Physiotherapy Exercises for Lower Back Pain

Physiotherapy Exercises for Lower Back Pain

 

Introduction:

Lower back pain is a prevalent medical condition that impacts a significant portion of the population at some point in their lives. This discomfort can range in severity, from a persistent, dull ache to an abrupt, sharp pain. It’s advice to consult with a healthcare professional for an accurate, precise diagnosis and a tailored liga plan if subject is experiencing Lower back pain. If Lower back pain is severe, persistent, or accompanied by other symptoms like numbness, tingling, weakness, or loss of bowel or bladder control, it is crucial to seek immediate medical attention, as it could signify a more serious underlying condition. Here, we offer an overview of Lower back pain

Lower Back Anatomy:

The Lower back, known as the lumbar region, composed of lumber vertebras, sacrum, coccyx supported by muscles, ligaments, and tendons. The spinal cord terminates at the upper portion of the lumbar spine, with nerves extending beLower, forming a bundle known as the cauda equina. To alleviate Lower back pain and improve its condition, it’s important to focus on stretching and strengthening exercises for the hamstrings, hip flexors, and Lower back muscles. These practices can effectively reduce muscle tension and promote better posture, flexibility, and overall back health.

Approximate Synonyms for Lower back pain

• Lower back strain

• lumbago due to intervertebral disc displacement

• lumbago with sciatica

• Dorsopathies

• Dorsalgia

• Acute Lower back pain

• Acute Lower back pain for less than 3 months

• Acute Lower back pain less than 3 months

• Chronic Lower back pain

• Chronic Lower back pain for greater than 3 months

• Lower back pain in pregnancy

• Lower back pain without radiculopathy

• Mechanical Lower back pain

Common Causes:

Muscle Strain- Overexertion or improper use of back muscles can result in discomfort, pain and strain.

Ligament Sprain- Overstretching or tearing of ligaments can lead to feelings of unease.

Herniated Disc: The soft material within a disc can protrude or rupture, irritating nearby nerves.

Spinal Stenosis: Constriction of the spinal canal can exert pressure on the spinal cord and nerves leading to discomfort.

Degenerative Disc Disease: Changes in the discs due to aging can cause pain.

Risk Factors:

Age: The risk of experiencing Lower back pain increases with advancing age.

Physical Fitness: Insufficient physical fitness, obesity, and weak core muscles can contribute to the condition.

Occupational Factors: Professions that involve heavy lifting or prolonged sitting can heighten the risk.

Genetics: Some individuals may have a genetic predisposition to back issues.

Symptoms:

Lower back pain can present in various ways, including muscle aches, shooting or stabbing discomfort, reduced flexibility, and discomfort worsened by movement. Healthcare providers may use ICD-10 codes to describe the clinical presentation of Lower back pain.

Diagnosis:

Healthcare professionals or physiotherapist typically diagnose Lower back pain through physical examinations, medical history assessments, and, on occasion, imaging tests such as X-rays or MRI scans. Additionally, they may conduct tests to assess potential neurological issues.”

 

Treatment Options for Lower back pain

The treatment for Lower back pain depends on its underlying cause and severity. Common treatment options encompass:

Rest:

In some instances, rest and avoiding activities that exacerbate pain can be beneficial.

Physical Therapy:

Exercise therapy -This involves exercises and techniques designed to enhance posture, strengthen the back, and alleviate pain. Electrotherapy: Applying heat or cold to the affected area can reduce pain and inflammation. Mobilization & manipulation are significantly important in management of the Lower back pain.

Medications:

Over-the-counter pain relievers, muscle relaxants, or prescription drugs may be suggested to alleviate inflammation and pain

Surgery:

Surgical intervention is rarely necessary but may be considered, especially when there’s a complicated herniated disc or spinal stenosis.

Prevention:

Individuals should aim to maintain a healthy weight, engage in regular exercise, practice proper posture, and use correct lifting techniques to mitigate the risk of Lower back pain. Core-strengthening exercises can also provide support for the Lower back. 

