This content was updated for accuracy and relevance on June 9, 2023
Are you suffering from low back pain? You are not alone. 8 out of 10 people in America suffer from low back pain, so “Why does my back hurt” and “what is the best course of action”?
Taking medications such as Advil or Tylenol or obtaining diagnostics such as an X-ray or MRI allows healthcare providers to objectively determine what conditions are occurring in the spinal column. However, imaging and medication have repeatedly displayed a lack of consistently improving and reducing back pain. Spine pain is one of the most challenging conditions to diagnose and treat, resulting in many people suffering from chronic pain or pain lasting longer than six months.
Understanding back pain
The vertebral spine is a series of stacked joints, making diagnosing the cause of pain tricky. Creating an individual treatment plan becomes challenging without understanding the true nature of an individual’s pain. The most important part of reducing back pain is evaluating what the possible causes may be coming from and addressing those issues. Most back pain is mechanical or responds to specific movements and exercises to increase and decrease pain.
Studies consistently support physical examination as one of the best ways to assess and reduce back pain, often providing more information than expensive and time-consuming diagnostic imaging and testing.
Movement examinations can identify:
- Joint obstruction, such as a disc
- Excess stress on tissues or muscles around the spine
- Structurally impaired tight tissues
Common causes of back pain
Though a medical examination will help identify the root cause of your pain, there could be various causes of your back issues. Some of the most common causes of back pain include:
- Sprains and strains
- Herniated discs
- Degenerative disc disease
- Arthritis
- Scoliosis
- Bad posture
- Spondylolisthesis
- Spinal stenosis
- Fractured vertebrae
- Myofascial pain syndrome
A structured physical examination provides the individual with specific movement preferences, which guide the prescription of exercises to treat the spinal conditions successfully. Your therapist will also take the time to assess the possibility of other causes of different types of back pain, such as cancer, fracture, rare conditions, infection, or nerve compression, that would require further medical evaluation.
How to exercise with lower back pain
#1 Don’t exercise first thing in the morning
According to ergonomic experts, many industrial lower back injuries tend to occur in the morning. The prevailing theory suggests that the spinal disc in the lower back absorbs fluid overnight, making them more susceptible to deform when faced with physical strain. To protect your lower back, it is advisable to allow one to two hours of gentle movement, such as walking, before doing your regular exercise session. You can also do some stretches to relieve morning back pain.
#2 Isometric strengthening of the spinal stabilizers
The primary role of your core muscles is to stabilize and limit excessive movement in the lumbar spine and pelvis. To promote a healthy spinal column and minimize the risk of lower back pain and injuries, it is recommended to avoid certain exercises like crunches, toes to bar, side bends, sit-ups, and seated twisting. Instead, incorporate exercises such as bird dogs, side hovers, Pallof press, and planks into your regular routine.
#3 Enhance function of hip flexors and gluteal muscles
To alleviate lower back pain problems, it is important for you to avoid activities that involve forward spine flexion, toe touching, and spine twisting. Surprisingly, a greater range of motion in the lumbar spine is often associated with increased rather than decreased pain. So what you should instead is focus on techniques like foam rolling and mobilizing the hip flexors and gluteal muscles, as prolonged sitting and popular “cardio training” tend to diminish their functionality. You can stabilize the pelvis and alleviate long-term lower back pain by reawakening these dormant muscles, particularly the gluteals and hip flexors.
#4 Focus on single-leg strength training
Ditch the front-loaded hip hinges, heavy lifting, cleans, snatch, and drop the loaded squats. Reduce spinal compression and train the legs, one at a time. Single-leg training reveals the right/left side movement asymmetries that drive lower back pain. Resolving these asymmetries and sparing the spine goes a long way to abolishing back pain. You will need some guidance on exercise selection and execution.
#5 Seek physical therapy
Exercise is the most powerful medication on the planet. Nothing else comes close. Take the proper dose of appropriate training and the results will be amazing. Take the wrong dose of inappropriate activity, and the results can be devastating. This is especially true for people with a history of lower back pain. Find a qualified physical therapist to guide you through your fitness journey. One way or the other you are going to spend time and money on your health. Proactive spending is always cheaper and more beneficial than reactive spending.
What is a physical or movement examination?
A movement or mechanical examination completed by a skilled physical therapist is the front-line method for improving back or spine pain. Often, you’re able to see a physical therapist without a prescription.
Step 1: Your therapist listens to and obtains a detailed history of your pain’s signs, symptoms, and patterns.
Step 2: Your therapist then obtains baselines and examines if your pain changes with specific movements. When working with a certified McKenzie or movement-based physical therapist, the response you note with these movements allows your therapist to sub-classify your pain into a movement category. This helps the therapist build an individualized program and forecast the likely course of action and time needed to feel better.
Step 3: Work with your therapist on improving limiting factors and pain by completing the correct movements and avoiding positions that can worsen the pain. This may include exercises to:
- Improve range of motion
- Build strength
- Reduce pain, tingling, or numbness in your leg, or
- Hands-on techniques to assist the patient when required.
Step 4
Learn how to reduce, maintain, and sustain the benefits and pain reduction yourself.
Other options
Because X-rays and MRI often show positive findings in patients without pain, we cannot rely solely on imaging to assist patients with getting back to normal. Medications do not usually treat the cause of pain, and prolonged rest has been shown to increase disability and time off from work. Seeing a physical therapist who can assess movement patterns and provide individual treatment that reduces back pain saves people time, money, and possible adverse side effects from medications, getting you back to your goals sooner.
To schedule an evaluation with a physical therapist, call the location nearest you or request an appointment online.
Article byFannya Manchak, PT, MSPT, CCCE, Cert. SFMA-1, DN, SportsMetrics and Jeffrey Vaisberg PT, DPT Cert. MDT, SFMA, CWC.
Ivy Rehab Physical Therapy, Broad Street, PA&Ivy Rehab, Claymont, DE
Jeffrey is a board-certified McKenzie provider, Doctor of physical therapy who practices in Claymont, DE and Feasterville, PA at Ivy Rehab Physical Therapy. He graduated with his Doctorate of Physical Therapy and Bachelor of Kinesiology degrees from Temple University. Dr. Jeff spent most of his career in Philadelphia treating many patients, from high-level athletes to patients suffering from chronic pain. One of Jeff’s specialties is helping people who have not had quality outcomes with their current or past treatment. As a lifelong student, Jeff utilizes his certifications in MDT for mechanical evaluation and treatment, StrongSteps for fall prevention, SFMA for functional movement, and weightlifting coaching. Jeff currently enjoys participating in HIIT and Muay Thai training and enjoys treating MMA athletes, weekend warriors of all skill levels, and patients suffering from chronic pain. Jeff has worked in outpatient orthopedics since graduating in 2011. He holds a direct access license in DE and PA, which allows patients to see him without a doctor’s or physician’s prescription. If you are suffering from pain, recovering from surgery or injury, or need a second opinion on your injury, Jeff is the perfect health care professional to help attain your goals.
