Acute low back pain paralyzes any activity and affects our everyday life. In contrast, due to continuity, chronic types of pain also deplete motivation for physical activity, which plays a vital role in improving mobility and consequently relieving pain. Furthermore, the etiology of the origin of pain indicates that the most common pests are also the most controllable, which means that we can essentially help ourselves and, with appropriate exercises and pharmacological and natural means, influence the relief of low back pain1.
LOW BACK EXERCISES: EPIDEMIOLOGY of low back pain | Different TYPES of low back pain | Low back pain causes | Risk | Preventiva | Exercises | Cross Exercises - Examples | Pain Relievers| Questions and Answers | Sources/references
The low back, or lower back, is a remarkable structure of interconnected bones, joints, nerves, ligaments, and muscles that work together to provide support, strength, and flexibility to the lumbar region.
Image: exercises for a healthy lower back and a healthy body.
However, the cross is more susceptible to injuries and pain because of this complex structure.
Epidemiology of low back pain
The spine consists of vertebral bones "stacked" on top of each other and separated by cartilage-like discs acting as shock absorbers. The spine carries the entire weight of the upper part of the body, which puts a heavy load on the lumbar portion of the spine and causes mechanical stress and tension. In addition, the spine in the lumbar region is curved, which is part of normal anatomy, but therefore the lower back is more prone to wear and tear.
Image: appearance and arrangement of vertebral bones. The pain originates mainly from the L1-5 vertebral bones.
This is also the main reason lower back pain is the most common cause of absenteeism and disability among the general population.2 Some studies have shown that up to 23% of adults suffer chronic pain. In the lower back, as many as 84% of adults have experienced lower back pain at least once.3
Different types of low back pain
From the point of view of diagnosis, specialist treatment, and later the choice of treatment methods, it is essential to distinguish between different types of low back pain. At the same time, it is crucial to determine the pain's underlying cause, severity, and location. In general, lower back pain is not treated as an independent disease but is reflected as a symptom depending on the duration and type of pain.
Acute low back pain
It usually comes on suddenly and lasts a few days to a few weeks.
Video content: acute and chronic back pain and its causes.
It occurs as a normal body response to injury or tissue damage. The pain gradually disappears if it is adequately treated. However, it is a sharper and burning pain that limits movement in the lower back, and the pain can also extend to the legs.
Chronic low back pain
It is defined as pain that lasts more than three months. This requires special attention if the condition is unresponsive to initial treatment initiated as acute pain management. Approximately 20% of people affected by acute low back pain develop chronic pain after a year4, which can be successfully relieved with exercise, natural preparations for local use, appropriate therapies, and painkillers.
Specific low back pain
In the case of specific pain, we can find a particular cause for it. Most often, it is sciatica, various traumas, deformations of intervertebral discs, inflammatory conditions, and the like. Since the cause is known, the underlying cause of the disease is treated. However, only 10% of adults find a specific reason for pain5.
Nonspecific low back pain
This type of pain, also called lumbago pain, affects people of all ages; it can be a crown or with repeated starts of acute phases. It is the most common type of pain for which there is no known cause, the cause is unclear, or it represents a combination of different factors. Therefore, treatment is aimed at alleviating pain and its consequences. On the one hand, this is also an advantage because we can help ourselves with analgesic drugs, non-pharmacological pain-killing therapies, regular exercise, and more. But on the other hand, it is essential to maintain a pain-free state.
Causes of lower back pain
Problems with the structural components of the spine cause low back pain.
Video content: the most common causes of back pain.
These are muscles, ligaments, tendons, discs, and bones. Damage to these structures can result from stress, inflammation, medical conditions, poor posture, and other factors.
Injuries, traumas, strains
If we make a sudden or awkward movement, lift heavy loads, or lift a specific load incorrectly, we can strain or damage muscles or ligaments. Cramps may occur in the muscles as they are overworked. Falls, sprains, fractures, and other injuries can cause low back pain. Excessive tension due to improper or excessive body movements is a common cause of pain. It is about the spine's structures being exposed to an external force.
Degenerative structural changes
Changes in the lumbar spine's structures and surrounding tissues leading to pain. The most common are degenerative changes that increase with age but are also familiar with specific workloads at work. As a result, structures wear out and cannot be completely restored to their original state. An example is osteoporosis as a primary disease. Still, due to the porosity and fragility of the bones, it also affects the bones of the spine, which increases the likelihood of compression fractures. The intervertebral discs also wear out, gradually putting more and more pressure on the nerves. Lumbar spinal stenosis can also develop, which narrows the spinal canal so much that it squeezes the nerve structures. Stenosis, however, causes various problems, such as sciatica. The sciatic nerve in the lumbar region is so pinched that it causes sharp pain that travels across the buttock and down the back of the leg.
