Advanced Pain Therapy, LLC

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Low-Impact Aerobic Conditioning

Finally, aerobic exercises that get the heart rate up and the blood flowing, but do so without jarring the spine, are very important for both rehabilitation and maintenance of the lower back. Aerobically fit patients will have fewer episodes of low back pain, and will experience less pain when an episode occurs. Patients with chronic low back pain who do not work on aerobic conditioning are more likely to eventually lose their ability to perform everyday activities. Examples of low-impact aerobic exercises that are gentle on the low back are:

  • Water exercises (also called pool therapy or aquatic therapy)
  • Stationary exercise biking
  • Exercise walking (including walking on a treadmill)

Dr. Marcello Sammarone, MD ‚óŹ 

Stretches to Reduce Back Pain

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A normal routine of back exercises can prevent low back pain and/or reduce the risk and duration of  "flare-ups." Controlled, gradual, progressive back pain exercises can help the back keep its strength and flexibility. Also, back movement improves the delivery of nutrients to spine, keeping discs, muscles, ligaments, and joints healthier.
Prior to starting a new exercise program, it is always desirable for patients to first see a spine specialist who is trained in developing individualized back exercise programs and in instructing patients to use the correct form and technique for each exercise. Low back pain exercise regimens will vary widely depending on the patient's diagnosis and amount of pain.

Stretching to Reduce Lower Back Pain

The body was designed with the spinal column and all of the connected muscles, ligaments, and tendons for motion, and limitations in the back's range of motion can cause low back pain. While it may take several weeks or months of regular stretching to see improvement, patients with chronic low back pain often find that more range of motion in their low back tends to relieve their low back pain. Some of the stretching exercises below may help alleviate low back pain.

  • Hamstring stretches. Researchers have noted a link between tight hamstrings (the large muscles in the back of the thigh) and low back pain, although it's not yet understood what way the relationship flows. However, it is known that hamstring tightness limits movement in the pelvis and can place it in a position that increases stress across the low back. Hamstring stretches can help relive the intensity of low back pain and the frequency of recurrences. There are a variety of hamstring stretching techniques that are gentle on the low back, such as sitting on a chair and placing one's leg on another chair to gently stretch the hamstring.

  • Psoas Major muscle stretching exercise. A tight Psoas Major muscle (in the front of the lower spine) can also limit low back movement. This muscle can be stretched by kneeling on one knee and moving the leg outward, tightening the guteal muscles on the side being stretched, and leaning forward through the hip joint (rather than bending through the lumbar spine). The stretch should be felt in the front of the hip that the patient is kneeling on.

Strengthening the Low Back to Reduce Pain

For the mechanical instability, dynamic lumbar stabilization exercises for patients with degenerative disc disease can provide help to stabilize the spinal segments. Good muscular control of the spine can help atone for a degenerated disc and reduce both vulnerability and pain. Focusing on training the lumbar extensor muscles is very important.
These exercises, which are best taught by a physical therapist, consist of the following:

  • Locating the position the spine is most comfortable in (neutral spine)
  • Teaching the back muscles to place the spine in the neutral position
  • Maintaining the neutral position through a series of motions that apply more and more degrees of freedom of motion.

Dynamic lumbar stabilization exercises are commonly prescribed for reducing sciatica-type pain from degenerative disc disease, or pain that can be felt in the buttock and/or down the back of the leg.