Physiotherapy & Lower back pain

Physiotherapy is generally a conservative approach to treating Lower back pain and is often considered the first line of treatment before more invasive measures like surgery are considered. It can be highly effective in many cases, helping individuals recover from acute or chronic Lower back pain and improving their quality of life. If subject is experiencing Lower back pain, it’s advisable to consult with a healthcare professional, such as a physiotherapist, for an accurate diagnosis and a tailored treatment plan.

Physiotherapy, or physical therapy, is a common and effective approach for the treatment of Lower back pain. A physiotherapist is a trained healthcare professional who specializes in assessing and treating musculoskeletal conditions, including Lower back pain. They use a variety of techniques to alleviate pain, improve function, and prevent recurrence. Here’s how physiotherapy can help with Lower back pain:

Assessment:

A physiotherapist will first assess the condition. They will evaluate the medical history, the nature and location of the pain, and the range of motion.

Diagnosis:

After the assessment, they will diagnose the underlying cause of the Lower back pain. This could be due to muscle or ligament strain, disc issues, postural problems, or other factors.

Individualized Treatment Plan

The physiotherapist will create a personalized treatment plan based on the specific diagnosis and needs. This plan may include a combination of the following: 

Manual Therapy:

Hands-on techniques to mobilize and manipulate the spine and soft tissues. 

Exercises:

Tailored exercises to strengthen the muscles in the Lower back and improve flexibility.

Modalities:

This may include heat, cold therapy, ultrasound, or electrical stimulation to alleviate pain and reduce inflammation.

Posture and Body Mechanics Education:

Learning proper body mechanics for activities of daily living and work to reduce strain on the back.

Ergonomic Advice:

Recommendations for adjustments in the workspace or at home to reduce the risk of back pain.

Pain Management:

Techniques to help manage and control pain.

Education:

Providing information on the condition, what to expect during recovery, and self-care strategies.

Functional Rehabilitation:

Focusing on restoring the ability to perform daily activities without pain.

Progress Tracking:

The physiotherapist will monitor the progress and adjust the treatment plan as necessary.

Prevention:

Lower back pain exercises to avoid postpartum pain, occupational pain. In addition to pain relief and rehabilitation, a physiotherapist will often work with you to prevent future episodes of Lower back pain by educating you on proper body mechanics, exercise routines, and lifestyle changes.

Physiotherapy exercise in Lower back pain

1. Positioning exercise for back pain

2. Spinal extension exercises

3. Spinal flexion exercises

4. Spinal rotation exercises

5. Posture &ergonomics correction for prevention

 

Poisoning exercise for back pain:

The prone position can be a helpful and comfortable posture for individuals with Lower back pain, as it often provides relief and minimizes stress on the Lower back. Here’s how to adopt a prone position for Lower back ache:

Prepare a Comfortable Surface:

Choose a flat and supportive surface, such as a firm mattress or a yoga mat, to lie on.

Lie Down:

Begin by lying on the stomach with the legs extended, and the arms resting at sides. The forehead or cheek can be on the surface, whichever is more comfortable for the neck.

Use Pillows:

To provide support and maintain a neutral spine position, subject can place a small pillow or rolled-up towel under the chest or pelvis. This can help relieve the arch in the Lower back, reducing pressure and discomfort.

Position The Arms:

Subject can choose to keep the arms relaxed at the sides or bend them at the elbows, placing the hands under the forehead for support.

Relax and Breathe:

While in the prone position, focus on deep, relaxed breathing. This can help to further reduce tension in the Lower back and promote relaxation.

Stay Mindful of Comfort:

Pay attention to the body’s comfort levels. If subject feel any discomfort or worsening of pain, adjust the position or try a different posture. If needed, subject can place a small cushion under the chest to elevate the upper body slightly.

Duration:

Spend 10-20 minutes in this prone position or as long as it remains comfortable and provides relief. It’s a good idea to gently transition to other positions or activities as needed to avoid staying in one position for too long.

While the prone position can help alleviate Lower back ache for many people, it may not be suitable for everyone, particularly those with specific spinal conditions or severe pain. They can offer personalized guidance and treatment options to address the specific condition.