Inflammatory processes
Different inflammatory processes can affect the intervertebral discs responsible for the pain. When the inflammation is in remission, the pain also subsides. We can help with natural preparations containing plant extracts with anti-inflammatory action. Rheumatic diseases that cause osteoarthritic and inflammatory changes in the spine are characteristic. One such is ankylosing spondylitis, a chronic rheumatic disease affecting certain joints and vertebrae in the lumbar region of the spine. Younger people also suffer from this disease.
Physical inactivity, poor posture
Lower back pain can be the result of certain daily activities or non-activities. Many years of incorrect posture and a sedentary lifestyle lead to gradual irregularities, especially in the shoulders and the sacral part of the spine.
Video content: How lousy posture contributes to lower back problems and pain.
Improper posture, both when sitting and standing, puts more and more strain on the spine, which is where the pain comes from. Poor posture further worsens conditions such as scoliosis, which mainly develops in childhood and means an abnormal spine curvature with rotation of the vertebrae. Physical inactivity is also essential, as weakened spinal and abdominal muscles cannot support the spine.
Other causes
Lower back pain can also occur due to certain medical conditions, which a specialist doctor must treat. Again, accurate diagnosis is essential here. For example, malignant tumors such as lung and prostate cancer can metastasize to the lumbar spine and press on the nerves, causing pain. The same applies to pain originating from diseases of the intra-abdominal organs, including the liver, gallbladder, and pancreas6.
Risks for the occurrence and worsening of low back pain
Lower back pain is most often compounded by various factors that represent risks for the event of pain and influence the further deterioration of low back pain.
Video content: 7 risk factors for lower back problems.
Most of the listed factors can be influenced mainly by ourselves, but others are not dependent on us.
Age
Age is not the primary cause of pain, but it affects the deterioration of degenerative changes in the spine. Bones lose their strength and flexibility, muscle elasticity and tone decrease, and intervertebral discs lose fluid and flexibility with age, reducing their ability to cushion the vertebrae.
Pregnancy
The body also prepares for childbirth with lax ligaments. Increased laxity stresses the joints of the lower back and pelvis, causing low back pain. In addition, due to changes in the uterus, the body's center of gravity also shifts, affecting the change in body posture, which causes pain.
Genetics
Some causes of pain have a genetic component that we cannot influence much. This is, for example, scoliosis and ankylosing spondylitis. However, research has shown that there may be a genetic predisposition to the development of nonspecific lumbago pain, which is associated with the degeneration of discs in the lower back7.
Inactive lifestyle
Lower back pain is more common in people who are not physically fit. Although rest is critical, too much rest and prolonged inactivity worsen back pain. Regular exercise, walking, and stretching help strengthen the back muscles and relieve joint stress and tension. However, lack of physical activity contributes to chronic low back pain8.
Overweight
Excess body weight puts strain on the back.
Image: excess body weight does not only harm the lower back and causes pain in this area.
Research has shown that abdominal obesity (defined by waist circumference) and general obesity (defined by body mass index) increase the risk of developing and worsening low back pain9.
Smoking
Smoking limits the flow of blood and oxygen to the intervertebral discs, which causes faster degeneration and, as a result, worsening pain.
Psychological factors
Stress affects the body in different ways. For example, mental stress causes muscle tension and stiffness, which worsens low back pain. Worse mental well-being also affects the perception of the severity of pain. On average, people with chronic pain are three times more likely to develop psychiatric symptoms. Usually, with mood or anxiety disorders, depressed patients are three times more likely to develop chronic pain10.
Preventive for the relief of lower back pain
Prevention is one of the most important ways to treat low back pain. Good posture, proper ergonomics and biomechanics, and daily exercise to strengthen the body are crucial in preventing damage to spinal structures. This stops additional wear and tear and prevents the condition from progressing. It is also important to lift loads correctly and avoid prolonged sitting.
Video content: causes, prevention, and treatment of back pain.
Proper treatment is necessary for specific medical conditions that also require surgical interventions. However, according to major international clinical guidelines, most people with low back pain require very little formal treatment within the health care system, including pain medication, steroid injections, surgery, and the like11.
Non-pharmacological interventions, including exercise, weight management, functional rehabilitation, and manual therapy, have improved the quality of life in back pain12. A healthy lifestyle that includes exercise, relaxation techniques, a balanced and nutrient-dense diet, and maintaining good posture falls under prevention measures to relieve low back pain. But if back pain already occurs, it can be treated with natural remedies like gels, patches, and cream, which contain concentrated plant extracts that reduce inflammation and have an antiseptic effect.
