Best exercises for lower back pain

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Relief of lower back pain with exercise

Back pain or commonly lower back pain is a common symptom that affects 60–80% of people at some time in their lives. Although the prevalence has not increased, reported disability from back pain has risen significantly in the last 30 years. A number of causes are responsible for it. While treating these we are very much concerned about having chronic pain and disabilities. To avoid these two exercises for lower back pain is a very effective method.

As a part of lower back pain treatment rest is given. Exercises for lower back pain overcome the bad consequences of rest. Exercise is part of the evidence-based recommendations for the treatment of various diseases, such as osteoarthritis, Ankylosing spondylitis and other conditions that cause lower back pain. Despite such evidence, implementation of exercise in daily practice is often neglected, however. Pain attitudes and biomechanical beliefs of the treatment provider influence exercise prescription, and pain intensity is used as a guideline to determine exercise intensity. Such low-intensity exercise may not provide the required training stimuli to achieve an improvement in strength and joint function. In patients with back pain, it may lead to overt pain behavior.

Exercise techniques can be classified into non resistive and resistive exercises. Non resistive exercises include range-of-motion exercise and aerobic exercise. Resistive exercises are strengthening exercises that may be isotonic, isometric, or isokinetic.

Aerobic Exercises for lower back pain

Aerobic exercise includes any type of exercise performed at moderate levels of intensity for extended periods. It includes walking, running, hiking, cycling, swimming, inline skating, and stair climbing. The aim of aerobic exercise is to increase endurance so that patients can do activities longer without feeling tired. Aerobic exercises have been shown to have a positive effect on cardiovascular diseases and excess weight and on conditions causing low back pain like mechanical back pain.

Strengthening Exercises for lower back pain

Here, a force from a therapist, free weights, or a machine applies resistance in opposition to the attempted movement of lumber muscle group by the subject. Resistance can be increased in strengthening exercises over time as muscle strength improves. The types of strengthening exercises are isometric or dynamic isotonic and isokinetic.

Isometric (or static) exercise is performed without a change in joint range or muscle length. Isometric exercise causes the least strain on joints and places less strain on the cardiovascular system than dynamic exercise. Isotonic exercise consists of muscle shortening (concentric) and muscle lengthening (eccentric) contractions. Isokinetic exercise involves movement through a fixed range of motion at a fixed rate of motion (velocity) against variable resistance that matches exactly the force generated by the patient at any point in the range. The stronger the force applied by the user, the greater is the resistance supplied. Equipment providing the latter type of accommodating resistance is highly sophisticated and expensive. This equipment also can provide a printout of the torque developed during the exercise activity.

Some examples are:

McKenzie exercises for lower back pain

Here extension of the spine done. This exercise can reduce pain generated from a compromised disc space. Extension exercises may also help reduce the pain of disc hernia and reduce pressure on a nerve root. Some of these exercises are done standing up while others are performed lying down. All of these upper and lower back exercises use core muscle contraction and, usually, arm motions to stabilize the trunk and extend the spine.

Some McKenzie techniques are:

Lying Prone

Patient is placed at the table or bed in prone position. The arms are parallel with the chest, with the hands near to the waist. The head is turned to one side. This position causes an extension of the lumbar spine. It is important that, while arising, the restored extension is maintained

Extension in Lying

The patient lies prone and the hands are placed near the shoulders. The hands are placed with the palms down. Now the patient makes a press up movement with straight arms. The waist stays near the table while the patient presses the thorax upwards

Extension in standing

Patient stands up straight with his feet apart. The hands are placed above waist. His hands fixes the waist while the patient leans backwards. The patient has to lean backwards as far as possible.

Rotation mobilization in extension

Patient lies in a prone position on the table or bed with his arms parallel with the trunk and the head turned to one side. Therapist stands next to the patient and places the heels of the hands on the lumbar region. One will fix the vertebra on top of the vertebra you want to rotate. The other hand will make a rotation of the vertebra beneath in the opposite direction.

