Low back pain can be caused by many things, as I have discussed before. The focus of this blog post though is on the dreaded disc bulge. This information is also valuable for anyone in pain who is lacking motion into extension. Extension is the position of standing up straight and leaning backwards.
The first thing that needs to be understood is the function of something called the lumbar lordosis. The lordosis is simply the name of the curve at the small of your back. When standing fully upright, you can clearly see this small arch on most everyone; however, whenever the back is rounded out, the curve is lost. Rounding of the back is often seen while sitting in a recliner, driving or riding in a car, stooping to pick up objects, working at the computer or with poor lifting mechanics.
I don’t want to bore you with the PT jargon, but it is important to know a little background on the subject. The lordosis is important, because it helps to disperse the compressive forces that are put on the spine just by standing or walking upright. In other words, this low back curve allows for shock absorbtion and flexibility. When we lose that curve (as seen in image on the right from the diagram above), the discs and surrounding tissues weaken and can result in tissue failure that leads to significant pain.1,2 I want to reiterate, low back pain can be a result of many things, but the focus of this post is on the disc.
Regardless of origin though, anytime there is an episode of recent low back pain, certain activities should be avoided or limited as much as possible: lifting, driving, stooping, or bending forward. In order to limit strain on these tissues and allow adequate healing, it is very important to maintain the natural lordosis (curve) as much as possible. If it is difficult to even stand up straight or you have pain after being in a bent position (sitting, stooping, bending over), the exercises seen in the video and described below can help establish alignment and return the body to its optimal position.
The understanding of the need to complete these exercises in the manner at which they are designed is as important as the actual exercises themselves.
To elaborate on the video a little more, the first exercise is to Lie Flat on your stomach. This may be difficult at first, but once your body relaxes, this will actually be relieving. Next, Prop Up on your elbows. Simply relax here for 2-3 minutes. This should always be a relieving position and give the body a comfortable position in which to re-establish a normal lordosis. When this becomes easier, move onto Press Ups. Place your hands under your shoulders and straighten your elbows as far as pain allows. Once in this position, slowly exhale and relax your pelvis to allow your back to “sag”. You should do this 10x with a 3-5 second hold at the top to allow full relaxation and exhalation. This may be pinching or difficult/painful to perform at first. An alternative is to perform a Standing Back Extension exercise (as seen below), which may be easier to do throughout the day. Either way, your pain should reduce pain, improve motion, and minimize/eliminate any leg symptoms you may be experiencing. These exercises should all be performed 6-8x/day.1 Of course, like anything, each person’s situation varies.
In general, most everyone can benefit from these mobility exercise, but to someone with disc-involved low back pain these exercises, stretches, and positional corrections can substantially minimize their discomfort and allow healing. As always, seek professional guidance with any questions or concerns. Pain should NOT increase, nor leg symptoms worsen. Listen to your body!
- McKenzie, R. (1980). Treat Your Own Back. New Zealand: New Zealand University Press.
- All images used from Google ® images, if not cited elswhere