Low Back Pain

Low back pain is extremely common. It has a lifetime prevalence of 84% and a high reoccurrence rate. Reassuringly most low back pain does respond to self-management with exercises and/or therapy. Movement can help you recover.  

It is recommended to see a medical professional if your low back pain hasn’t improved with self-management over 4-12 weeks OR is accompanied with any of the following:

• Pain, numbness or tingling in your leg(s)
• Changes in going to the washroom or instances of incontinence
• Severe pain
• Changes in weight
• Feeling unwell, fever or chills

Current recommendations from clinical practice guidelines strongly recommend exercise therapy. Exercises has been shown to decrease pain intensity and improve disability and long-term function. However, there is a large degree of variability about what from of exercise has been studies in research. No one type has been shown to be superior to others. Clinically, we typically prescribe 3 types of exercises for low back pain:

1. Stretching exercises

Stretching exercises are designed to improve the flexibility of the hip and back muscles. By improving their flexibility, you will have a better range of motion and less pain. If pain is primarily coming from the joints in the low back, stretches that flex your back (round it) usually work best. If pain is coming from a disc in the low back, stretches the emphasize extension of the lower back are often preferred. If you feels a stretch is helping, feel free to do more of it. Conversely, if you feel like it makes you feel worse please limit it and discuss it with a medical professional. 

2. Stability exercises

Core stability refers to our sense of where our torso and pelvis is in space and our ability to control that. Stabilizer muscles are the small muscles that sit close to your vertebrae and act to balance the vertebrae one on top of the other. If the stabilizers are working correctly, it is similar to doing squats on the ground. You can move better, generate more load and be safer. When the stabilizers are not working efficiently, it is similar to doing squats on a wobble board – we are unable, able to generate less force and muscles will tighten up more to try to protect the spine.

With chronic low back pain we can see delayed or limited activation of these muscles. For example, you go to push open a door. Usually the stabilizers will engage before pushing the door. If these stabilizer muscles are dysfunctional, we will start pushing open the door, then the stabilizers will realize they need to engage and fire. This can lease to increased stress and stain on your low back. 

3. Strengthening exercises

Core strength refers to the ability of our body to utilize our torso during higher-force movements and generate power. Core strength is an important component of rehabilitation programs for posture, back pain and hip conditions. Is usually involves the deep stabilizers of the spine controlling the spines position and then the larger, power muscle generating force. This is an important part of rehabilitation because it helps you regain function in your daily life. 

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