Physical exercises and exercise
It is a common and wrong idea that we should avoid exercising when we have lower back pain. At first glance, it seems that exercises and stretching only worsen the existing condition. However, this is not true. This is also confirmed by meta-analyses, which show that regular physical activity is associated with a 10-15% lower risk of chronic low back pain and that chronic low back pain was reduced in 35-45% of subjects who started exercising 13.
Video content: physical exercises that can relieve back pain.
Exercise represents the best long-term solution to reduce low back pain and reduce the frequency of repeated pain attacks.
The most suitable physical exercises for low back pain are14:
Aerobic exercises
Moderate aerobic exercises, such as brisk walking, running, swimming, and cycling, increase the flow of blood and nutrients to the soft tissues in the back, improving the tissue regeneration process and reducing stiffness. Aerobic exercise also increases the body's production of endorphins. These brain substances bind to opiate receptors in the pain control system of the brain and spinal cord, thereby reducing the perception of pain.
Exercises to strengthen the core muscles
People with low back pain limit movement in the trunk because they want to reduce pain in the lumbosacral region. However, this only further impairs core strength and, in turn, increases lumbar instability. This is why exercises that activate the core muscles are essential. These muscles run the length of the entire torso and are jointly responsible for good spine stabilization, balance, and posture.
Flexibility exercises
Stretching the soft tissues of the back, legs, and buttocks, such as the hamstrings, trunk extensors (erectors) and hip flexors, ligaments, and tendons can help mobilize the spine or help maintain its normal curvature and increase the range of motion spine15. In addition, stretching exercises improve the flexibility of the muscle tendons and ligaments in the back, which is essential for expanding the range of motion of the joints.
Exercises for the cross-examples
Before starting a new exercise program, it is good to consult and check whether certain sports activities and exercises suit our abilities and physical fitness. For example, when exercising for the lower back, it is essential to maintain the correct posture, perform the exercise techniques correctly, and warm up properly before the exercises. Rest is also necessary for muscle regeneration.
In the case of poor physical fitness, it makes sense to increase the loads gradually. If we overload the body too quickly with exercises that are too heavy and too long, we risk additional injuries. During the practice itself, we focus on the pain level, especially during specific movements, and adjust it according to the intensity of the exercise. In the beginning, the activities may slightly increase the symptoms of pain, but eventually, they become more accessible as we regain strength and gain movement skills.
We have prepared a set of exercises for the cross designed by M.Sc. sports and movement sciences. Cross-exercises are intended to strengthen the various muscles that support the lumbar spine. They can be performed in the comfort of your home. These are exercises with your weight that do not require other equipment. The lower back exercises allow us to load and stretch all the muscles adequately. Hence, it makes sense to perform them in individual cycles, depending on the difficulty level.
Exercise 1
From a lying position on your back, bend your legs and grab your knees with your hands. You followed by circling with the legs. Again, the hands guide the movement above while the legs are relaxed. We do 20 repetitions in each direction. In this way, we warm up and relax the pelvic floor muscles and the lower back muscles.
Exercise 2
Lie down on your back, bend your legs, and put your hands away from your body. Feet, but they are on the floor, and their knees are touching. On exhalation, roll the legs to one side while turning the head in the opposite direction. We can lower our legs with each exhalation if our body allows us. This will make the stretch more intense. Hold the position for 30 seconds on each side. With this exercise, we stretch the front and especially the back of the torso.
Exercise 3
Lie down on your stomach, fold your arms, and put your palms under your head. The legs must be extended, and the torso relaxed. In this critical position, we tense the gluteal and abdominal muscles and only slowly lift our legs off the floor. The elevation of the feet from the ground should be minimal. The legs should be stretched and the feet relaxed. Then we lower ourselves to the starting position. Even before we touch the ground, we rise again. Do ten repetitions, holding each lift for 5 seconds. This exercise strengthens the buttocks and lower back muscles.
Exercise 4
We bend our legs and put our hands behind our heads. On exhalation, a slight rise of the upper body follows, whereby the lumbar part of the back constantly remains in contact with the ground. When inhaling, we lower ourselves to the starting position. Before we touch the ground with our hands, we raise the upper body again. It is essential that the headrests are in the palms and that the elbows are spread apart. We do two sets of 15 repetitions. This exercise strengthens the abdominal muscles.
