Exercise as a treatment for chronic low back pain

The Spine Center at New England Baptist Hospital studied exercise as a prescribed treatment for chronic low back pain.  They concluded that exercise was not harmful to an already injured back, but it can, indeed reduce back pain and create a healthy back again. I found the abstract for this study at http://www.ncbi.nlm.nih.gov/pubmed/14749199

Of course, you may have already heard this message.  So why do so many people continue to suffer with it?  I believe it stems from 3 main reasons;

1. Lack of knowledge.  What exercises should I do?
2. Lack of motivation.  The “I am on the couch and I can’t get up” syndrome.
3. Waiting to be pain-free.  “I’ll start exercising on a good day.”

Lack of Knowledge;

I can’t tell you how poor of an excuse this one is!  There is SO MUCH information on what types of exercises help back problems that I hesitate to review them here.  Just go to U-Tube and search for “exercises for the back” and you will find hundreds of them.  Ok, so it can be a little overwhelming, I admit. So here is a good starting place;

•    Upper back problems are usually caused by a weakness in the muscles that surround the shoulder blades (scapula).
•    Lower back problems are usually caused by a weakness in the lower stomach (abdominal) muscles.

For pain in the upper back caused by weak Trapezius and Rhomboid muscles just pull your shoulder blades together 5-10 times, several times per day.  Later you can graduate to pulling the shoulder blades together, then “slide” those tight shoulder blades up and down the backbone (Thoracic Vertebrae).  Remember to perform these movements WITHOUT Arching your lower back, which can simply migrate your pain from the upper back to the lower back.

For pain in the lower back cause by weak lower Abdominal muscles, the “Pelvic Tilt” is the best tool in your arsenal.  Stand as straight as you can with your feet a comfortable distance apart.  Now slowly pull the bottom of your hips (pelvis) forward by tightening your lower abdominal muscles.  Think about tucking your tailbone under your body tilting the bottom of your hip bones forward.  That will feel in your body as if you are rounding the small of your back.  This puts your lower back into a strong position and can, alone, relieve much of your pain.  Repeat this motion every time you think about your back throughout the day.  Since this motion alone will not strengthen your abdominal muscles enough to relieve your chronic pain, perform the following exercises 3-4 times throughout the week; Pick-Pocket, Hip-Up, and leg lift.

To perform the “Pick-Pocket” movement, sit on the floor with your knees tucked to your chest and your feet 1-2 inches off the floor.  Touch both hands to the side of one hip as if reaching into your pocket, then move both hands to the other hip (to the pocket on the other side).  Continue to move your hands from one pocket to the other, back and forth touching both pockets at least ten (10) times each.  Begin with quick, brisk movements until you feel the abdominal muscles getting stronger.  This will take a few weeks.  Now slow the movement to about half speed, taking twice as long to touch each pocket.  The slower you do this movement, the more work you are doing.  This one is also very easy to get kids involved.  Just set each child next to you and instead of “picking” your own pocket, “pick” theirs instead.  They will soon understand the fun in trying to tickle you and each other in those brief moments.

To perform the “Hip-Up” movement, lay on your back on the floor or other flat, stable surface with your head down on the floor (or surface) and your feet up in the air bent at the waist and straight in the knees.  Now use your abdominal muscles to raise your hips up off the floor as high as you can in an explosive movement.  Repeat this 10 times, several days a week.

To perform the “Leg Lift” movement, begin by sitting in a stable chair that has arm rests but no rollers.  Sit with approximately 3-4 inches between your back and the back rest of the chair; you will not be using the back rest.  Perform a pelvic tilt (see above).  Your upper torso should be erect with the top of the head reaching up toward the ceiling.   Then, keep one leg on the floor for stability and lift the other knee as close to your chest as your body will allow while keeping your back erect.  Repeat this movement on the first leg 10 times, then 10 times with the other leg.  After this movement becomes easy and comfortable for you to perform, then try raising both legs at one time.  At this point most people need to counter-balance the leg-raise by leaning back.  This is fine but should be kept to a minimum.  The more you lean back, the less work your abdominal muscles have to do.  This is where the arms of the chair come in handy.  Use your hands on the arm rests to stabilize yourself.  Remember, there is a BIG JUMP from lifting one leg at a time to lifting both, so don’t become discouraged.   Just keep switching off between raising one leg and raising 2 legs until 10 repetitions are complete.  Later you will find you will be able to do more 2-legged raises and fewer single-leg raises in the set of 10.  When you can perform 10, 2-legged raises in a chair with relative ease, you may graduate to the same movement while sitting on the floor with your hands also on the floor.

Lack of motivation;

Don’t kick yourself or use lack of motivation as an excuse to give up on your exercise program.  You are BETTER than that! Lack of motivation happens to even the most dedicated of us.  Instead, try these helpful tips;

• Workout with a buddy.  Studies prove that people who work out together tend to work harder, longer, and more consistently.  No one wants to be the excuse for someone else not getting their workout so each buddy feels the responsibility to show up and not cancel unless a good reason can be provided.  Each buddy tries to “show off” or “prove themselves” to the other.  This stimulates each one to do their best every time.
• Keep the same routine.  When you skip a workout, your body will feel the change and stimulate action to get back to the normal routine.  It is also easier to fit it into your week when others around you know the routine and expect nothing else from you during that time.
• Do something enjoyable for the workout.  Even if you can’t play tennis yet due to your back trouble, you can make the workout fun.  Play your favorite music or even a TV show, create a contest with yourself to do more than the last time or do it with a fun flare,  wear funky clothes that make you feel energized (just. . . don’t go out in public!),  take your work out to the park where the air invigorates your senses (separate from wearing the funky clothes, like I said, don’t go out in public with them).  Do whatever you need to do to keep “exercise” from sounding like “work”.

Remember, “exercise” should never be a 4-letter word!

Waiting to be Pain-Free;

If you keep waiting to be free of your pain before starting your new exercise regimen, your muscles will continue to atrophy (reduce in size and in tone), the back pain will only get worse and you will never be free of its debilitating effects.  Instead, start at a low level today, right now! And you will see result faster than you will if you wait until a “good day” that may never come.  The longer you wait, the longer the positive results will take to be noticed.  It is best to start when you still have some muscle tone to work with. START NOW!

So, have I taken away all your excuses yet? If you can think of more excuses not to get started on your healthy road forward, please let me know the excuse you are currently using.  I would love to chop it to pieces!  Have I given you ideas to improve your torso and create a healthy back?  Please contact me if you would like more ideas.  Oh, by the way, if you have chronic back pain due to over-exertion, it might be caused by internal inflammation.  Try rubbing Calamine Lotion (yes, that old pink stuff your Grandparents used to use for bug bights) on the affected area.  It will draw the inflammation up, away from the muscles relieving some of the pressure on the bones and the nerves.

That is my last tip for this segment.  Enjoy your health!

Andra