.
Sit upright in a chair normally with your legs apart. Bend forward and down towards your feet as far as possible with your arms stretched outwards. You should feel it in your back and in your legs. Hold it for 20 seconds, then do it twice more for a total of three times. If you’ve progressed in your stretching and want to do it a little more intensely, grab your ankles and pull yourself downward – gently!
Stretch out on aisle 7
Grocery shopping is hard on people with back pain. Rather than try to tough it out, when your back starts to really hurt, stop for a minute, find a bench (most large grocery stores have benches in the front, near the checkout aisles) and do the seated forward flexion stretch. Instead of doing it three times for 20 seconds, do it five times for 10 seconds. Then return to your shopping.
Cross leg stretch
At some point during the day, take a minute to lie down and work on your hamstrings with a cross leg stretch. Lie on your back and cross your left foot over your right thigh. Then bend your right knee, put your hands behind that knee and gently pull it toward your chest. When it gets high enough that you can feel a comfortable stretch, hold it for 20 seconds. Repeat that exercise with the other side – right foot over your left thigh. Do each side three times, holding for 20 seconds each time.
Remember that you should never bounce when you stretch. Thirty years ago, your high school gym teachers may have told you to stretch and then bounce but they were very wrong and athletic professionals now know better; bouncing while you stretch is a good way to injure yourself. Just stretch until you feel it, then hold the position for the proper amount of time.
Stretching is the primary “homework” assignment I give in physical therapy, but cardio is also important. Even more than with stretching, patients are often loathe to do cardio exercises when they hurt, but it really does help. Every major study of back pain indicates that for almost everyone, a low or moderate amount of aerobic activity is beneficial.
Of course it all depends on your diagnoses and individual abilities but in general, getting your heart rate up for a little while every day gets more oxygen and more blood flow into your joints and tissues, improving your movement and your body’s ability to heal itself.
How soon will you feel relief? In most cases, the stretches will make you feel better immediately. If you do the wake-up stretch before you get out of bed one morning and don’t do it the next, you’ll realize the difference as soon as your feet hit the floor. And over time, the stretches will give you more range of motion and less pain all the time, not just immediately after you do them. My patients who keep up with their stretching routine are usually much better within three or four visits; six at the most. That’s not temporary relief – that’s pain relief that will stay with them as long as they keep it up.
So don’t hold still – get up, move around, and see a physical therapist to get some recommendations for your specific case.
Stephanie Musselman heads up the physical therapy department at Integrative Pain Specialists. Licensed in the Commonwealth of Virginia, Stephanie earned her BS degree in Kinesiology from Shenandoah University in 2000. She then attended Virginia Commonwealth University Medical College of VA, and in 2003, received her Doctorate of Physical Therapy.
Find out more about our physical therapy division or schedule an appointment at www.feelbetterrva.com