Exercise 5
Slowly lower the hips back from the kneeling position so that the buttocks come closer to the heels. Next, we stretch our arms forward as much as possible and push the shoulder girdle toward the ground. Then reach to one side with your hands and tilt your pelvis to the opposite side to feel the stretch on one side of your back. Hold the exercise for 30 seconds, then move your hands to the other side and follow the movement with your pelvis. With this exercise, we stretch the back muscles on both sides, the trunk's side flexors, and the shoulder girdle and chest muscles.
Exercise 6
From lying on your back, lift your legs off the floor and bend them to a right angle. The feet are facing the body. The arms are bent, and the palms are behind the head. On exhalation, lift the upper part of the body slightly while the back's lumbar region should be in direct contact with the floor. Elbows should be in line with the head. In no case should we pull the upper body forward with our hands? The head and neck must be relaxed. The speed of movement should be adapted to our breathing. Therefore, exhaling, lifting the body, and inhaling, returning to the starting position. We do two sets of 15 repetitions. The exercise strengthens the entire front of the abdominal muscles and improves the mobility of the thoracic spine.
Remedies for low back pain relief
With regular physical activity and a healthy lifestyle, we can significantly influence the risk of low back pain and the intensity and duration of the pain. However, other support means can be used in cases of low back pain.
Pharmacotherapy
In pharmacotherapy, certain drugs are used, which doctors prescribe only for a short period, taking into account the patient's other medical conditions. Such drugs may be indicated in cases of acute pain, but it is necessary to adjust the dosage or discontinue the medication when the pain improves or disappears.16
Video content: What are the best legal prescription drugs for back pain problems?
Medications for low back pain relief include non-steroidal anti-inflammatory drugs (ibuprofen), analgesics (aspirin), muscle relaxants, and in some cases also, opioids. Each of them also has specific side effects. For example, NSAIDs suppress inflammation, pain, and fever, but they increase the risk of gastric and duodenal ulcers and cause troubles to the cardiovascular system.17
Local pain relief
In addition to oral agents, topical pain relievers are available, such as various creams, gels, patches, and sprays. The advantage is that the patches can be easily applied to dry and cleansed skin or directly to the cross and easily removed after a certain period. In addition, the creams are rubbed into the skin by gently massaging the affected area, which further helps to relieve the muscles.
Topical agents are applied to the skin, and the skin, our largest organ, absorbs its active ingredients, and thus the elements pass into the bloodstream. This is precisely why it is all the more important to pay attention to the active ingredients in these products. Natural ingredients are the safest, as they do not burden the stomach, liver, kidneys, and heart.
Remedies with natural active ingredients effectively relieve pain and begin to work after application to the skin. At the same time, they can be used over a more extended period without interruptions, as they have no unwanted side effects. In addition, they can be used every day and all day, so they are suitable for both acute and chronic joint and muscle pain.
The functioning of plants is primarily based on the interaction of several components. Natural ingredients have been used traditionally in various forms for years. Patches often use a combination of plant extracts, such as concentrated extracts of camphor, arnica, lavender, devil's claw, and white willow. MSM organic sulfur can also be added. In gel, menthol is added in creams< /a>, and glucosamine sulfate is also a common ingredient.
Questions and answers
What is the best exercise for the lower back?
11 names of exercises to strengthen the lower back:
- Superman. This exercise involves the entire back of the body, from the upper back to the lower legs. ...
- Swimmers.
- Good morning.
- Bird dog.
- Rear bridge.
- Forearm board.
- Dumbbell-free renegade rows
- Cat cow.
Sources and references
1. https://www.statpearls.com/ArticleLibrary/viewarticle/18089
2. https://atm.amegroups.com/article/view/38037/html
3. https://pubmed.ncbi.nlm.nih.gov/21665125/
4. https://link.springer.com/article/10.1007/s11940-001-0051-4
5. https://pubmed.ncbi.nlm.nih.gov/27745712/
6. https://www.med.or.jp/english/pdf/2004_05/227_233.pdf
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722740/
8. Picavet HSJ, Schouten JSAG. Physical load in daily life and low back problems in the general population - The MORGEN Study. Prev Med2000; 31:506–12
9. https://pubmed.ncbi.nlm.nih.gov/30044543/
10. https://www.health.harvard.edu/mind-and-mood/depression-and-pain
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560373/
12. https://pubmed.ncbi.nlm.nih.gov/32214063/
13. https://pubmed.ncbi.nlm.nih.gov/28615218/
14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934575/
15. MacAuley D., Best T. Evidence-Based Sports Medicine. 2nd ed. Blackwell Publishing; Oxford, UK: 2007
16. https://pubmed.ncbi.nlm.nih.gov/29321099/
17. https://pubmed.ncbi.nlm.nih.gov/18823646/
