Low Back Pain

It can be difficult to find good exercises to do to help your lower back pain, especially when you are older. Lower back pain is estimated to affect 70% of people in their lifetime (1). In Australia, that means approximately 4 million people have sore backs (2). It’s no surprise that, with so many people affected, there are MANY treatment options out there and even more opinions on how to “fix your back”. In this article we will discuss the best exercises for lower back pain according to our experience with our clients. We’ll also discuss how back pain in the elderly needs different management. We find that Aqua therapy for lower back pain is very effective and one of the best exercises for lower back pain (for more information please go to our hydrotherapy page)

Most people are unable to say what caused their back pain. Many of our clients say that they just woke up from sleep and noticed that their back aches, while others noticed their backs refusing to go on and start aching during work. Below are the common possible causes of why your back might hurt:

1. 1. 1. Ligament sprains, muscle strains and muscle spasms
      2. Injury while playing sports, a car accident or a fall can compress the spine and cause a disc herniation
      3. Spondylosis which is a wear and tear of the joints and bones of the spine as people get older. This is a common cause of lower back pain in the elderly.
      4. Inflammatory disease of the spine like rheumatoid arthritis, spondylitis and even osteoarthritis.
      5. Sciatica which results from compression on the sciatic nerve resulting in a low back pain that extends to your buttocks and down the back of your leg. The pain is usually described as shock-like or burning.
      6. Osteoporosis which is a progressive decrease in bone density that leads to painful vertebrae fractures. This is a common cause of lower back pain in the elderly.
      7. A deformity in your spine.

Not being active enough, weak lower back muscles, and tight and overactive other muscles can contribute or cause lower back pain over time. Think of a hammer hitting a table. It may not break it straight away, but over time the repetitive force may lead to it breaking. Your back is exposed to strain every day and can normally repair before the hammer hits again. However, if your muscles/spine/the way you move aren’t functioning well over time your back will take this strain until one day you wake up with pain “out of the blue”.

Everyone’s muscles and joints are different and there is no “one size fits all” type of exercise for lower back pain. This is why doctors often refer to physiotherapists, like us, to prescribe the best exercises for YOUR lower back pain. Older clients especially need therapists familiar with the specific needs of older clients who often have other conditions, as well as lower back pain, that prevent them doing traditional lower back exercises.

Some people are more prone to back pain that others. Below are some of the reasons why:

• • • Age: Being older is a factor as our body structures change as we age. Age does not CAUSE lower back pain, however. A lot of older clients we see have very minimal lower back pain, whereas back pain can affect those at any age.
    • Fitness level: Inactivity and sedentary lifestyle is also a huge factor as our muscles change in strength and endurance level. Sitting is considered the “new smoking” in terms of health risk.
    • Weight gain: Being overweight, obese, puts significant stress on the back and may lead to low back pain.
    • Job-related factors: Having a job that requires heavy lifting, pushing, or pulling, particularly when it involves twisting or vibrating the spine, can lead to low back pain. Working at a desk all day can contribute to pain, especially from poor posture or sitting in a chair with not enough back support.

A good tip – Whatever your life/work is, your back needs to be stronger than what you do. If your back is stronger than is needed for the activities you do, then you’ll find these activities easier.

The following are the roles physiotherapy play in the management of low back pain:

1. 1. 1. Advice and early activity – Evidence shows that encouraging early movement in case of lower back pain is one of the most significant aspects of treatment. We can teach you how to move within your limits and lifestyle.
      2. Mobilisation, electrotherapy (TENS/ultrasound and others), heat, massage, and other physio manual techniques. This is to improve pain-free movements of the joints of your spine and can be useful in the short term to help your pain and movement to enable you to move/exercise more easily.
      3. Specific stabilization exercises – Emphasis is focused on improving the strength and stability of your weakened muscles especially core muscles.
      4. Stretches – Stretches especially ones that take strain off lower back, and improve movement of nerves are prescribed that suits your needs.
      5. Ergonomic advice – It involves guiding you on using the appropriate workstation to avoid aggravation of your low back pain.
      6. Postural guidelines – This involves educating you about the correct postural habits and ways to maintain accurate posture to avoid low back pain.