Chronic Lower Back Pain | Exercise Remedies For Chronic Low Back Pain

By Dr Ken Nakamura+

Chronic Low Back Pain | Exercise Remedies For Chronic Low Back Pain - Toronto Downtown Chiropractor

Do you have chronic lower back pain?

 

Have you tried chiropractic, physiotherapy, and massage therapy with temporary relief or no relief at all? You might need a second opinion or you just might need the right exercises.

 

In this issue of Bodi Empowerment I give you some evidence based exercises for chronic lower back pain and explain to you some of the reasons for why you’ve had this lower back pain for so long.

 

Stability For Chronic Lower Back Pain

 

Contrary to what you might think a flexible spine is not a good way to avoid chronic lower back pain. If you are flexible like a dancer or a gymnast chances are you will likely have more lower back later on [1]. The muscles of the lower back including the rest of the core are there for stability. Stability in this case refers to less movement.

 

It’s safer for the body to keep the movements in the lower back limited. Too much movement and you start aggravating your discs and spinal joints leading to osteoarthritis. Too little movement leads to muscle stiffness, unnatural spinal vertebrae movements and eventually osteoarthritis. What should you do then?

 

You need some strength but stability and endurance are more important to prevent lower back pain. Part of the reason why people with very strong backs  have chronic lower back pain is that they may have enormous strength but relatively less stability and endurance. (Stability exercises are shown below)

Reasons For Chronic Lower Back Pain

 

  • Lack of lower back stability and endurance

 

 

 

  • Psychology: It’s very well established through the research that chronic lower back pain is affected by how you think. I explain all these factors in detail later on.

 

Chronic Lower Back Pain Supports & Belts

 

The 1994 National institute for Occupational Safety and Health (NIOSH) “Workplace Use of Back Belts” concluded that: 

 

  • Those who have never had a previous back injury have no additional protective benefit from wearing a belt.

 

  • Those who were injured while wearing a belt risk a more severe injury then if belts were not worn.

 

  • Belts change the lifting style of people to either decrease loads for some and increase load for others.

 

  • Increased cardiovascular risk due to increased diastolic blood pressure and heart rate, and linked to varicose veins in the testicles, hemorrhoids and hernias.

 

  • Belts should not be used for long-term use. You should wean the use of beltshe period after they finish wearing the belt is when people are most vulnerable to injury.

 

See Also: Low Back Support- The Definitive Guide To Low Back Belts

 

Recommendations:

  • No: not for the healthy individuals.

  • Yes: For injured worker returning to work temporarily

 

Chronic Low Back Pain & Your Psychology

If you identify with any of these factors then you have a greater chance that your lower back pain will become a chronic lower back pain [2].

 

  • Belief that pain and activity are harmful. People that are scared to move and exercise do themselves more harm. Even the most painful of chronic low back pains don’t benefit from bedrest beyond 2 days according to numerous studies [3].

 

  • ‘Sickness behaviours’ means that you are behaving as if you are sick like you have the flu. You stay in bed, are lethargic and don’t do anything around the house [4].

 

  • Low, negative or depressive moods. This is the biggest factor for transforming an acute low back pain into a chronic low back pain. The more depressed or negative you are the more likely you are to experience low back pain. For most people that are depressed they are making a low back problem into much larger low back disability.

 

  • Treatment that does not fit best practice guidelines or evidence-based care. For example going to a chiropractor or physiotherapist that does the exact same thing week after week. A sure sign you got a lemon is if you are not given specific exercises for your condition and body type.

 

  • Claims, court cases and compensation. Claims are a fact of life. If you are suing another person or on workers compensation this reinforces to your mind that you should stay sick. While your case likely has great merit you also have something to gain by continuing to feel bad. Unconsciously or consciously the body will try to stay painful.

 

  • History of back pain, time-off, other claims. Previous injuries and pain build up, especially if they were not treated correctly with evidence based care and given the right exercises. (Some exercises are shown below)

 

  • Problems at work, poor job satisfaction. If you are not happy at work your lower back pain won’t be happy.

 

  • Heavy work, unsociable hours. Heavy work damages the low back especially the discs, and ligaments.

 

  • Overprotective family or lack of support. This is again a mood and happiness issue.

