Lower back pain
Mid-global pandemic, many of us are in full self-isolation to protect ourselves and our family. Isolation – in most cases – has some health consequences due to the sedentary and diet lifestyle; both of which compromise the health of the spine.
What is important to understand that this can be prevented/treated by your personal commitment to undertake a proper exercise programme.
The spinal column is a very susceptible region to pain with the job of maintaining the upright position; absorbing and distributing loads; sustaining and protecting the spinal cord; and serving as a muscle and ligament attachment. The spine has two curvatures – the primary (which include the dorsal and sacred kyphosis) and the secondary (cervical, and lumbar lordosis).
Lower back pain
Lower back pain is determined as pain in the spinal region or lumbar paravertebral and affects about 80% of the population. It tends to occur greatest in men and women of over 45 years in age. 90% of cases are of mechanical origin where in most cases no specific cause is identified and 10% of cases are of non-mechanical origin where some are associated with serious pathologies.
Lower back pain can be classified as acute (pain started less than 6 weeks ago), sub-acute (between 6 weeks and up to 3 months) and chronic (occurred more than 3 months ago).
Acute lower back pain is generally not dangerous or serious and has a good response to conservative and symptomatic treatment. However, in more specific and serious cases, surgery may be required.
Chronic lower back pain is dependent on a multiple of factors (difficult symptomatic relief) and is intensified by social and behavioural factors. For treatment, physiotherapy, anti-depressants or corticoids infiltrations could be prescribed.
The 90% cases of pain classified as mechanical tend to be due to structural changes or overload and the 10% of cases of pain classified as non-mechanical tend to be due to inflammatory, infectious, tumoral, non-vertebral or visceral conditions.
In lumbosciatalgia, there are several clinical symptoms resulting from the impairment of a lumbosacral root of the sciatic nerve and associated with this condition may be lower back pain. 90% of discal lumbosciatalgia improve with proper treatment and only 10% have a requirement for surgical intervention. There are several symptoms associated with sciatic nerve injury such as: pain in the the back of the thigh or the soles of the feet (lack of or reduced feeling, tingling, burning sensation and pain) or weakness in the knee and/or foot (difficulty walking, inability to move the foot or flex the knee – the latter two occuring in severe and advanced cases of injury).
The risk of lower back pain
The people most likely to develop a sciatic nerve dysfunction are those who sit for a long time, such as, for example people who drive for their profession or administrative workers, – being key targets for sciatic nerve pain.
In some cases, surgical removal of trapped nerve can be beneficial.
The diagnosis can be made through examinations such as: analytical and radiological examination, nuclear medicine, bone densitometry, psychological evaluation, contrast examinations and biopsy. As discussed in the introduction, the best way to prevent/treat the different causes of this injury is through preventive exercises and avoiding aggravating activities such as sitting for many hours.
Some exercises for pain control
The number of series and repetitions may vary according to the effort tolerance of each person – although we recommend at least 10 repetitions of each exercise.
Lumbar flexion/extension: Lift the head and drop the back, lower the head, and arch the back (cat stretch).
Cross extension: Looking at the ground on knees and hands, lifting the left arm and right leg keeping the neck still. Hold the position for about 10 seconds and return to the starting position. Do the same exercise, but this time with the right arm and left leg.
Stretching the piriform: Maintain the position of the image below and lift the foot off the ground (it helps by hugging with the leg on which the foot is supported with the hands and pull it towards the belly).
Side plank: In the position of lateral decubitus support the weight of the body for 30 seconds (according to the image below). The time can increase according to the resistance to the effort of each person.
Adapted from the original: https://www.cmm.com.pt/lombalgia-2/
Effects of scrambler therapy on pain and depression of patients with chronic low back pain: case study.; Han JW, Lee DK; J Phys Ther Sci, 30(7):913-914, 03 Jul 2018
The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients.Lee JS, Kang SJ; J Exerc Rehabil, 12(5):463-470, 31 Oct 2016
The effects of combination patterns of proprioceptive neuromuscular facilitation and ball exercise on pain and muscle activity of chronic low back pain patients.; Lee CW, Hwangbo K, Lee IS; J Phys Ther Sci, 26(1):93-96, 01 Jan 2014
Low back pain. A Frank V(306): 901-909, 3 Apr 1993