Top 12 tips for Low Back Pain

by Dr Karen Chan (Physiotherapist, Acupuncturist)

As a physiotherapist and acupuncturist of over 20 years, one of the most common conditions I see is ‘Low Back Pain’. Pain from injuries (muscles/ligament strain/sprain, disc bulges, nerve impingements, ‘sciatica’, fractures), wear and tear/ arthritis, pregnancy, muscle imbalances, scoliosis and autoimmune conditions are just some to name a few.

The following tips are my general tips for people with, or for prevention of low back pain. I recommend the combination of all 12 tips, rather than just one or two; as I find this helps more so. Keep in mind, that if you have a low back condition, it does not replace treatment and is best to consult with your physiotherapist to specifically individualise these tips and treatment for you.

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1. Stretching- with our everyday demands of ‘go, go, go’ or prolonged/repetitive activities/postures, our muscles and joints are inclined to get stiff and tight. Imagine our bodies constantly contracting; we will all become one tight ball, lose our flexibility and then be prone to injury. Aim to maintain good flexibility in our low backs, gluteals, hamstrings and hip flexors in particularly. A gentle form of yoga (Hatha Yoga) can often be beneficial when guided by an experienced instructor.

2. Strengthening- This is an obvious one but often not addressed. People often think that because we lift and bend all day we are already strengthening. However we are often strengthening and overusing the wrong areas or putting extra unwanted pressure on the low back instead. Aim to increase strength in the low back, abdominal muscles, gluteals and lower legs. Swimming and pilates are common exercises which help to specifically target back strengthening. However, please consult with your health professional to ensure you are doing your exercises with good technique

3. Movement- Gone are the days of prescribed bed rest (apart from sleeping) for back pain. It is now recommended to keep relatively moving rather than resting in bed all day. Do ‘little bits often’. Avoid generally being in one position or doing one activity for too long (30mins) without a break. Eg chores- wiser to do in short spurts or spread over a couple of days. Your back will appreciate it much more. I often say 2x30min walks are better than 1x1hour walk. Apply this concept to all your activities.

4. Posture- When your back is sore; generally the most provocative posture is the combination of bending/lifting/twisting. So ensure if this needs to be done that it is done well (see point 6). Prolonged sitting is generally not advised for people with low back pain due to the immediate increase of weight on the low back structures so ideally ensure you get up and stretch/move often (see point 3). An ergonomic workstation/sit-stand desk/chair also needs to be addressed if this is an aggravating factor

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5. Sleeping - Aim for a healthy amount of sleep (7-9hours for an adult) to allow your body to rest and heal. Sleep on a firm, not soft mattress to give your back better support. And use sleeping aids like pillows to support. If you sleep on your side, put a pillow between your knees; and if you sleep on your back, put the pillow/s underneath your knees. Aim to keep your spine in a neutral position ie avoid crossing legs over your body.

6. Bend/Lift well- ensure to brace your abdomen, use your legs and avoid repetitive bending/twisting/lifting action as to not put extra unwanted pressure on your low back. ‘Bend with with legs and hips, not the back’

7. Healthy weight/diet/hydration- ‘We are what we eat!’. Think of nutrition as our body’s way of helping our body heal from the inside. The importance is often under-estimated and is usually easily rectified. Ensure adequate hydration and healthy balanced regular meals. If we are carrying those extra few kgs, this will have a direct impact on the low back. Also think of water as ‘oil for the joints and muscles’- if you are not hydrated enough (generally<2L for an averaged sized adult), the muscles and joints are more likely to dehydrate and cramp, causing more pain

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8. Avoid stress- Ongoing chronic stress and its release of stress hormones will contribute to increased chronic pain. So ideally try and practice forms of emotional resilience tools eg Mindfulness, meditation, relaxation techniques

9. Think before you move- often taking the little bit of time to think before you move can make such a difference. Often we instinctively do what we have formed as habits or the quickest route eg quickly turn/twist when someone calls our name; whereas just taking the time to slowly turn with the feet is more ideal.

10. Liniments- heating/ice gels, magnesium ointments or anti-inflammatory gels when appropriate. Talk to your health professional about which is better for you

11. Hot packs- Heat will generally help to ease pain associated with tight muscles/cramps/knots and help increase blood flow which is required for the healing process. I often get asked ‘heat or cold’. There is still often debate regarding the use of ice (even Dr Mirkin who coined the acronym ‘RICE’ has discussed ice and its association with delayed healing). Generally ice can help with pain relief and decreased swelling, however appears to decrease blood flow to the affected area and delays the healing process. After an acute injury (<48hours), I generally prefer to encourage the use of pain medication and anti-inflammatories as encouraged by your medics, and then use of heat to assist thereafter.

12. Seek medical and health professional help- Have a proper assessment and treatment with qualified professionals- your GPs, Physiotherapists (help mobilise/increase range/flexibility, decrease pain and prescribe an appropriate exercise program to help rehabilitate), acupuncturists (to help with pain reduction/management), and massage therapists (to help release muscle imbalances). Learn what can specifically help your condition and how to manage it.

As mentioned, the above are general tips and if you have a particular condition, please don’t hesitate to contact us regarding our Physiotherapy, Acupuncture, Massage, Dietetics, Yoga, and/or Mindfulness services.

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