 

Chronic Lower Back Pain Exercises

Some of these are the exercises recommended by the world renowned Stuart McGill.

Stir the Pot For Chronic Lower Back Pain

abdominal exercises for Chronic Low Back Pain- Toronto Downtown Chiropractor

 

  • Facedown with your elbows on the ball and toes firmly planted.
  • Move your elbows like you are stirring a pot.
  • Make sure you try to keep your lower back stable.

Bird Dog For Chronic Low Back Pain

Low back Support Back belt -post back belt exercises

  • Get into a crawling position with your hands and feet shoulder-width apart.
  • Harden your core by contracting your abs and lower back. This is called bracing.
  • Lift up your arm first. If this is easy, then lift your leg only. If that is easy, then lift the opposite legs and arms, for example right leg, left arm.
  • 3 sets of 10. If you are shaking a little or cannot balance quite right, you’re doing the right exercise, i.e.  lifting just the leg or arm might be easy, but lifting opposite arms and legs might put you off-balance a bit. Make sure you are stable before going to the advanced bird dog.

Intermediate Bird Dog: Make a fist and contract your whole upper limb. Draw 6 X 6 inch boxes or 15 cm X 15 cm boxes (approximately) in the air with your hand and foot.

Advanced Bird Dog: Raise the leg and arm on the same side. Curl-ups

Side Plank For Chronic Lower Back Pain

Side Plank for Abdominals for Chronic Low Back Pain- Toronto Downtown Chiropractor

  • Get on your side with your elbows underneath your shoulders.
  • Your feet stacked on each other.
  • To make it harder you can raise up your arm like the picture above.
  • Bring your pelvis down to the floor than bring it up again 10 times.
  • Don’t rest when you touch the floor.
  • Try to do three sets each day.

 

Tell us what you think in the comments below and like us on Facebook. This Toronto Downtown Chiropractor will answer all questions in the comments section.

 

 

Research

  1. Low Back disorders: Evidence Based Prevention and Rehabilitation Stuart McGill
  2. Ashby S, Richards K, James C. The effect of fear of movement on the lives of people with chronic low back pain… including commentary by Carleton RN, Poulain C, Meyer K, and Glombiewski JA. International Journal of Therapy & Rehabilitation [serial online]. May 2010;17(5):232-243. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed May 2, 2011.
  3. Hill J, Fritz J. Psychosocial Influences on Low Back Pain, Disability, and Response to Treatment. Physical Therapy. 2011;91 (5): 712-721. http://ptjournal.apta.org/cgi/content/extract/91/5/735 .
  4. Br J Gen Pract. 1997 Oct;47(423):647-52. Systematic reviews of bed rest and advice to stay active for acute low back pain. Waddell G1, Feder G, Lewis M.

Author

Dr Ken Nakamura

Who is Dr. Ken? I’m a father, spouse, chiropractor, and I love what I do! I created Bodi Empowerment to bring you and everyone-else safe and effective methods for self-treatment by basing my articles on research to everything I can. Still many parts will be based on 18 years of experience, seminars, and collaboration with other health experts; which means you will get opinions as well. Sometimes my articles won’t agree with what is currently accepted, but I am not here to please everyone. I’m here to empower you through the knowledge that I give you. Dr. Ken works at Rebalance Sports Medicine in downtown, Toronto.

11 Responses to Chronic Lower Back Pain | Exercise Remedies For Chronic Low Back Pain
  • Gangadhar says:
    March 26, 2014 at 12:21 am

    Hello sir,wat happens to my lower back.. Am unable to understand wat is red and yellow flag..please tell me eloboratly..becoz my age is only 26 …how would I go further..surgery or any thing else and also tell me good medications for my lower back pain ….please help me sir…becoz I already taken physio therapy and chiropractor…no change found in my lower back…

    • Dr Ken Nakamura says:
      March 26, 2014 at 12:37 am

      I can see that you are very concerned as you should be. You should seek the opinion of your family doctor then three orthopedic surgeons. As there is a financial interest in a surgeon telling you to get surgery (correct me if I am wrong-depends on the country and how surgeons are compensated) you cannot rely on one opinion. Some unethical people would recommend surgery when one is not necessary.

