Back Pain & Physical Therapy Exercises

The sedentary lifestyle of an individual can lead to various uncomfortable and enervating physical problems. Similarly, back pain is one of the most prevalent physical health concerns that require immediate medical attention to dig out the causes and preventive measures to get rid of it. Back pain is commonly observed in adults caused by muscle strain, injury or long hours sittings, incorrect sitting posture, etc. 

Across the globe, around 84% of people are currently suffering from lower back pain, which is also considered one of the most communal reasons for absence from work. 

Common Causes of Back Pain

Doctors can identify the cause by conducting various tests or imaging studies. The most common causes of lower back pain are as follows;

• Muscle or ligament strain and Sprains: Repeated twisting, heavy lifting, overextending the reach, and awkward body movement can cause muscle or ligament strain. The constant strain can cause painful muscle sprains.
• Herniated or ruptured discs: Back pain generally starts due to an accident or sports injury that can damage your spine. 
• Sciatica: After a herniated or ruptured disc, the compression on the sciatic nerve can cause sharp lower back pain that radiates down through your buttocks and legs. 
• Pregnancy: Pregnant women usually complain about lower back pain. As the baby’s size grows, it stretches your belly, muscles, and ligaments, sometimes causing severe back pain.
• Arthritis: Spinal stenosis can narrow the space around the spinal cord that can adversely affect the lower back.
• Osteoporosis: The spongy and fragile bones can develop painful fractures in spine vertebrates that lead to sore back pain.

Risk Factors for back pain

Following factors can cause risk of developing back pain even in children and teenagers as well; 

• Age (Back pain usually starts after 30 years of age.)
• Lack of Exercise
• Overweight
• Diseases, e.g., arthritis and cancer 
• Improper lifting
• Psychological conditions such as depression and anxiety
• Smoking

When do you need to see a doctor?

Mostly back pain can be relieved by changing lifestyles, adopting natural remedies, and staying active. You need to approach the doctor if the back pain; 

• Persists from the last few weeks. 
• Intense in nature and cannot get healed by rest and home remedies. 
• Extends below the knee.
• Causes numbness and weakness in the legs.
• Causes bladder problems.
• Leads to sudden weight loss.
• Accompanied by a fever.
• Inflammation or swelling on the back.
• Faces difficulty urinating.
• Follows a blow to your back or other injuries.

Preventive Measures or Treatments of Back Pain

To keep your back healthy and strong, you need to take the following preventive measures or treatments; 

• Smart ‘Body Posture’: You should avoid a posture that can twist or strain your back. For this, you should always try to; 

• Stand Smart 
• Sit Smart 
• Lift Smart 

• Build muscle strength and flexibility: Abdominal and back muscle exercises can strengthen your muscles and works as a natural girdle for your back.
• Maintain a healthy weight: Being overweight can badly affect your back muscles that can cause severe back pain. You should immediately trim down your body weight to get rid of back pain threats.  
• Quit smoking: The risk of back pain can increase with the frequency of smoking cigarettes per day. You should quit cigarette smoking to reduce the risk of persistent back pain.
• Exercise: It is one of the most important and effective activities to prevent back pain. It includes regular aerobics activities that don’t strain or jolt your back. It is quite beneficial to enhance your back muscle strength and endurance to function properly. Following are the exercises that your physiotherapist might suggest you;

List of Physical Therapy Exercises of Back Pain

• Spinal Decompression Therapy: It is nonsurgical decompression therapy to stretch the spine for relieving back pain.

Steps to perform Exercise of Back Pain

1. Use a parallel bar that is just higher than the body. 
2. Grab the bar and firmly hold it.
3. Hang with the bar for 30 seconds. 
4. Repeat it 5-times daily and can be enhanced with the body adjustment to the exercises. 

• Cobra Stretch: It is a powerful and easy yoga pose that uses a pull force to extend the spine. A physiotherapist usually recommends this exercise to stretch your entire body and relieve lower back pain. 

Steps to perform Exercise

1. Lie the front side of the body on the floor.
2. Place the hands on the ground while keeping the shoulders up. 
3. Keep the hips (front side) on the floor. 
4. Raise the upper body by giving support with the elbow.
5. Hold the body in a raised position for 10–15 seconds and slowly lower the upper body back to the floor.
6. Gradually increase the holding position for 30 seconds.
7.  Repeat it ten times.

