Keys to man­ag­ing lower back pain

Great Health Guide - - CONTENTS - Kusal Goonewar­dena

IF you are suf­fer­ing back pain, it’s most im­por­tant to re­main ac­tive. This may seem counter-in­tu­itive, and may be dif­fi­cult. But ex­ten­sive re­search has con­firmed pro­longed pe­ri­ods of bed rest wors­ens lower back pain. If you are in pain the best mantra you can en­act is ‘lit­tle and of­ten’; move a lit­tle, as of­ten as you can. Even­tu­ally you can grad­u­ally in­crease your range of move­ment.

Here are some keys to man­ag­ing lower back pain.

1. Watch out for stress. A stress­ful en­vi­ron­ment will worsen your back pain. It’s nat­u­ral to worry about how bad your pain is, when it is go­ing to heal and how much it is go­ing to af­fect your ef­fi­ciency, but wor­ry­ing too much will harm you.

2. Deep breath­ing. Feel­ing tense only makes things worse, so you need to some­how re­lax your body dur­ing pe­ri­ods of pain. Rhyth­mic and slow breath­ing helps calm your mind.

3. Use a heat pad or ice pack. Heat and ice is most ef­fec­tive when re­liev­ing pain. Gen­er­ally, the rule is that if an in­jury is hot to the touch, use ice; if it’s cold, use heat. But you may de­velop a per­sonal pref­er­ence so be pre­pared to try one or the other and stick with it for the first few weeks.

4. Con­sider lum­bar sup­ports such as back sup­port, corsets and braces. Th­ese might also be help­ful in al­le­vi­at­ing pain for some peo­ple.

5. Fol­low a home ex­er­cise pro­gram. I can­not stress enough how im­por­tant it is to keep ac­tive and mov­ing. Once the orig­i­nal pain has passed, a home ex­er­cise pro­gram will help you to progress.

6. Use of pil­lows. When sleep­ing, plac­ing a pil­low be­tween or un­der your knees may help your back.

7. Do light stretch­ing ex­er­cises sev­eral times a day. This will help with the pain and may be con­tin­ued as a pre­ven­ta­tive mea­sure. Re­mem­ber ‘lit­tle and of­ten’; move a lit­tle as of­ten as pos­si­ble, within tol­er­a­ble lev­els of pain.

What ex­er­cises will help?

Of­ten the first place to start is pos­ture – the cause of so much back pain. It’s im­por­tant that your body is in align­ment, other­wise you are work­ing in­ef­fi­cient mus­cle groups and sys­tems.

But there are some good ex­er­cises to con­sider as well.

Here are my top seven ex­er­cises for back pain.

1. Cat and camel stretch. Get down on all fours, with your hands un­der the shoul­ders and knees be­low your hips. First step – let your head down and try to cre­ate a slight curve of your back to­wards the ceil­ing (like a cat stretch­ing). Hold the po­si­tion for


five sec­onds. Once done, try and sag your trunk as far as you can so that your back is arched, but do not pull it down. Hold again for five sec­onds.

2. Ham­string stretch. Lie straight on your back with your leg as straight as pos­si­ble and try to gen­tly pull it up, un­til you feel a com­fort­able stretch. Hold for 30 sec­onds. Re­peat with same side three-to-five times and then re­peat with the other leg.

3. Knee to chest. Lie on your back on a ta­ble or any firm sur­face – bend one of your legs for­ward, hold­ing your hands tightly be­hind the thigh, while keep­ing your op­po­site leg flat. Pull it to­wards your chest (pain per­mit­ting). Hold for 30 sec­onds. Switch legs and then re­peat.

4. Pelvic tilt. Lie straight on your back, with your feet flat and knees bent. Push the small of your back into the floor by pulling the lower ab­dom­i­nal mus­cles up and in­side. Hold the back flat as you breathe in and out. Hold for five sec­onds. Re­peat.

5. Pelvic lift. Lie on your back, keep­ing your knees bent and feet flat on the floor. Push down through your feet and slowly lift your bot­tom up from the floor. Hold for 10 sec­onds. Re­turn to orig­i­nal po­si­tion and re­peat 10 times. See im­age be­low.

6. Pir­i­formis stretch. Lie down on the floor with one foot placed on the lat­eral as­pect of the op­po­site side knee. Now, with your arm, gen­tly try to pull the thigh of your bent leg and twist the body. Hold for 30 sec­onds. Re­peat with the same side for threeto-five times and then re­peat with the other leg.

7. Push-up. Lie flat on your stom­ach, place your hands and palms down, un­der your shoul­ders and straighten your arms to raise your body from the floor. Keep­ing your body straight, lower your up­per body, hold for five sec­onds, then re­turn to nor­mal po­si­tion and re­peat. If push-ups are dif­fi­cult then bend your knees and push up from your knees rather than your feet.


The ex­er­cises should only be at­tempted within tol­er­a­ble com­fort lev­els. Stop im­me­di­ately if any ex­er­cises cause pain or in­crease your symp­toms. Some ex­er­cises will agree with your in­jury but oth­ers will not. Af­ter do­ing them for a pe­riod of 24 hours, lis­ten to your body and con­tinue with the most ef­fec­tive.

Stub­born back pain may need pro­fes­sional ad­vice and hands-on treat­ment. It’s im­por­tant that any pro­fes­sional you see pro­vides a di­ag­no­sis and a plan of ac­tion. Ex­pect to see some im­prove­ments in three ses­sions or fewer – if there is no im­prove­ment then con­sider a se­cond opin­ion.


• Reg­u­lar move­ment within tol­er­a­ble pain lev­els is crit­i­cal.

• Fol­low an ex­er­cise pro­gram, do stretches and use other sup­ports such as ice and heat.

• If there’s no im­prove­ment seek pro­fes­sional help and don’t be afraid to seek a se­cond opin­ion.

Kusal Goonewar­dena is an ex­pe­ri­enced phys­io­ther­a­pist, lec­turer, con­sul­tant and men­tor to thou­sands of phys­io­ther­apy stu­dents around the world. Kusal has au­thored books in­clud­ing: Low Back Pain – 30 Days to Pain Free; 3 Minute Work­outs; and co-au­thored Nat­u­ral Heal­ing: Quiet and Calm. Kusal con­sults via his clinic, Elite Akademy.

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