    • Dr Ken Nakamura says:
      August 2, 2014 at 8:45 pm

      Thanks for you comment Gangadhar. You need to consult with a neurosurgeon as you have yellow and possibly a red flag. Red flags mean you need surgery and yellow flag means it means you should be cautious because it maybe a surgical case or turn into a surgical case.

      This is why You should not do the exercises.

      Are you sure you consulted a chirproactic clinic? If you are in India there are only four clinics in the whole country.

      Hope that helps your possible disc herniation.

  • Gangadhar says:
    March 25, 2014 at 8:04 pm

    Respected sir,am glad to see ur articles.this articles are very infomative and very helpful,becoz I searched more than 100websites for treating back pain,i think ur the very best becoz ur helping a whole world like god….and am having central disc protusion at l5s1..am doing back stretching,and back strengthening exercises but my problem not solve….can I do above exercises…is it helpful for me…please help sir

    • Dr Ken Nakamura says:
      March 25, 2014 at 9:56 pm

      Thanks for comment. In your case Gangadhar you let me know in the disc herniation part II comment section (different article) that you have what is called Yellow and red flags. This means your lower back and disc is likely too unstable to deal with simply by exercises. I recommend you seek the care of a health professional to make sure you are not going to have long term problems by not taking of this promptly.

      I hope you find a honest and skillful health practitioner in your area for your disc herniation.

  • Radha says:
    March 15, 2014 at 12:54 am

    Hello Doctor.
    Thank you for all the information on back issues and exercises to heal.
    I have had low back pain for over 32 years. Sometimes it is really bad and other times it is manageable . We are planning a week safari trip to Masai Mara in July and I understand the roads are so bad and driving can be brutal. I was thinking perhaps a back belt will save my back. I have never worn a back belt and I don’t plan to wear it regularly. This would be only for occasional use when I know my back needs to be protected. Please advice.
    Thank you .

  • Just says:
    March 14, 2014 at 12:27 am

    Hi pretty good excercises. I am an athlete with a strong lower back and a okay core. I can plank for 2 minutes pretty easily but i have problems with strenghtening my abdonumus muscles. For an example i cant do sit ups because they start to hurt to much. I have a lower back problem now for 2 years and tried some stuff can you give me some good advice?

    • Dr Ken Nakamura says:
      March 14, 2014 at 8:46 am

      Thanks for the comment Just. We know from the research that sit-ups increase the pressure on the lower back discs and eventually can cause disc herniations. You can do these exercises with a medicine ball. http://www.bodiempowerment.com/posture/posture-correct-your-exaggerated-low-back-arch/ (The exercise is at the very bottom of the article). If you want to make it harder just raise one leg up. I try go back and forth about 15 times on one side than 15 times with the other leg up without resting in between.

      Another is to go to a chin-up bar hold your self up and raise up your knees. To make it harder raise up your legs with a straight leg so your legs are parallel to the ground. To make it even harder bring your legs up so it touches the bar (this might aggravate your low back).

      Hope that helps your lower back pain.

  • Diane Atwell says:
    March 9, 2014 at 12:58 am

    Hi – Great exercises and blog post. All of your posts are very informative. I have a question. Do you think tight hamstrings relate to lower back pain? If so, how would you suggest stretching them? Thanks

    • Dr Ken Nakamura says:
      March 9, 2014 at 5:27 am

      Thanks for a great question Diane. Like so many things when it comes to chronic lower back pain it depends who you ask.

      I rely on Stuart McGill for some of my information on lower back pain. Basically by increasing endurance in the core muscles and stretching other muscles you can get a stable core to take pressure off the lower back ligaments and discs. Tight hamstrings are really not a large problem. When you take the pressure off the spine like the disc you will take pressure off the nerve that goes to the hamstrings. When the nerve to hamstring calms down the hamstring loosens up.

      If you want to take the pressure off the hamstrings without causing further problems take a tennis ball while you are sitting. Put the tennis ball underneath the hamstring you want to stretch then, bend your knee. then straighten your knee. You are in essence doing ART on your own hamstring. You shouldn’t do this if you have acute pain or severe sciatica.

      Bad stretches for the hamstring are the “hurdler’s stretch” where you are on the floor with one leg straight and the other bent. Then you try to reach your toes. Another bad one is toe touches while standing.

      Hope that helps your chronic lower back pain.

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