Lower back pain is an all too common complaint these days in modern society. It is estimated that 1 in 3 people suffer from lower back pain on a daily basis and more than eighty percent of people will experience back pain at some point in their life. The lower back takes a great amount of load with our lifestyle. The lower back transfers forces from the axial spine to the extremities making it prone to injury. The lumbar spine L4-L5 and L5-S1 are the two lowest segments most likely to wear down over time or be injured. The lower back has great flexibility however is often subject to injury and overuse. There are many conditions of the lower back from muscle strain, disc injuries and joint irritation. The cause of lower back pain can be from numerous underlying problems varying immensely from lifting heavy objects, weak core muscles, obesity, sudden movements, sedentary lifestyle, stress, poor sleeping position and poor posture from prolonged sitting.

Low back pain may be classified as acute (intense pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (dull pain more than 12 weeks). Acute back pain is usually due to sprains or strains and typically resolves in a few weeks. Chronic back pain however is more complicated in terms of its causes and its treatment. Chronic lower back is often a combination of lifestyle factors with both physical and psychological aspects. A multidisciplinary treatment approach provides the best possible outcomes. Follow these simple effective self-help strategies in preventing back pain and stop it from returning in the future.

1. Strengthen your Core

Core exercises are not only an important part of a well-rounded fitness program it is essential for good back health. Core strength is fundamental for maintaining proper posture, stabilisation of the lower back and hips with everyday movements and also especially important with dynamic sports. A regular strength training routine to maintain a strong core is beneficial for trunk stability, balance and preventing injuries of the lower back especially twisting movements. Strengthening your core muscles helps to prevent spinal injuries to structures of the lower back including discs, joints, ligaments and soft tissue. Performing core exercises twice a week is advised to help reduce the risk of lower back related injuries.

Often the root cause of a lot of chronic lower back problems comes from muscle imbalances of the pelvis. A weak core in conjunction with tight hip flexors is one of the major underlining issues putting mechanical stress on the lower back. If you are sitting a lot during the day with your hips flexed your hips flexors or psoas muscles will begin to shorten. Tight hip flexors pull your pelvis forward otherwise known as an anterior pelvic tilt. If your core is not strong it will not be able to stabilise and counteract this movement. This will create an excessive lumbar lordosis curve predisposing your lower back to injury.

2. Correct your Posture

Being aware of your posture and potential aggravating activities is helpful for preventing back pain. Poor back posture causes stress of muscles, ligaments and intervertebral discs of the spine. Overtime it can lead to early degeneration and chronic pain. Sitting for prolonged periods at the desk with either poor posture or a chair that does not support the natural curve of your lower back spine is not good. Consider getting an ergonomic chair or even better a standing desk. Sitting puts 40% more pressure on your spine than standing does. Standing desks are great for when your postural muscles start to fatigue and when you start to fall into faulty postural alignment. Having the variation between standing and sitting allows for better posture and recovery time for muscles. If you have lower back pain try standing to take pressure off your back.

Postural muscles are endurance muscles meaning they are required to sustain prolong contraction over a long period of time. One of the major causes of poor posture is the muscle imbalance between the large tight pectorial muscles of the chest and the apposing smaller often weak rhomboid scapula retractor muscles of the back. To counteract forward or rounded shoulders strengthening exercises of your upper back are recommended to stabilise your scapula keeping your shoulders down and back. In conjunction stretching of your pectoral muscles in a doorway or using a foam roller on your upper back is advised to correct this forward shoulder positioning

3. Lift Heavy Objects Properly

Improper or heavy lifting is a common cause of back pain. Prevention is always better than a cure. Having the correct lifting technique by squatting can save your back from injury and going into acute muscle spasm. Bending from your knees not your lower back is a habit that can be learnt and can start to become automatic overtime. Lifting heavy objects puts undue pressure on your lower backend needs to be avoided wherever possible. A bulging disc is often an injury caused by heavy lifting. A disc bulge is an injury that is often a gradual build up of muscle tightness overtime combined with poor lifting technique leading to a singular traumatic event. Avoiding lifting heavy objects is advised but may be a component of your job. Even if you are not lifting heavy objects with your work carrying a bulky laptop bag, suitcase, camera, or a load of groceries can also cause strain on your back. Whenever possible, take some weight off your shoulders by carrying less and distributing the weight evenly to both sides of your body.

4. Lose Some Extra Weight

Taking control of your weight is not only beneficial for your overall health your back will also thank you. Excessive belly weight can be a factor of lower back pain. Extra kilograms around the stomach shifts  your centre of gravity forward and this puts mechanical stress on the lower back. The more weight on the stomach the more the lower back has to curve to counteract. Excessive lower back curve or lumbar lordosis strains ligaments and is more likely to cause a bulging disc over time.

5. Stretch Tight Muscles

The body is designed for movement. Muscles need to be moved and stretch regularly. Stiffness in the lower back often occurs after prolonged periods of sustained positions of sitting, lying or standing. Relieve the strain of the day whenever you can by getting up, walking around, and doing some simple stretches. Tight muscles of the lower back effect flexibility, posture, stability and overall function.

Taking up yoga is a good idea if you are one who forgets to stretch regularly. According to a study published in the journal Archives of Internal Medicine people who took yoga or stretching classes are twice as likely to cut back on pain medications for their back aches as people who managed symptoms on their own. The most common muscles that cause lower back pain are the glutes, hip flexors and the hamstrings. Muscular trigger points in the glutes can refer pain to the lower back and down the leg mimicking sciatica like symptoms. The hip flexors or psoas muscle pulls the pelvis forward causing an anterior pelvic tilt and excessive lumbar lordosis. The main cause of psoas tightness is adaptive shortening from sitting for prolonged periods of time at work. Chronic hamstring tightness is also a common problem which pulls down on the pelvis putting stress on the lower back.

6. Find the Right Sleeping Position

Sleeping position is an important habit to get right when you count the hours we sleep per night. Sleep position can prevent lower back pain and help to relieve it when it’s painful. Finding a comfortable position when your back is in pain can have you tossing and turning all night. You want your back in a neutral position meaning not over arched and not flat either. Lying on your back with a pillow behind your knees is one of the best positions to sleep. Elevating your legs slightly relieves pressure on your lower back whilst you sleep. Sleeping on your side with a pillow between your knees slightly bend is a good alternative position. The pillow between your knees helps to prevent your top hip from rolling in and twisting your lower back. Sleeping on your stomach is often the worst position as it puts pressure on your back and even more pressure on your neck as your having to turn to one side.

7. Take Care of Your Emotions

Emotional stress and anxiety are emotions that can manifest physically often sensitise and prolong lower back pain. Dr. John Sarno, Professor of Rehabilitation Medicine at New York University School of Medicine coined the phrase Tension Myositis Syndrome (TMS) to describe stress-related back pain. In Dr. Sarno’s theory is that patients who do not deal with their stress and anxiety push them out of their conscious awareness and into their unconscious and is used as the mind’s defence mechanism. The conscious mind is distracted by the physical pain, as the psychological repression process keeps the anger contained in the unconscious and preventing it from entering conscious awareness. This unconscious tension starts a cascade of changes in the autonomic nervous system of the body:

  1. Constriction of blood vessels throughout the body
  2. Reduction of blood flow to the muscles and other tissues
  3. Decrease in oxygen in the muscles and tissues of the body
  4. Build-up of biochemical waste in the muscles

Find some ways to reduce stress in your daily life. Whether it be meditation, yoga or simply doing a hobby you enjoy. Reducing stress helps manage chronic pain.