By Dr. Mercola
Low back pain is the most commonly reported type of pain and a leading cause of disability in America.1
It's one of the most common causes for missed work and for visits to
the doctor's office, outnumbered only by upper respiratory illness.2
Estimates suggest approximately 80 percent of adults will suffer from low back pain in their lifetime.3
The cost of low back pain is high, both in monetary value and in
pain control. And, it is estimated that a minimum of $50 billion is
spent each year in direct healthcare costs to treat low back pain.4
Unfortunately, many people believe that back pain will resolve
spontaneously without treatment. Instead, statistics from 2003
demonstrated that 62 percent of patients with back pain continue to
report pain 12 months after the initial incident.5 Chronic back pain is also a major driver of painkiller addiction, which can lead to a lethal overdose.
There is a better way. How you use your body is directly related to
how your body responds, including pain. Although low back pain is
challenging and may be debilitating, you have options for both
treatment and prevention.
What Increases Your Risk of Low Back Pain
Age
You may experience degenerative
changes to your spine as you age. In some cases, these changes are
affected by the way you use your back and the strength of the muscles
supporting your spine.
People between the ages of 30 and 60 are
more likely to have spinal disc-related problems and people over 60
are more likely to suffer from osteoarthritic pain.6
Weight
Excess weight places additional
burden on your joints, including your lower back, and inflammatory
factors associated with increased weight may also contribute to pain.7
Your
spine is designed to distribute your body weight load. An excess may
lead to structural changes and damage. Your lower back, or lumbar
spine, is the most vulnerable to the effects of obesity.8
Sedentary Lifestyle A lack of exercise
does more than affect your risk of heart attack or stroke. It also
increases stiffness and weakens muscles needed to support your back.
Regular stretching and strengthening exercises may reduce your back
pain or prevent you from experiencing low back pain.9
Sitting and Standing Posture
Your posture
during sitting may change the normal curvature of the lower back,
increasing pressure on spinal discs and the ischium, both associated
with lower back pain.10Poor
posture during both sitting and standing may predispose you to lower
back pain as it may cause increased stress on your back.11
Smoking Smoking
reduces the amount of oxygen delivered to your body tissue. This
adversely affects your spinal discs and increases your risk of back
pain. Research demonstrates smokers have a 1.5 to 2.5 times greater
risk of developing back pain over nonsmokers.12
Pregnancy Pregnant women
are more predisposed to low back pain, with the added weight of the
baby changing the center of gravity and increasing the lower back
curvature.13
Occupational and Sports Hazards Repetitive lifting, bending and twisting
or long hours of standing and sitting may increase your risk of low
back pain from overuse or from poor functional posture, increasing
the weight and stress on your lower back.14,15
Medical and Family History
Other
factors that may play a role in your low back pain include a past
medical history of osteoarthritis, disc degeneration, spondylolysis,
osteoporosis and discogenic disease. A family history of back pain
may also increase your risk.16
An Ounce of Prevention Is Worth a Pound of Cure
Many of these risk factors may respond to a program of stretches and
strengthening exercises to change the way you use your back and
improve the neuromuscular connections. However, like most health
conditions, it is far easier to prevent the problem than it is to fix
it.
Your lower back does not function independently of the rest of your core. This means you need strong abdominal muscles to support your lower back, and flexible muscles to reduce the potential for strains and sprains.
The healthier your back and musculature are, the better your chances of preventing a problem or recovering quickly.
Your lower back responds to interconnections between your shoulders
and your pelvis, even down to your quadriceps and hamstring muscles.
These large muscles in your upper legs are connected to your pelvis,
which in turn is connected to your lower back.
Tight hamstrings or quadriceps can pull your pelvis out of alignment and increase the risk of lower back pain.
A systematic review and meta-analysis demonstrated a successful
prevention program, or one that kept someone from reporting a bout of
low back pain for one or more years, rested almost exclusively on
exercise programs.17 Participants did not find relief from back belts or orthotics.
Both of these factors tended to increase muscle weakness and lead to
further pain. Participants who exercised regularly, using either
strength training or a combination of strength training and aerobic
exercise, were considerably less likely to experience further back pain
within the year.
Effective Stretches and Exercises May Help Heal Your Lower Back Pain
Start using these stretches and strengthening exercises slowly. If
you experience pain, back off the intensity of your program. It is
important to have proper body alignment during the exercises in order
to stretch and strengthen the right muscles.
You won't need to dedicate hours each day to improve your back pain.
But, it is important that you are consistent, even after you
experience relief from the pain and discomfort. In the video above, Dr.
Eric Goodman and I demonstrate a number of Foundation Training
exercises that are specifically designed to address back pain and
related issues. Below, you'll also find a list of standard stretches
that can be very helpful.
Hamstring Stretch
Although a standing
stretch is the most common, it also places more stress on your lower
back. Instead, use a seated or wall stretch. A seated stretch begins
with you seated in a firm chair.Extend one leg and reach down slowly to
touch your toe.
