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Chronic Lower Back Pain? Contents What causes chronic lower back pain? . 3 What treatment can I receive? . 5 What exercises should I do? . 6 YOUR GUIDE TO Exercises . 7 Phase 1 . 7 Phase 2 . 11 CHRONIC Phase 3 . 14 LOWER BACK Introduction Please take note of the following something that you have read in this PAIN before starting any of the exercises guide. in this guide: G Many people have found quick and G IPRS are committed to helping you lasting relief from their chronic lower to recover in the shortest and safest back pain by acting upon the possible time. information provided, but everyone decides for themselves what to do G The information contained in this An IPRS Guide to provide you with this information. Should you L guide is intended to assist in doubt a particular exercise in your managing your recovery. A with exercises and advice to situation, please consult your health T ease your condition G This guide is based on the latest professional. medical research in the field and E When consulting your health contains the best advice available to L professional, it is wise to take this the best of our knowledge. E guide with you to show them. G This guide is complementary to K G If you have any uncertainties or other medical services and is not S queries regarding the information, intended as a substitute for a health please do not hesitate to contact us O care provider’s consultation. on our free phone number L G Never disregard medical advice or 0800 072 1227 or email us at U delay in seeking advice because of [email protected]. C S U M What is chronic lower back pain? Chronic lower back pain (LBP) is OSTEOPOROSIS defined as pain that persists longer Osteoporosis is a condition that arises than 12 weeks and is often attributed to from a decrease in your bone density degenerative or traumatic conditions (your body is failing to produce new of the spine. The evolution of chronic bone and is absorbing too much of the LBP is complex, with physiologic, existing bone). This will lead to your psychological, and psychosocial bones becoming thinner and weaker, influences. and therefore prone to fracturing (breaking). Conditions that may be causing your back pain BULGING (HERNIATED) DISC Most bulging discs are known to occur in the lower back, known as the lumbar spine. This condition occurs when the discs, between the vertebrae, weaken KYPHOSIS AND LORDOSIS or start to slowly degenerate. This can Kyphosis is an increased curvature of cause the cartilage to bulge, or be the normal upper back curve, also pushed into an area containing the SCIATICA known as the thoracic spine . Lordosis spinal chord or another nerve. This can This condition results from the is an increased curvature of the lead to the pain that you may be irritation of the sciatic nerve, which is normal lower back curve, also known experiencing. the large nerve that carries nerve as the lumbar spine. Changes away fibres down to the right and left leg, from the normal curviture of the spine and runs from the lumbar spine to the can result in pain as there is a greater lower leg. There are a number of pressure exerted on the vertebrae, factors that can irritate the nerve, but discs, and musculature that supports the most common cause occurs when SCOLIOSIS these areas. a bulging, or herniated, disc starts to This involves a curvature of the spine push against the sciatic nerve. The and can come in the form of a ‘C’ curve symptoms that you are likely to feel (one curve) or an ‘S’ curve (two curves). are a burning type pain in the lower This picture is an example of what back that may then extend into the scoliosis may look like. Bear in mind buttocks and either leg. In some that some cases will not be as severe as severe cases the symptoms may shown here. Exercises are available to differ and you will experience the people, who are diagnosed with the numbness and a feeling as if you have condition of scoliosis. lost some control over your legs. This is due to the pressure being placed on the nerve. Medical Illustration Copyright © 2008 Nucleus Medical Art, All rights reserved. Medical Illustration Copyright © 2008 Nucleus Medical Art, All rights reserved. 