Self-treatment exercises for lower back pain

This exercise is called a “mirror exercise” and can be helpful when you have a “blocked” back and you’re leaning to one side because of it. The patient has to lean with his upper body against the wall, while his feet take same distance from the wall. Now the patient has to move his pelvis against the wall and back to the beginning position.

Dynamic lumbar stabilization exercises for lower back pain

In this technique the physical therapist first tries to find the patient’s neutral spine, or the position that allows the patient to feel most comfortable. The back muscles are then exercised to teach the spine how to stay in this position. This back exercise technique relies on the awareness of where one’s joints are positioned. These back exercises provide pain relief and help keep the back strong and well positioned.

Stretching exercises for lower back pain

Back flexion exercise

Lie on your back and pull both knees to the chest while simultaneously flexing the head forward until a comfortable stretch is felt in a balled-up position.

Knee to chest stretch

Lie on your back with the knees bent and both heels on the floor, place both hands behind one knee and bring it to the chest.

Standing Hamstring Stretch

Simply bend forward, while standing, at the waist with arms hanging down and with legs relatively straight. Try to touch the toes but do not strain to do so. Stop when a stretch is felt in the hamstring.

Chair Hamstring Stretch

Sit on a chair and place the legs straight out in front on another chair. In this position, reach toward the toes. One leg at a time may be stretched.

Towel Hamstring Stretch

Lie on the floor and pull the leg up and straighten by holding onto a towel that is wrapped behind the foot. One leg at a time may be stretched.

Wall Hamstring Stretch

Lie on the floor, with the buttocks against a wall, and place the foot up against the wall. Then try to push the knee straight. One leg at a time may be stretched.

In order to make stretching exercise a part of one’s daily routine, it is best to stretch every morning when getting up and before going to bed. Stretching exercises are good back hygiene, just like brushing one’s teeth twice a day is good dental hygiene.

Home based exercises for lower back pain

The term self-management emphasizes the responsibility of the individual patient in the management of the disease. Home-based self-care emphasizing exercise is part of the self-management process. It is regarded as essential for the successful management of ankylosing spondylitis. Patients receiving this advice significantly improved self-efficacy for exercise, self-reported mobility, and levels of exercise, and revealed a tendency to improve function compared with a control group.

Aquatic exercises for lower back pain

Bathing in water (balneotherapy or spa therapy) has a long-standing tradition in the management of musculoskeletal disorders. Its effect is attributed to the physical properties of water resulting in biomechanical changes, such as joint unloading and relaxation. Further expected effects are physiologic changes, such as increased urination and dilution of blood. A systematic review of randomized controlled trials investigating bathing therapy acknowledged the positive findings reported in most trials. Owing to insufficient scientific evidence, however, a conclusion about the efficacy of bathing therapy for patients with arthritis could not be reached. Aquatic therapy is a subgroup of bathing therapy and consists of exercises in a hot water pool. The recommended water temperature is 33°C to 34°C (92°F to 94°F). Aquatic therapy combines the benefits of bathing therapy and exercise. Exercising and independent walking are possible because of the buoyancy and support of the water, even when walking aids or assistance is required on dry land. The additional benefit of the water could be an explanation for the improved muscle strength in the lower limbs of women with fibromyalgia exercising in waist-high water, while the strength of other muscles did not change. Additional benefits were improvements in pain and health-related quality of life. A comparison of the effects of deep water running and land-based exercises in women with fibromyalgia showed no differences in aerobic gain, but did show more advantages related to emotional aspects. Patients with osteoarthritis achieved more functional gains with water-based and land-based exercise programs than a control group. Pain relief was better with aquatic exercise.

High Intensity versus Low Intensity Exercise

The applicability of high-intensity exercises for patients with lower back pain has long been questioned because of concerns about accelerating joint damage. Treatment recommendations for these patients traditionally consisted of exercise restriction or exercise programs limited to non weight-bearing isometric exercises and range-of-motion exercises. There is growing evidence, however, that intensive exercise programs are more effective than conservative treatment in improving the muscle strength and functional ability of patients. Patients with preexisting extensive large joint damage should be advised to refrain from activities that excessively strain the damaged joints because high-intensity, weight-bearing exercises seem to accelerate joint damage.

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