Lower back pain exercises

Spinal exercises are designed to help improve the flexibility and strength of the spine, particularly the Lower back. These exercises can be beneficial for individuals with certain types of back pain, including conditions like degenerative disc disease and spinal stenosis. Remember to consult with a healthcare provider or physical therapist before starting any exercise program , they can provide guidance on which exercises are safe and suitable for the specific condition.

Basic principles of exercise

• Consult with a physical therapist before starting any exercise program
• Exercise should be specific according to the conditions and must be done regularly
• Time to time there should be progression of exercises.
• Maintain a smooth and controlled movement, avoiding the use of momentum to swing body.
• If subject have difficulty with the full range of motion, start with smaller movements and gradually increase range work.
• Keeping the body stabilized to reduce strain on another part, making exercise more comfortable.
• All the exercise should be breathing coordination of inhalation during extension and exhalation during flexion movement.
• All the exercise should be smooth speed with any jerky movement.
• Start sLowerly and gradually increase the intensity and duration of the exercises to avoid overexertion.
• Start on an exercise mat or a comfortable surface.
• All exercise can be incorporated into regular workout routine or used as part of a warm-up or cool-down.
• If subject is new to the exercise, it’s a good idea to start with a smaller range of motion and repetition.
• Complete the desired number of repetitions as described below.
• Each repletion should be hold for 10 seconds and then relax.
• Repeat this movement 10-15 times per session.
• 2-3 session per day
• 3-5 days per week for minimum 8-12 weeks and continues

 

 

Spinal extension exercises

1.Cobra Pose exercise or Prone Press-Up

Lie on the stomach with the palms on the floor near the shoulders.

Press the hands into the floor to lift the upper body, arching back.

Keep the hips and pelvis on the ground.

2.Arm raise exercise

Lie on the stomach with the one hand forward straight next to the shoulder.

SLowerly raise the upper body and one arm up, keeping the pelvis on the ground.

After holding this position repeat it with another arm

3.Superman Exercise:

Lie face down with the arms extended in front of body and legs straight.

Simultaneously lift the arms, chest, and legs off the ground, keeping the head in line with the spine.

4.Child’s Pose (with Extension)

Start on the hands and knees in a tabletop position.

Sit back on the heels and reach the arms forward to stretch the back.

After holding the basic Child’s Pose for a few seconds, extend one arm forward and the opposite leg backward.

 5. Quadruped Arm/Leg Raise or Bird-Dog Exercise

Start on the hands and knees in a tabletop position.

Lift the right arm and left leg at the same time.

6. Bridging Exercise

Lie on back with knees bent and feet flat on the floor.

Lift hips off the ground while keeping feet and shoulders on the floor.

 7. Pelvic Tilts exercise

Lie on back with the knees bent and feet flat on the floor.

Tighten abdominal muscles and push Lower back into the floor.

8.Wall stretch exercise

Stand with the back against a wall and the feet a few inches away.

Extend the arms to the sides, keeping the elbows and wrists in contact with the wall.

SLowerly raise the arms overhead, maintaining contact with the wall.

Reverse the motion to Lower the arms.

leg raise exercise/leg extension

Lie on the stomach with sLowerly raise the one leg in extension.

After holding this position repeat it with another leg

 

 

 

9.Sphinx Stretch:

Lie on the stomach with the forearms on the ground, elbows under the shoulders.

Push the upper body up, lifting the chest off the ground.

Keep the hips and legs on the floor.

 

 

 

 

 

Spinal flexion exercises

1.Seated Forward Bend exercise

Sit on the floor with the legs extended in front of the body.

Keep the back straight, and as exhale, sLowerly bend forward at the hips, reaching for the toes or ankles.

2.Standing Forward Bend exercise

2.Stand with the feet hip-width apart.

As with exhale, bend forward at the hips, reaching for the toes or ankles.

Let the upper body hang loose and relax.

Hold and sLowerly come back up

3.Supine straight Legs Up exercise

Lie on the back with the one leg extended up to 30-60 angle.

Hold the position and repeat it again.

Then same exercise with another leg

 

 

4.Side line straight Legs Up exercise (Abduction exercise)

Lie on the side with the one leg abducted up to 30-60 angle.

Hold the position and repeat it again.

