One of the most common complaints that we see at The Physiotherapy Place clinic is lower back pain. We have seen an increase of people working from home due to the pandemic which usually results in less day to day activity and an increase in postural stresses. The majority of lower back pain is not serious and does not require investigation or surgery but it can be distressing at the time.
As physiotherapists we aim to identify some of the structures involved in lower back pain, giving reassurance to the patient and providing treatment of the lower back and surrounding areas. The spine and lower back, especially, is designed to move even when in pain therefore within our Musselburgh and Portobello clinics, exercise and stretches are usually prescribed to aid the recovery from lower back pain.
Stretches for lower back pain:
As we have said, stretches or mobility exercises are frequently prescribed to get the spine moving in order to relieve symptoms. These stretches can be done several times a day and help introduce more flexibility and mobility into the spine which should help ease pain. If there is no improvement in pain and symptoms within a few weeks despite regular stretches then physiotherapy input may be required.
Persistent pain does not always indicate that something more serious is going on but it may require further assessment and hands on treatment to break the cycle of pain.
We demonstrate 3 of the most affective stretches for lower backs here.
Exercises to avoid with lower back pain:
Are there any stretches or exercises to avoid with lower back pain?
Firstly we need to say that not everyone’s back pain is the same and different positions and movements can cause pain to some but not others. In general, your body will guide what it is tolerating and if an exercise is very painful then we may have to avoid or modify that exercise to manage pain accordingly.
Exercises which tend to put more strain on the lower back are abdominal exercises like sit-ups and double-leg lifts. It does not mean that these are not beneficial exercises but it may mean that when you are in pain then you may not be able to tolerate them at that time.
The same can be said for more impactful exercises like running, tennis and football. These are activities that are enjoyed by many all over the world but again, depending on pain levels you may need to modify or avoid these for a period of time whilst your back pain improves. Trying to increase activity and exercises is a great way of improving and preventing lower back pain.
Can I exercise too much?
We have mentioned so far that exercise is a great way to keep the lower back flexible and mobile to maintain spinal joint health. However, can we do too much? When we see patients in either our Portobello or Musselburgh clinic, part of the assessment is asking about activity levels and if there are any recent changes. What we find in practice is that the majority of patients presenting with lower back pain have had some change to lifestyle, work or exercise levels.
There has been enormous disruption in people’s lives during the pandemic with work life balance being tipped on its head. This change has led to many people returning to exercise after at times a long layoff. If you increase exercise load too much too quickly then the body may struggle to adapt to change and this is where you could experience an episode of lower back pain or pain in other areas of the body.
Another scenario is where a person is exercising most days if not daily but doing little stretches or mobility work for the spine. In this case we can start to see niggles or aches start to appear in the lower back in which you may be able to continue to exercise initially, however, in most cases the pain increases and you may need to stop or modify those activities.
Specific stretches and mobility are a great way to build resilience into the lower back and at The Physiotherapy place we are always encouraging our patients to move more regularly, but as we have seen, if the jump in activity levels is too great then the body can find it harder to adapt and pain may ensue.
I have a desk job which involves lots of sitting. Am I at risk of lower back pain?
We have already mentioned that there has been a huge increase of office workers working from home over the pandemic which can have its positives and negatives. At the physiotherapy clinic we have seen many people working longer hours at home with a poor desktop set up with some moving little from the sitting position for many hours. Even someone who is exercising regularly but may be working from home we find the lower back can still stiffen, muscles tighten and the end result can be pain.
More patients have adopted hybrid working in which they are going into the office more than previously and for some this can be positive as they are more active with commuting, moving around an office steps/stairs and moving more generally to communicate to others.
As physiotherapists we would advise patients to have an ergonomic assessment if they are in a job which involves a lot of sitting. This helps ensure posture is maintained and the risk of injury is reduced. A good desktop setup however is no excuse to sit for many hours whilst working without changing position or moving away from sitting.
Good practice, even in the absence of pain, is to change position regularly, move away from sitting or try some of the stretches for lower back that we mentioned earlier.
Key messages from this blog:
The majority of lower back pain is not serious.
Exercising regularly is good for you.
Be wary of significant jumps of work load or exercise levels
Try and ensure a best possible setup if working at a desk.
Move more often when at your desk
Specific stretches and mobility exercises can help prevent and manage back pain.