Put Your Back Into It - Lower Back Pain and the Benefits of Exercise
Unfortunately, lower back pain is something that nearly everyone will experience in their life. Therefore, it is important to understand what it is, how it occurs and how you can prevent it.
The Anatomy of the Lower Back
Understanding the anatomy of your lower spine can help you better understand your body and how to manage/treat your lower back pain. The spine is broken down into three different regions: cervical (neck), thoracic (ribcage) and lumbar (lower back). Within the lumbar region you have 5 vertebrae named L1 - L5, which progressively increase in size as you go down, allowing them to bear the body's weight more efficiently. Your vertebrae provide protection for your spinal cord and act as attachment points for muscles. Between these vertebrae are intervertebral discs. These provide cushioning and act as shock absorbers to protect your vertebrae during spinal movements. The vertebrae are also connected by facet joints, allowing for stability with multidirectional movement. Alongside the bones you have the lumbar muscles which are broken down into three broad functions:
The extensor muscles, which help to keep the spine upright, and assist with bending backwards.
The flexor muscles, which allow the spine to bend forward and assist with lifting and arching the lower back.
The oblique muscles, which assist in spinal rotation.
Lower Back Pain Presentations
Lower back pain can describe a range of conditions related to bone, joints, connective tissue, muscles and nerves of the back. Common causes of lower back pain include:
Congenital - skeletal irregularities and spina bifida
Injuries - sprains or traumatic injury
Degenerative - arthritis, spondylosis or disc degeneration
Nerve and spinal cord - sciatica, spinal nerve compression, inflammation or injury, stenosis, spondylolisthesis, ruptured or herniated discs, infections, osteoporosis
Symptom presentation with lower back pain can vary between each person. Possible symptoms can include:
Pain (sharp, dull, constant ache)
Tingling, numbness or weakness (typically nerve-related)
Muscle stiffness & spasms
Exercise Benefits for Lower Back Pain
In relation to the prevalence of lower back pain within Australia, research demonstrates that a combination of muscular strength, flexibility and aerobic training can be beneficial in non-specific back pain rehabilitation. Importantly, aerobic exercise can increase blood flow to the back, which can assist in stiffness reduction and promote healing. In addition to managing lower back pain, exercise plays an important role in prevention. A recent meta-analysis has shown that exercise alone can reduce back pain onset by 33%, with regular exercise participation decreasing severity and disability of pain.
Whilst there are no specific prescription principles for lower back pain, it is important to keep your spine moving and stay as active as possible. This can be achieved through regular resistance training to increase muscle strength around the back to assist in spinal support.
The Importance of Movement with a Lower Back Injury
There’s a common misconception that to reduce back pain, rest, ice and immobilisation is the go-to. Contrary to this belief, there is significant evidence to suggest that movement and exercise can decrease pain and inflammatory response.
In the case of injury, muscle guarding is the body’s first line of protection - acting as a way to prevent further damage. However, prolonged muscle guarding can elicit a false pain response, which means we continue to immobilise the initial site of injury. As a result, the body may start to produce compensatory movements which can cause strength imbalances. This highlights the important role of exercise; the body was designed to move, and when this movement is restricted, injury recovery can become unnecessarily prolonged.
Promoting movement in the early stages of injury through simple mobility drills is essential for returning to normal function. Some examples of light mobility exercises that you can complete include:
Thread the Needle
Cat/Cow
Slow torso rotations
Child’s Pose
Cobra Pose
Reducing the risk of Lower Back Pain
There are numerous ways in which you can reduce your risk of pain development. These include:
Regularly participating in physical activity and exercise, including stretching/mobility, aerobic exercise and strength training
Practice healthy habits, e.g. decrease smoking
Maintaining a healthy weight
If you work in an office, have a chair with adequate back support
Managing psychological stress by participating in related therapies
