Lower back pain is one of the most frustrating chronic musculoskeletal conditions, simply because it seems to appear and disappear with no rhyme or reason. People with chronic lower back pain can experience unpredictable and intense "flare ups" that leave them sidelined for days, or even weeks.
This week, I'll share a few tips for managing chronic lower back pain -- pain that a person has dealt with before, over time, not the sudden and unfamiliar agony caused by an acute injury, such as damage to an intervertebral disc. Acute pain is a different situation.
Chronic low back pain can be produced by many factors, but the two main culprits are typically core weakness and inflexibility. Those who sit all day are particularly susceptible, as the seated position increases vertebral pressure in the lumbar (lower back) region of the spine.
As someone who has struggled with chronic lower back pain for decades, I have learned that natural pain management is the key for me.
"Pain management" can be a scary term, especially for those who have experience with the typical medical approach to the topic. It's a world of cortisone injections, opioid prescriptions and low-level physical therapy. Yuck.
But there are ways to manage chronic lower back pain that do not involve a trip to the pharmacy. First, stretch -- a lot. Stretch the hamstrings, lower back, gluteals, quadriceps and hip flexors. These muscles all pull on the spine and hips in varying ways, so it's extremely important to maintain good flexibility among them.
Staying limber allows each muscle group to work with the next in a collaborative and unencumbered way.
The second key to managing chronic lower back pain is to avoid dangerous positions. For me, bending from the waist to pick up a heavy object is an absolute no-no. I ask for help with really heavy objects just to be safe, and I have learned that even if I can lift something, it doesn't mean I should.
Muscular weakness is the final obstacle to natural pain management, mostly because strong core muscles help to support the spine and surrounding structures. Abdominal exercises and low intensity lower back training are both important elements that not only help one manage lower back pain, but prevent the dreaded flare-ups.
This week's exercise addresses flexibility within one of the key muscles affecting lower back pain. The Iliopsoas Stretch is appropriate for almost anyone, but ease into this position very slowly to be safe.
1. Place an exercise mat on the floor.
2. Kneel down with your right knee on the mat and the left knee up.
3. Step forward with the left foot so that it's a couple of feet in front of you.
4. Straighten your spine so that you have very upright posture, and extend your right hand toward the ceiling.
5. From this position, squeeze your right gluteal muscles and press forward with your hips.
6. As you reach the end of your range of motion, lean slightly to the left to increase the stretch in the front of your right hip.
7. Hold for 15 seconds, then switch sides and repeat.
8. Perform five repetitions on each side.
The key to performing the Iliopsoas Stretch correctly is, ironically, maintaining good spinal posture throughout. This will create length in the torso and help to ensure that the target muscles are addressed while maintaining a low risk for discomfort.
It's a great way to start the day, and an exercise that I perform several times per week. Enjoy!
Matt Parrott has a doctorate in education (sport studies) and a master's in kinesiology and is certified by the American College of Sports Medicine.