Ask The Trainer: Lower Back Pain

What causes lower back pain?

Back pain is a major health issue in Western countries and 60%–80% of adults are likely to experience low back pain at some point during their lives according to the US National Library of Medicine & National Institutes of Health. 

Back pain is currently the largest reported reason for sickness absence in the UK accounting for 40% of sickness absence in the NHS and overall, it costs £10 billion for the UK economy. 

Back pain can range from a muscle aching to a shooting, burning or stabbing sensation. In addition, the pain may radiate down the leg or worsen with bending, twisting, lifting, standing or walking. People with back pain report limitations in daily activities such as work, housework and leisure activities. 

The segment structure of the back and its complex system of joints provide the strength and flexibility we need in our daily lives. The causes of back problems are often caused by bad posture and activity-related mishaps but could also be linked to illnesses, natural bone degeneration or body structural changes as, for example, during pregnancy. 

Conditions commonly linked to back pain include: 

• Muscle or ligament strain: Back muscles and spinal ligaments can be affected by repeated heavy lifting or a sudden awkward movement. Leading a sedentary lifestyle or if you’re in poor physical condition, constant strain on your back can cause painful muscle spasms. During pregnancy, the lower back is the area most commonly affected due to the impact on the posture causing muscle strain in the lumbar area. 

• Bulging or ruptured discs: Discs act as cushions between the bones (vertebrae) in your spine. The soft material inside a disk can bulge or rupture and press on a nerve. However, you can have a bulging or ruptured disk without back pain. 

• Abnormal shape of the spine (Scoliosis, Kyphosis, Lordosis). Spinal irregularity impacts two to three percent of the population or about six to nine million Americans according to the American Association of Neurological Surgeons. For those affected, a common symptom often includes lower back pain or discomfort.

• Arthritis: Arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis. This condition can lead to back pain, particularly around the lower back. 

• Osteoporosis: This is a condition where your bones become porous and brittle which may cause your spine’s vertebrae to develop painful fractures and uncomfortable back pain. 

• Non-mechanical Disease Processes: Cancer of the spine, Bladder infections, kidney stones, kidney infections, pelvic inflammatory disease, sleeping disorders and stress. 

Most women experience back pain at some point during the course of their pregnancy. The reasons for this are twofold. Carrying excess weight around the abdominal area not only affects the muscle tone of the abdomen, but it also alters the mother-to-be’s centre of gravity and posture. Also, the impact of the hormonal changes as the pregnancy hormone, relaxin, loosens the ligaments causing the women to become more at risk of general joint strains including strains to the joints in the spine. 

As a preventative measure, adopting lifestyle adjustments to help manage and avoid lower back pain can be very beneficial in the long term. 

Below are some examples: 

• Improve physical fitness and stay active: Regular exercise can help improve core muscles strength and flexibility that support your spine. It is advised to do a smaller amount of physical activity regularly at least 3 times a week for 30 minutes. 

• Maintain proper body weight: Maintain a healthy weight and eat a nutritious diet with sufficient daily intake of calcium, phosphorus, and vitamin D to promote new bone growth. 

• Make your workspace as ergonomic as possible: If you sit at a desk, make sure your chair has plenty of lower-back support and your hips are at a right angle to the floor. Correct sitting posture is good for a healthy spine and back. Proper lifting and carrying techniques should be considered too. 

• Pay attention to your posture: Try to maintain good posture when sitting at home, at work or in the car. Staying in awkward positions while working or driving, for example, will affect the soft tissues in your back that support your spine, and will increase your pain or your recovery time. 

• Manage your mental health: People who have anxiety and depression, or face excessive stress, are more likely to experience back pain over time. Making your mental health a priority can help reduce your risk of lower back pain. 

• Quit smoking: Smoking reduces blood flow to the lower spine, which can contribute to spinal disc degeneration. Smoking also increases the risk of osteoporosis and impedes healing. 

• Seek help if you are not sure on what to do: A complete back exercise program designed by a personal trainer that consists of stretching and strengthening the core back muscles, abdominal, and lower body which are all necessary for supporting and stabilizing the spine, as well as regular aerobic conditioning. Pilates and yoga are also great alternatives. A personal trainer will prescribe specific exercises based on individual needs and will largely depend on factors such as fitness level, specific back pain diagnosis, and personal preferences.

What are the best three exercises to fix lower back pain?

1) Cat-Cow Stretch 

The objective of this exercise is to stretch the back muscles along the spine as well as the shoulders, neck, and chest. 

Start by getting onto all fours with hands shoulders-width apart and knees hip-width apart on the ground. Press into your hands and feet and inhale as you look up, filling the abdomen with air then exhale and tuck your chin into your chest arching your spine towards the ceiling. 

Repeat the stretch, moving with each breath for 10 reps. 

2) Partial Abdominal Curl 

This exercise aims to strengthen the core abdominal muscles to improve spinal support and stability. 

First lie back on the floor and bend your knees, keeping your feet flat and hip-width apart. Cross your hands over your chest and inhale deeply. As you exhale, engage your abdominal muscles by pulling in your stomach. Gently raise the head and shoulder about 2 inches off the ground, keeping your neck in line with the spine and eyes looking above your knee. Hold the pose for as long as you are breathing out (around 3 seconds) and release into the starting position. 

Perform 3 sets of 10 repetitions. 

3) Superman 

This exercise is designed to strengthen the extensor muscles along either side of the spine helping to improve spinal and pelvic support. 

Start by lying face down on the ground and stretch both arms out in front of the body and stretch your legs out and flat on the ground. Raise both your hands and feet off the ground and aim to keep them about 6 inches off the floor. Use your core muscles to try and pull in your belly button towards your spine and lift it off of the floor. Keep your head straight and look at the floor to avoid neck strain. Stretch your hands out and upwards as far as possible. 

Hold the pose for 3 seconds (or as long as you breath out) and release to the starting position. Perform 3 sets of 10 repetitions.

Most of the time and with the right preventative measures, back pain resolves on its own. Practicing home care techniques such as taking rest, ice, and heat packs may also help, however, in some cases, it requires medical or surgical treatment. If back pain is disrupting daily life, then it’s time to talk to a doctor to help identify the underlying cause of the back pain and to put a plan in place to help mitigate the discomfort and resume normal activities. 

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Written By Aline: Female fitness expert at MotivatePT – Reps Level 3 Qualified / Pre & Post Natal