How Do I Manage Low Back Pain?

Low back pain is a very common injury and form of disability amongst adults. It is the fifth most common reason for physician visits, and will affect approximately 60-80% of adults throughout their lifetime. Pain that occurs for greater than 3 months is considered to be chronic low back pain (Knan and Hargunani, 2014). 

There are many different factors that can cause back pain. In people who have low back pain:

• 27% is caused by mechanical factors including; a herniated disc, scoliosis, spondylosis, fracture, spinal stenosis etc.

• 2% is referred pain from other illnesses that might include: renal disease, chronic pelvic inflammatory disease, pancreatitis etc.

• 1% is caused by non mechanical including; infection, neoplastia (cancer), inflammatory arthritis

• 70% is caused by non specific factors (lumbar strain or sprain)

The majority of cases of low back pain are caused by “non specific factors” which means that there is no direct diagnosable cause to the low back pain, this makes low back pain complex and difficult to treat (Allen and Hulber, 2009). However exercise has been proven to be an effective treatment for low back pain. 

Exercise for the Treatment of Low Back Pain

With non specific low back pain, there are many different treatment options. Exercise therapy has been researched extensively and found to have beneficial effects for the management of chronic low back pain. Researchers have found that trunk coordination, strengthening and endurance exercises reduced low back pain and disability in patients with subacute (less than three months) and chronic (greater than three months) low back pain (Delitto et al, 2012).

Often treatment involves strengthening the muscles around the low back including the deep core muscles, and glutes including the (gluteus medius and minimus) to help support the spine.

Core Exercises for Low Back Pain

Your core makes up all the muscles in your trunk from your ribcage to your pelvis. You core helps you balance, prepare for movement, bend your trunk (torso) in all directions and stay stable during movement. For more information on what the core does click the button below. 

Core exercises play an important role in the management of chronic low back pain. There are four general types of core exercises that can be done; 

• Balance exercises – in standing, sitting, or on unstable surfaces

• Stabilization – holding your body in place (including: planks, side planks, bird dogs etc.)

• Motor control exercises – learning how to activate and control core muscles

• Segmental stabilization – activation of the deep core muscles

In the Journal of Physical Therapy Science one study found that all four kinds of core exercises were helpful in the treatment of low back pain, but particular focus should be on training the deep core muscles (Chang, Lin, Lae, 2015). Below we will talk about the role of these deep core muscles and how to activate them.