Exercise for Back Pain

You probably know that exercise is one of the best things you can do for your sore, aching back. Getting on your feet is another matter.

Back pain takes many forms, of course. You may have injured your back in an automobile

accident; or experienced pain when you reached down to pick up a piece of paper. You may have muscle pain, arthritis, disc-related pain stemming from a pinched nerve. You may have constant, excruciating pain; or you may hurt only when you move.

If your pain is bad enough, you’re probably seeing a doctor, and your treatment, including any exercise plan, will be determined by the precise nature of your diagnosis.

• Avoid the type of activity that caused the pain.

• While some bed rest may be needed, don’t overdo it. After a day or two, bed rest will tend to increase muscle stiffness and weakness, leading to even greater pain.

• If there’s inflammation, ice may help at first. Later, heat can be soothing.

• Anti-inflammatory and pain-killing drugs are useful, and a doctor may prescribe muscle relaxants.

• Learn as much as you can about the cause of your back pain and start following an exercise plan recommended by your doctor or physical therapist.

Even though the value of exercise both for prevention and treatment of back pain is widely accepted, a recent study published in Arthritis Care and Research [February, 2009] found that only about half of patients are given a prescription for exercise. Understandably, those most likely to prescribe exercise were physical therapists. And for maximum safety and effectiveness, it’s a good idea to have your therapy supervised by a PT.

Any vigorous, jerking movements are to be avoided, but nearly everyone benefits from moving and stretching the muscles, ligaments and tendons around the spinal column that tighten up in reaction to pain.

The tension may be particularly strong first thing in the morning. Simple stretching exercises then, and at intervals throughout the day, can bring back some suppleness and mobility.

Good stretching should be to the point of mild tension and held for at least 15 to 20 seconds. Movements should be slow and relaxed with no bouncing and should not bring on pain.

LEAN FORWARD FROM CHAIR: One simple way to stretch your back is to slowly lean forward from your chair, head down and neck relaxed, to touch your toes. Hold for 10 to 20 seconds and use your hands to push yourself upright.

THE CAT: You’ve seen cats do it. Get on your hands and knees and arch your upper back while contracting your stomach muscles. Relax and let your head drop between your arms. Hold for 5 seconds and then slowly raise your head and lower your back. Avoid creating a swayback posture.

KNEE TO CHEST: While lying on your back with legs straight out, place your hands around one knee and bring it toward your chest. Hold for 5 to 10 seconds, then lower your leg and repeat with the other leg.

BOTH KNEES TO CHEST: This is the same as the exercise above, except pull both knees to the chest.

SHOULDER BLADE SQUEEZE: Sitting on an armless chair or stool, squeeze your shoulder blades while keeping your chin tucked in and your chest high. Hold for 5 seconds, then relax.

MID-BACK STRETCH: Stand with your feet apart and hands on your hips. At the waist, twist slowly to the right looking over your shoulder as far as you can. Hold, return, and then twist to the left.

The hips and buttocks support the back, and it’s important to stretch these muscles as well.

LOWER BACK ROTATIONAL STRETCH: Lying on your back with your knees bent, roll your knees to one side and then the other while keeping your shoulders flat on the floor.

PIRIFORMIS MUSCLE STRETCH: While lying on your back, cross one leg over the other and gently pull the other knee toward the chest.

HIP STRETCH: While standing with feet shoulder-width apart, take a half step backward with your right foot and shift your weight to this hip while bending the left knee. While keeping your right leg straight, reach down it until you feel a stretch in the outer hip.

You don’t have to wait until your back is sore to start stretching it regularly. And the same goes for preventive exercises to strengthen your back and stomach.

THE HALF SIT-UP or crunch should always be done with knees bent and feet flat on the floor. Tuck your chin in and raise your shoulders off the floor, reaching with both hands toward your knees.

HEEL SLIDES: Lying on your back with legs straight, slowly bend one knee and then straighten it. Repeat 10 times with each leg.

ANKLE PUMPS: On your back with legs straight, move your ankles up and down. Repeat 10 times.

There are many other good exercises for the back and abdomen: straight leg lifts, heel raises, wall squats. And many more on a balance ball. A physical therapist would be glad to show you several.

Dr. Alex Thompson is board certified in strength and conditioning programs for individuals of all ages. If interested in a personal trainer, please call Dr. Alex Thompson at anyone of his locations: • Hettinger/567-6044

• Bowman /523-3286 • Mott /824-3222 • New England/ 579-4507.

Whether you’re seeing a physical therapist or following your own plan, aerobic exercise should be part of your back treatment. In addition to its effect on blood circulation and muscle fitness, aerobic exercise causes the body to release pain-killing endorphins. Studies have found a strong association between back pain and depression, and exercise can play a big role in lifting mood and relieving anxiety.

For back pain patients, aerobic activities should be low impact. Walking is better than running; biking and swimming are preferred to walking. Those who have not exercised previously should start slowly and work up to an aerobic session lasting 20 to 60 minutes at least three or four times a week.

Despite the debilitating nature of back pain, studies have found that most patients get better on their own within a few weeks. Those who start exercising during that period can relieve some of the misery, hasten recovery and perhaps develop a habit that will have a lasting influence on good health.

11/12/2009