Change legs and stretch the other side. A wall
stretch is done lying on your back with your buttocks up against a wall
or high-back chair. Place the foot against the wall or chair and make
the knee as straight as you can.18As
you progress you'll be able to get closer to your toes in the seated
position or your knee straighter while on the floor. It is important to
stretch gradually and not push so hard you strain the muscle.
Gluteal Stretch
Your gluteal muscles
are interconnected with your lower back. Stretch and relax these muscles
by lying on your back with both knees bent and your lower back
flattened to the floor. Draw one knee to your chest, while you keep the
other foot on the floor. Hold for 20 seconds and repeat with your other
leg. Stretch both legs twice, once daily.19
Piriformis Stretch
The piriformis
muscle is small and located deep in your buttocks. When it spasms it can
cause pain your buttocks and irritate the sciatic nerve, triggering
pain down your leg. The muscle stabilizes the hip joint, lifting and
rotating the thigh away from the body. It is involved in almost every
movement of your legs and hips.20
Lie
on your back with both feet flat to the floor and knees bent. Place
your right ankle on your left knee. Grab your left thigh and pull the
leg toward your chest. Hold for 15 to 20 seconds. Release and repeat on
the other side.21
Hip Flexor Stretch
Your hip flexors
are a group of muscles that connect your pelvis, leg and abdomen. These
are some of the most powerful muscles in your body, responsible for
flexing your hip and raising your leg. Sitting for long periods of time
and competitive swimming, are two activities causing the flexor muscles
to tighten and affect your lower back.22,23
A
kneeling hip flexor stretch starts with you on your knees on the floor.
Holding on to a chair or other solid object, place one leg behind you
and lean in slightly to the chair.24 The glute bridge stretch does more than stretch your hip flexors, it also works your gluteal muscles and abs.
Lying on your back with your knees bent and feet flat on the floor
hip-width apart, flatten your back to the floor and exhale while raising
your hips off the floor. Tighten your glutes when you get to the top.
Inhale and return to the starting position.25
Quadriceps Stretch
If you have tight
quadriceps, they will affect the tilt of your pelvis and therefore your
lower back. Common stretches require you to bend your knee until your
heel touches your buttocks. However, this stretch places increased
stress on your knee joint. Instead, you can stretch your quadriceps
without bending your knee.
Standing next to a chair, bed or table,
extend your right leg behind you. Hold on to a chair for stability and
prevent falling. Keeping your body upright, align your left hip over
your left heel maintaining left hip and foot in a forward position.
Tighten your glutes and imagine your right leg extending through your
right hip. You should feel light tension in both your hip and quads.
Repeat on the other leg.26
Lower Back Stretch
The goal is to
stretch and relax your lower back muscles without adding stress or
pressure to the area. Lie on your back with your buttocks as close to a
wall as possible. Raise your legs straight up the wall and scoot in
closer to the wall. Press your lower back into the floor and relax.27
Planking
Strong abdominal and back
muscles will help protect your lower back and improve your ability to
stand and sit with correct posture. Planks will strengthen your
shoulders, abs, back, glutes and the large muscles in your legs.
Lie
on your stomach. Rise up on your elbows, holding your elbows directly
below your shoulders. Pull your body up on your toes and hold a position
similar to doing a push-up, except you are on your elbows. Work up to
holding for 3 minutes. For a program to help you achieve this goal, see
my article "30-Day Plank Challenge."
Diaphragmatic Breathing
Not all back
pain originates from the same source. However, keeping your hips,
pelvis, rib cage and core muscles in alignment helps you to use your
body correctly and reduce the potential for further back pain.
Diaphragmatic breathing techniques are a good way to stabilize your back
and naturally add traction to your spine.
Lie on your back with
your heels on a chair. Align your position so there is a 90-degree angle
at your hips and your knees. This might require you to experiment with
different chairs to find one at the right height for you. Place a pillow
between your legs.
Without using your lower back, activate your
glutes and your abdominal muscles to raise your buttocks off the floor
just a few inches. In this bridge position, inhale deeply through your
nose, feeling your lower ribs rotate outward to fill your lungs. Exhale
completely using your core muscles to internally rotate your ribs.
Inhale for a count of five, exhale for a count of seven and pause for a
count of three. Do this five times, maintaining the bridge position,
then rest. Repeat one more time.28
Foam Rolling Hamstrings and Quadriceps
Foam
rolling your hamstrings and quadriceps muscles helps the muscles to
relax, give you a deep tissue massage and speed healing. These muscles
contribute to your lower back pain. Roll over a foam roller just one to
three times each day for the hamstrings and quadriceps, after doing your
strengthening and stretching exercises. You can read more about how to
avoid common mistakes made using the foam roller in my previous article,
"5 Foam Rolling Mistakes to Avoid."
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