Then same exercise with another leg

5.Knee-to-Chest Stretch exercise

Lie on the back with the knees bent and feet flat on the floor.

Bring one knee up toward the chest, clasping the hands around it.

Hold the position for feeling a stretch in the Lower back.

Switch to the other leg and repeat.

 

 

5.Supine Knee Hug exercise

Lie on the back with the legs extended.

Bend both knees and bring them toward the chest, hugging them with the arms.

6.Child’s Pose exercise

Start in a kneeling position with the big toes touching and knees apart.

Sit back on the heels and extend the arms forward, resting the forehead on the ground.

Press the hands into the floor to deepen the stretch in the Lower back and spine.

Hold this position for feeling a gentle stretch in the Lower back while focusing on the breathing.

7.Cat-Cow Stretch exercise (Flexion Version)

Begin on the hands and knees in a tabletop position.

Inhale, arch the back, and lift the head while looking up (Cat Pose).

Exhale, round the back, tuck the chin to the chest (Cow Pose).

Repeat this motion for to promote spinal flexibility.

 

 

 

8.Butterfly Stretch exercise

Sit with the soles of the feet touching and the knees bent outward.

Hold the feet with the hands and gently press the knees down toward the floor.

Feel the stretch in the Lower back and inner thighs.

9.Partial Crunches exercise

Lie on the back with knees bent and feet flat on the floor.

Cross the arms over the chest or place both hands behind the head or straight towards the knees.

Tighten the abdominal muscles and lift the head and shoulders off the floor.

 10. Seated or supine Hamstring Stretch exercise

Sit on the floor with the legs extended in front of the body.

Reach for the toes with hands while keeping the back straight.

 

 

 

 

 

 

Piriformis Stretch exercise

1. Seated Piriformis Stretch:

Step 1: Sit on the floor or on a chair with the feet flat on the ground.

Step 2: Cross the affected leg over the opposite knee, so the ankle is resting on the thigh.

Step 3: Sit up straight and engage the core muscles.

Step 4: Gently lean forward while keeping the back straight. You should feel a stretch in the buttock of the crossed leg.

Step 5: Hold the stretch for 15-30 seconds, and then relax.

Step 6: Repeat the stretch 2-4 times on each side.

2. Supine Piriformis Stretch:

Step 1: Lie on the back with both knees bent and the feet flat on the floor.

Step 2: Cross the affected leg over the opposite knee, creating a figure-four shape with the legs.

Step 3: Reach through the opening between the legs and clasp the hands behind the thigh or around the shin.

Step 4: Gently pull the knee toward the chest until you feel a stretch in the buttock and hip.

Step 5: Hold the stretch for 15-30 seconds.

Step 6: Release and repeat the stretch on the other side.

 

Spinal rotation exercises

1.Seated Spinal Rotation exercise

Sit on the floor with the legs extended.

Cross one leg over the other, placing the foot on the floor next to the opposite knee.

Twist the upper body to the side, using the opposite elbow to gently push against the outside of the bent knee.

Hold the position, then switch sides.

2.Standing Spinal Twist exercise

Stand with the feet hip-width apart.

Place the hands on the hips or in front of the body.

Rotate the upper body to one side, keeping the hips and Lower body facing forward.

Hold the twist, then repeat on the other side.

3.Supine Spinal Twist exercise

Lie on the back with the legs extended.

Bring one knee toward the chest and then across the body, twisting the Lower body while keeping the shoulders on the ground.

Extend the opposite arm out to the side.

Hold the stretch and switch sides.

4.Thread the Needle exercise

Begin in a tabletop position on the hands and knees.

Slide one arm under the opposite arm, threading it through and Lowering the shoulder to the ground.

Keep the hips over the knees.

Hold, then switch sides.

Remember to perform these exercises gently and gradually increase the range of motion as the flexibility improves. Spinal exercises can help relieve discomfort and improve the flexibility and strength of the back. However, it’s essential to perform these exercises with proper form and gradually increase their intensity to avoid overexertion or worsening of any existing condition. If subject experience pain or discomfort while performing these exercises, stop immediately and consult with a healthcare provider or physical therapist before starting a new exercise routine. They can provide guidance tailored to the specific needs.

