Male torso seen from behind.

By Adam Watson

Lower back pain is a debilitating symptom, which is usually aggravated by periods of activity, and conversely, periods of prolonged rest. In fact, according to the National Institute of Neurological Disorders and Stroke, lower back pain is the most common cause of job-related disability and a leading contributor to missed days of work. It is estimated that roughly 60-70% of individuals in industrialized countries will experience common lower back pain at some point in their lives (Duthey, 2013).

Physical Activity and Lower Back Pain

The lower back is comprised of a vast network of muscles, bones, joints, nerves, and ligaments that are primarily responsible for providing postural support, stability, and corrective action (McGill, 2013). The scope of this article will focus on the lower back muscles, specifically the deep spinal stabilizer muscles, and how to effectively strengthen them. In a study published in the American Journal of Physical Medicine and Rehabilitation in 2005, it was shown that the deep spinal stabilizer muscles are atrophied (wasted away) in individuals with chronic lower back pain (Barr et al., 2013). Therefore, it is of paramount importance to rehabilitate these muscles by strengthening them, so that the individuals burdened can increase their postural stability and ultimately reduce their experience of pain.

 Exercises to Treat Lower Back Pain

Here are 4 very effective exercises which have been shown to strengthen the deep spinal stabilizer muscles and reduce overall lower back pain.

Cat-Camel:

  1. Start in table-top position on the floor (hands directly under shoulders, knees directly under hips).
  2. Round your upper back to the sky whilst dropping your chin to your chest.
  3. Then, invert your back towards the floor and bring your forehead to the sky.

Bird Dog:

  1. Start in table-top position on the floor.
  2. Extend your left arm and right arm straight out in front of you and behind you, respectively.
  3. Resume table top position.
  4. Extend the opposite arm and leg straight out.

Single-Leg-Lower and Reach:

  1. Assume a position lying on your back and hold one leg at a 90-degree position, and the other foot in front of your glute muscles.
  2. Proceed to fully extend your leg in front of your glutes, straight out.
  3. Bring your foot back to your glutes, while keeping it off the floor the entire time.
  4. After you have completed each repetition, repeat on the other leg.

Side Plank on Knees:

  1. Position yourself on your side, with your forearm resting on the ground directly under your shoulder and on the side of your knees and lower legs (one leg should be on top of the other).
  2. You will then aim to raise your hips as high skyward as possible and hold this position until you can’t any longer.
  3. Repeat on the other side.

Note: Abstain from doing a full side plank (feet are the first contact on the floor), as that will engage the abdominal muscles more.

Frequency (Days per week) Reps Sets
Cat-Camel 3x 10-12 Perform 1 set each on the 1stweek, increasing to 2 sets the 2ndweek, and continue increasing weekly.
Bird Dog 3x 10-12
Single-Leg-Lower and Reach 3x 10-12, per side
Side Plank on Knees 3x Until Fatigued, per side

 

Weight Management

Not only is having a strengthened core the best way to reduce lower back pain, but healthily managing weight will have a large impact as well. It’s been suggested that the incidents of lower back pain in overweight and obese individuals is 1.2, and 1.55 times greater than in normal weight individuals, respectively (Peng et al., 2018). This is primarily due to the extra weight in the midsection, misaligning the body’s natural posture and creating muscular imbalances by shifting the body forward. Additionally, maintaining a healthy weight through nutrition and exercise decreases systemic inflammation, which has been suggested as a large contributor to lower back pain (da Cruz Fernandes et al., 2018; Hashem et al., 2018).

In conclusion, by engaging in physical activity, monitoring nutrition, and performing these simple exercises, one can go a long way in reducing lower back pain.

Adam Watsonis a registered kinesiologist in Kelowna, British Columbia. He specializes in understanding and working with individuals living with chronic disease, and aids in developing specialized exercise programs to improve their physical functioning and quality of life. He strongly believes that although some individuals are burdened with disease and/or have an injury, everyone possesses the ability to return to an optimal level of functioning. If you have any questions or want to get in contact, send him an email at Adamw15@mail.ubc.ca.

References

Barr, K. P., Griggs, M., and Cadby T. (2005). Lumbar stabilization: Core concepts and current literature, part one. Am. J. Phys. Med. Rehabil. 84:473–480.

da Cruz Fernandes, I. M., Pinto, R. Z., Ferreira, P., & Lira, F. S. (2018). Low back pain, obesity, and inflammatory markers: exercise as potential treatment. Journal of exercise rehabilitation14(2), 168.

Duthey, B. (2013). Background paper 6.24 low back pain. Priority medicines for Europe and the world. Global Burden of Disease, 1-29.

Hashem, L. E., Roffey, D. M., Alfasi, A. M., Papineau, G. D., Wai, D. C., Phan, P., & Wai, E. K. (2018). Exploration of the inter-relationships between obesity, physical inactivity, inflammation, and low back pain. Spine43(17), 1218-1224.

McGill, S. M. (2013). Ultimate back fitness and performance, Backfitpro Inc., Waterloo, Canada. ISBN 0‐9736018‐0‐4.

Peng, T., Pérez, A., & Gabriel, K. P. (2018). The Association Among Overweight, Obesity, and Low Back Pain in US Adults: A Cross-Sectional Study of the 2015 National Health Interview Survey. Journal of manipulative and physiological therapeutics41(4), 294-303.