• Cat-Cow Stretch: It is a yoga pose that enhances the flexibility of the neck, shoulder, and spine. It also stretches the muscles of the chest, abdomen, hips, and back. The cat-cow pose is the most simple and effective way to prevent back pain. 

Steps to perform Exercise

1. Keep the lower body part (below the knee) on the floor.
2. Hold your body on your hands and knees.
3. Align your wrists just beneath your shoulders and knees beneath your hips.
4. Place your spine as a straight line that connects the shoulders to the hips. 
5. Bend your head down to look at the floor for 10-15 seconds by keeping your shoulders up. And then go back to the original position.
6. Repeat this exercise 15-20 times daily that can be increased over time. 

• Forearm Plank: It refers to the full-body exercise that targets muscles of the whole body (upper body, core body, and lower body). It is a classical exercise that makes your body functional from head to toe. This exercise is very beneficial for patients suffering from lower back pain. 

Steps to perform Exercise

• Lay down on the mat with the forearm, keep the face down.

1. Lift your core body as you stay in the rest position on the forearms and toes.
2. Hold the body for 20–30 seconds.
3. Release it slowly.
4. Repeat this activity at least 5-10 times daily. It can be enhanced when your body becomes habitual of it.

• Knee Hugs:  It is an easy and relaxing exercise to reduce back pain by stretching your lower body. This exercise is named knee hugs, in which you can hug your both knees simultaneously. 

Steps to perform Exercise

1. Lie the upper body on the floor, with the knees bent, and keep the feet on the floor.
2. Grasp both knees with your hands and pull them toward the chest.
3. Hold it for 10-15 seconds, release them slowly. 
4. Repeat this activity minimum of 5-times daily that can be extended with the passage of time.

• Hip Bridge: This hip-stretching exercise is beneficial to enable pelvic motions and strengthen the lower back. This exercise is effective for individuals with back and hip pathologies, also named a hip extensor. 

Steps to perform Exercise

1. Lie on your back and bend your knees by maintaining the few inches’ distances between your hips and feet. 
2. Place the arms at the body side and hands near the buttocks.
3. Lift the hips upward in a way that creates a diagonal line of your body from shoulders to knees.
4. Hold the position for 1–2 seconds and slowly lower down the back in the original position. 

• Sit-ups: It is an abdominal exercise to strengthen your core body muscles and significantly reduce lower back pain. Physiotherapists rarely recommend this exercise as it is pretty hard and challenging to perform while suffering from back pain.  

Steps to perform Exercise

1. Lie on your back.
2. Keep the feet flat on the floor.
3. Bend your knees at a 90-degree angle.
4. Place the hands at the back of your neck just below the head. 
5. Bring the head upward while placing the hands at the back of the neck until you sit down on the floor.  
6. During sitting posture, your abdomen must touch your thaies. 
7. Hold the position for 2-3 seconds.
8. Slowly lower down the back in the original position.
9. Repeat this activity 10-15 times daily.  

References: 

• https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906 retrieved on February 17, 2022.  
•  https://www.uofmhealth.org/health-library/tr5948 retrieved on February 17, 2022.  
•  https://www.movementforlife.com/articles/physical-therapy-lower-back-pain-10-best-exercises-relief retrieved on February 17, 2022.  
•  https://www.iowaclinic.com/physical-therapy/stretch-and-strengthen-your-way-out-of-lower-back-pain/ retrieved on February 17, 2022.  
•  https://www.dorsalhealth.com/blog/physical-therapy-exercises-lower-back retrieved on February 17, 2022.  
•  https://thrive.kaiserpermanente.org/care-near-you/northern-california/santarosa/wp-content/uploads/sites/15/2015/09/Low-Back-Pain-Exercises_tcm28-181043.pdf retrieved on February 17, 2022.  
• https://www.medicalnewstoday.com/articles/bulging-disk-in-back#causes-and-risks retrieved on February 17, 2022. 
• https://www.medicalnewstoday.com/articles/321959#causes retrieved on February 17, 2022.