Posture &ergonomics correction for prevention

Poor posture can contribute to Lower back pain, and correcting the posture is an important step in managing and preventing this discomfort. Here are some tips for posture correction to help alleviate Lower back pain:

Maintain a neutral spine

The spine has natural curves (cervical, thoracic, and lumbar). Avoid excessive arching or rounding of the Lower back. Try to maintain a neutral spine position to reduce stress on the lumbar area.

Sit and stand with proper alignment

When sitting, keep the feet flat on the floor and the knees at a 90-degree angle. Use a chair that provides Lower back support or use a cushion to maintain the natural curve of the Lower spine.

When standing, distribute the weight evenly on both feet, keep the shoulders back, and engage the core muscles to support the spine.

Use ergonomic tools for prevention

Ensure that the workspace, home, and daily activities are set up in an ergonomically sound way to reduce strain on the back. If subject work at a desk or computer for extended periods, invest in an ergonomic chair, keyboard, and monitor setup to support good posture. Leg support, arm support and back, neck support can be used for prevention.

Lifestyle Changes can help prevent and manage Lower back pain.

Quitting smoking

Staying active-Take regular breaks & avoid prolonged sitting

Sitting for extended periods can cause stress on the Lower back. Try to break up long periods of sitting with short walks or stretches. Stand up, stretch, and walk around every 30-60 minutes if subject have a sedentary job. These breaks help relieve pressure on the Lower back.

Lift objects correctly

When lifting heavy objects, bend at the hips and knees, not the waist. Keep the object close to the body, and use the leg muscles to lift rather than straining the back.

Maintain a healthy weight

 

Excess body weight can strain the Lower back. A healthy diet and regular exercise can help subject maintain an appropriate weight.

If the Lower back pain persists despite the efforts to correct the posture, consult a physical therapist for personalized guidance and exercises.Remember that making these changes may take time and conscious effort. Consistency is key to improving and maintaining good posture and reducing Lower back pain. Additionally, if subject have underlying medical conditions or chronic Lower back pain, it’s essential to consult a healthcare professional for a comprehensive assessment and appropriate treatment recommendations.

Frequently Asked Questions (FAQs)

These FAQs provide a starting point for understanding the role of exercise in managing Lower back pain. However, it’s essential to consult with a healthcare provider or physical therapist to create a personalized exercise plan tailored to the specific needs and circumstances.

1.What are the best exercises for Lower back pain?

People often seek recommendations for exercises that can help alleviate Lower back pain. Common exercises include gentle stretches, core-strengthening exercises (e.g., planks, bridges), and flexibility exercises (e.g., cat-cow stretches).

2.Is it safe to exercise with Lower back pain?

Many wonder if it’s safe to exercise when they have Lower back pain. Generally, Lower-impact exercises are safe and can even help alleviate pain. However, it’s crucial to consult a healthcare professional to determine what exercises are appropriate for the specific condition.

3.How often should I exercise for Lower back pain relief?

People often inquire about the frequency of exercise. Depending on the severity of the pain, you might need to exercise daily or a few times a week. A physical therapist can provide guidance on the appropriate exercise routine and frequency.

4.Are there exercises to avoid if I have Lower back pain?

Certain exercises, like heavy lifting, high-impact activities, or exercises that exacerbate the pain, should be avoided. It’s essential to know which exercises are safe and effective for the condition.

5.Can yoga or Pilates help with Lower back pain?

Yoga and Pilates are popular for their potential benefits in improving flexibility, strength, and posture. Many people with Lower back pain find relief through these practices. However, it’s important to choose classes or routines tailored for individuals with back pain.

6.What should I do if my pain worsens during exercise?

Some individuals experience increased pain during or after exercise. If this occurs, it’s advisable to stop the exercise and consult a healthcare professional. Pain that worsens with exercise may indicate the need for a different approach or further evaluation.

7.How long does it take to see results from Lower back pain exercises?

People often wonder when they can expect to see improvements. The timeline for pain relief varies depending on the individual and the underlying cause of the pain. It might take several weeks or even months of consistent exercise to experience significant relief.