Are you experiencing low back pain? If so, you are not alone. An estimated 75-85% of Americans experience some form of back pain during their life. Back pain can be debilitating and pervade every aspect of life. It can be difficult to find comfort in any position, let alone maintain the level of activity most of our clients strive for.Â
Helping my clients find comfort again, and regain feel-good movements after a back injury is one of the reasons why I love being a physical therapist. In this blog, I will cover causes of low back pain and how to manage the pain during flair ups so you can get back to the activities you love quickly and safely.Â
Anatomy Crash Course
Understanding the anatomy of the back is crucial in comprehending how various structures can contribute to back pain. The spine is made up of 33 vertebrae divided into cervical, thoracic, lumbar, sacral, and coccygeal regions. These vertebrae are cushioned by intervertebral discs, which act as shock absorbers and allow for flexibility. Ligaments and muscles support the spine, providing stability and movement. Nerves branch out from the spinal cord through small openings between the vertebrae. When these discs degenerate or herniate, they can press on these nerves, causing pain that radiates to other areas of the body, such as the hips and legs. Additionally, muscle strain, ligament sprains, and conditions like spinal stenosis or arthritis can also lead to back pain, making it essential to understand and address the specific source of discomfort. There is no, “one size fits all” for treating back pain.Â
Causes of Low Back Pain
There are many causes of low back pain. One culprit is that many of us spend most of our lives our lives in a “forward” position. (Sitting, bending, lifting, walking, running, biking, etc.) Forward bending of the spine predisposes our discs to push posteriorly and place pressure on our nerves. Think about a jelly doughnut: if you squeeze it on one side, the jelly will push out the other side. Sometimes this pressure on the nerve can cause symptoms into the buttock/hip and even down the leg.
Back Pain Relief
After a back flare-up, its common for the pain to be worse with sitting and/or bending. So how do you relieve this pain? Oftentimes, bending the opposite direction can feel painful so we then avoid this position due to that initial discomfort. You may be surprised to hear that it could actually be your ticket out of pain!Â
The McKenzie Method incorporates a series of exercises designed to alleviate low back pain by extending the spine, centralizing symptoms and improving spinal function. These exercises primarily involve repeated movements and positions. Below are a few exercises to get you started.Â
Prone press-up:Â
- Start on your stomach, face down and then gradually lift your upper body, using your arms.Â
- Keep your hips and legs relaxed on the floor, similar to a cobra pose in yoga.
- Repeat 10x, aim for at least 2-3 sets
This movement helps to relieve pressure on the spinal discs and nerves.
Standing lumbar extension:Â
- Start standing with hands on your lower back and gently arch backward.Â
- Repeat 10x, aim for at least 2-3 sets
Check Your Symptoms
After a few rounds of the McKenzie Method, we then check your symptoms to see if there is an effect: change in intensity or location of pain. If pain decreases overall or moves closer to the spine (out of the leg and into the back) it is called centralization and shows the nerve is less irritated. This is a green light. Keep going!Â
If pain increases overall after 2 sets, or moves further away from the spine into the hip or down the leg is called peripheralization and means the nerve is more irritated. This would be a red light. Stop!
We often also check your range of motion, strength, and neural tension before and after to see if there are any changes.
Tailoring Treatment for Different Ages and Conditions
Not everyone responds to this mode of treatment. This tends to be best for young to middle-aged individuals. As we age, the holes where are nerves exit the spine narrow and can also put pressure on the nerves, causing similar pain. These individuals typically have more pain with standing and feel better with sitting. If so, the exercises above may actually place more pressure on the nerve and be aggravating. Instead, the opposite direction (pulling the knees to the chest) may be relieving. Again, there is no one-size fits all solution.Â
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Personalized Guidance for Effective Back Pain Relief
It can be difficult to determine the best exercises and understand the meaning of the body’s response to back pain on your own. These exercises require optimal form with relaxed legs. Sometimes individuals respond best to altered positions, like placing the hips offset for the motion. After pressure is removed from the nerve we progress exercises to stabilize the spine and prevent future injury.Â
If you are feeling overwhelmed and frustrated with back pain, come in and see us–we can figure it out together! Our PTs provide you with the tools to eliminate your pain and get you back to living and loving life. Once your directional preference is determined, you can become independent in helping your back pain at home and while out doing the activities you love.Â
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Disclaimer: The information in this blog is for educational purposes only. The exercises are given as examples and may not be appropriate for you or your condition. We can not stress enough the importance of individualized care, especially for back pain!Â
Author: Sydney McDonough, PT, DPT
