What causes chronic lower back pain?
Chronic lower back pain can occur for many different reasons. In some cases more than one factor contributes to the pain. The most common causes are likely tight muscles in and around the hips and abdomen (or core). People with tight hamstrings, gluteals/piriformis and hip flexors are especially at risk for back pain. Weakness in these muscles or an imbalance is the result of many different factors such as poor posture while sitting, carrying items in a back pants pocket, uncorrected foot problems, poor sleeping position; and driving a stick-shift vehicle. Sometimes low back pain will be set off by poor lifting technique (e.g. Picking a heavy box up off the floor) or twisting while lifting/carrying a heavy object.
I try to avoid all activity when my back hurts. The pain eventually goes away, but I end up losing a day or two of work. Is there anything else I can do when my back hurts?
Each year, Americans lose 93 million days of work, at a cost of $11 billion, due to low back injuries. They spend another $5 to $24 billion in direct medical expenses. Relaxing and lying down is an effective way to temporarily alleviate lower back pain; however it does little to get you off your back and into work. The best measure is to relax while still maintaining a light level of activity (i.e. slow walks around the block). Remaining somewhat active keeps the back muscles flexible and mobile. It is also important to keep the back muscles strong and flexible by incorporating a regular routine of stretching strengthening and aerobic conditioning.
Contact your doctor if…
The pain goes down your leg
Your leg, foot, groin or rectal area feels numb.
You have fever, nausea or vomiting, stomachache, weakness or sweating.
You lose control over going to the bathroom.
Your pain was caused by an injury.
Your pain is so intense you can't move around.
Your pain doesn't seem to be getting better after 2 to 3 weeks.
How can regular exercise help me manage lower back pain?
Regular Exercise is extremely effective at managing and preventing lower back pain. A properly designed exercise program will strengthen muscles, reduce body fat, improve flexibility and help prevent and manage stress, anxiety and depression. Any exercise program should include specific exercises to strengthen the abdominals and lower back. As well, the program must incorporate stretching exercises for the hamstrings, hip flexors, abs, gluteals (butt muscles) and low back. Stretching and strengthening the lower back will also help to improve posture and prevent muscle imbalances. The most important thing to remember is always to keep active and participate in an exercise program that includes stretching, strengthening and low impact aerobic conditioning. Keep reading for some simple stretches and exercises to help manage lower back pain.
Glute exercise:
Start by lying face down flat on a table or bench, with your legs hanging off the edge and your feet on the floor. Keep your knees slightly bent and raise one leg until the back of your thigh is in line with your body. Lower the leg without allowing your foot to touch the ground. Complete two sets of 15-20 repetitions for each leg.
Crunch:
Lying on your back on the floor, bend your knees and raise your arms so they are perpendicular to the floor. Slowly bring your shoulders off the ground by rounding your back forwards and squeezing your stomach. Make sure to keep your arms perpendicular to the ground throughout each exercise. Complete two sets of 15-20 repetitions.
Superman’s:
Start lying on your stomach with your arms and legs stretched out so that your arms are next to your ears. Slowly raise your left arm and right leg at the same time. Make sure to keep both limbs straight. Hold of one second and then repeat using your right arm and left leg. Complete two sets of 15-20 repetitions.
My back hurts the most when I am sitting at my desk or on a long drive. Is there anything I can do at work to help alleviate the pain and prevent it from coming back?
Sitting for prolonged periods will cause the hamstrings and hip flexors to tighten. As well, poor posture resulting in slouching or leaning to one side can put excessive strain on back muscles. If you are seated for at your desk or in the car for long periods take a 5-minute break every 45-60minutes. During the break you should get up and move around. It is also useful to stretch a little bit during each break (Some easy stretches for at work are found below). When sitting at your desk try to sit with knees above hips (i.e. with your feet on a stool or milk crate) and make sure you are sitting up straight. While driving, keep your car seat upright to help prevent slouching and poor posture
Basic Stretches to Reduce/Prevent Lower Back Pain
Lower Back
Sit in a chair and keep your hips straight, twist your body to the right side, bringing your left hand to the outside of your right knee. Gently apply pressure to the right knee while twisting the torso to the right. Hold for 20-30s and then switch sides.
Hamstrings
Sitting in a chair and keep you left knee bent and your right leg straight with your heel on the floor and toes pointing up. You want to, reach for the toes on your right foot keeping your right leg straight by leaning your torso forwards. Hold for 20-30s and then switch sides.
Glutes/Piriformis
Sit in a chair with your left leg bent to 90 degrees and your foot flat on the floor. Cross your right leg over so your right foot is resting on your left knee. Place your right forearm down the length of your right shin with your hand near the ankle and your elbow near the knee. Gently lean your chest toward the crossed leg. Hold for 20-30s and then switch sides.
Samson Stretch for Hip Flexors
In a lunge position interlace your fingers and raise them overhead so your palms are facing the ceiling. Keep you back knee on the ground and slowly push your hips forward and reach upwards with your hands. Hold for 20-30s and then switch sides.