3 www.nucleusinc.com www.nucleusinc.com 4 What treatment can I receive? If you are suffering from chronic lower MANUAL THERAPY LIFESTYLE back pain it is important to visit your Physical therapy is often required to There are ways in which you can look 3.When carrying parcels in both GP, registered chiropractor or decrease muscle spasm, reduce after your back and work more at hands, try and carry similar loads on physiotherapist, so that a full inflammation, provide mobilisation prevention of your injury rather both sides. examination can be performed and a techniques, massage and other than cure: 4.Try and use satchels that can strap diagnosis reached as to the cause of modalities which will all help to on both shoulders, to share the weight your lower back pain. If necessary your decrease the pain and get you back to 1. Be aware of your everyday posture and prevent leaning to one side. GP may arrange for X-rays to get a full function as soon as possible. The i.e. try not to slouch when sitting or better view of the bones, or an MRI extent to which these techniques will standing. Periodically stand up and 5.Watch your weight, extra weight scan to get a clearer view of the soft help is very dependant on your walk around the house/office. When can increase the chances of you tissue, discs etc in your spine. diagnosis. standing, try to balance your weight developing a back injury, as it CHOICE OF TREATMENT G Ice/heat therapy is often used by evenly between the right and left leg. encourages abnormal postures. It can also prolong the recovery process. This will depend entirely on the therapists, and can be used as a home 2.Be aware of your lifting technique. diagnosis/cause of the lower back therapy to relieve pain, reduce Keep objects close to your body, and 6.Understand your diagnosis and pain. Some types may benefit from inflammation and reduce muscle use your knees, keeping your back make sure that you look after your physical therapy, massage, and/or spasms. straight when lifting an object. Use back in the future, by through medications (e.g. non-steroidal anti- EXERCISE your feet to turn, try not to twist your including good habits into your inflammatory drugs), whilst others Exercise can play a significant role in back. every day life. may require injections, bracing or easing the pain of chronic lower back surgery. pain and preventing its reoccurance. DRUG TREATMENT The main goals of rehabilitation for G Paracetamol based pain killers are indivduals with chronic lower back What exercises should I do? usually prescribed by doctors to help pain are to prevent further weakness G Range of movement 2. Avoid over stretching, therefore with pain management. and pain, and to maximise strength, stability, flexibility, endurance and (ROM)/stretching exercises only take the stretch to a comfortable G Anti-inflammatory drugs are mobility. The maintenance of a G Strengthening exercises pain/stretch level. usually prescibed by doctors to G Aerobic exercises: cycling, regular exercise routine is essential to 3. If necessary, accumulate exercise control the inflammatory process. swimming, water-aerobics, walking. preventing future episodes of lower dose throughout the day. For G Steroids such as cortisone It is suggested you do aerobic back pain. example three sets of 10 minute (injections and tablets) are also used exercise for 20-30 minutes, three exercises may be preferred to 30 to manage pain and inflammation. times a week. minutes of continuous exercise. DIET SPECIAL CONSIDERATIONS It is important that you maintain a 1. Stretching and stability exercises 4. Some post-exercise soft tissue healthy, balanced diet in order to avoid should be performed daily, even on discomfort may be expected. excessive weight gain. Added weight the days when there is no pain. will put increased strain on your lower back and may greatly aggravate your condition. 5 6 GLUTE STRETCH Exercises phase 1 Lying on your back, rest your right When first starting an exercise when you have ‘bad’ days or if you have ankle on your left knee. Using programme, start slowly and only do done something to cause a flare up. your hands lift your left leg into as much as you are comfortable with. the air, bending your knee at 90°. If you have pain, other than slight For example: only do the stretches Pull your left leg gently towards muscle stiffness after exercise, then and stability exercises, as in phase one. your body. You should feel the you have done too much or are doing If this happens when you have stretch in the upper part of your the exercises incorrectly, and need to progressed to phase 2, do not be right leg (i.e. buttock region). adjust your programme or consult scared to regress for a day or two until your therapist. you feel better and are able to Adapt your exercise programme continue the strengthening exercises. QUADRICEPS STRETCH Lying on your side, pull your heel in towards your buttocks until a S T R E T C H I N G E X E R C I S E S comfortable stretch is felt in the G Repeat each of these stretches G You can use a towel to aid you in front of your thigh.
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