For individuals dealing with newly formed or chronic lower back pain, can making daily walks a part of a weekly routine help relieve pain and discomfort symptoms and prevent strains and injuries?
Walking For Low Back Pain Relief
Walking is recommended to treat and prevent chronic or recurrent lower back pain. A study found that a personalized and progressive weekly walking program that builds up to 130 minutes of moderate intensity can significantly relieve severe lower back pain and prevent future flare-ups. (Pocovi N. C. et al., 2024) Walking is a cost-effective and easily accessible way to relieve lower back pain and prevent recurring or future injuries. It strengthens the back muscles, improves posture, and stabilizes the spine. (Suh JH, et al., 2019) Other benefits include improved overall physical health, posture, and circulation.
How Walking Helps
Walking for low back pain relief and general movement is better than not engaging in physical activities for individuals with recurrent lower back pain. Being sedentary can worsen back pain symptoms. (National Library of Medicine. 2019) Walking is second nature and is easy to incorporate into a weekly routine to help relieve back pain and improve overall health (Macquarie University, 2024)
Increases Spinal Flexibility
Walking and gentle movements increase the lower back’s functional range of motion, improve spinal flexibility, and reduce stiffness. (Smith J. A. et al., 2022)
Stabilizes Lumbar/Low Back Muscles
Walking builds muscle endurance and strength in the paraspinal muscles, increasing lumbar spinal stabilization. (Suh JH, et al., 2019)
Strengthens Core Muscles
Walking increases the body load and strengthens core muscles like the transversus abdominis, which lowers the risk of chronic lower back pain. (Lee J. S. and Kang S. J. 2016)
Improves Posture
Movement of the legs during walking enhances bodily awareness and helps correct posture.(Henry M. and Baudry S. 2019)
Increases Blood Circulation
Walking increases blood circulation to the muscles, supplying essential nutrients to spinal discs. It also reduces the frequency and severity of lower back muscle spasms. (Sitthipornvorakul E. et al., 2018)
Lubricates Spinal joints
Low-impact walking improves synovial fluid production and circulation, lubricating the lumbar spine’s facet joints and other joints that tend to get achy, such as the knees. (Zhang S. L. et al., 2013)
Relieves Inflammation
Walking helps reduce the presence of pro-inflammatory cytokines, like (IL-8 and TNF-alpha) associated with chronic lower back pain. (Slouma M. et al., 2023)
Promotes Weight Loss
Walking and a healthy diet can help individuals lose excess fat, which puts added strain on the lower back and correlates with lumbar intervertebral disc degeneration. (Wang M. et al., 2024)
Stress Relief
Regular walking can reduce mental stress associated with chronic lower back pain. (Choi S. et al., 2021)
Releases Endorphins
Moderate to vigorous physical activity, like walking at about 3 miles per hour for a half-hour daily, stimulates the release of endorphins, the body’s natural pain relievers. (Bruehl S. et al., 2020)
Walking Correctly
To get all the benefits of walking for low back pain relief, it is recommended to practice the following (Macquarie University, 2024)
Start slowly.
Gradually build intensity.
Stay consistent with the walking program.
Track progress to maintain motivation.
Healthcare Provider Consultation
Walking is a low-risk, low-impact activity well-tolerated by most individuals with nonspecific low back pain. (Pocovi N. C. et al., 2022) Because it doesn’t involve twisting or vigorous movements, it is considered a safe exercise for individuals with back pain symptoms (Gordon R. and Bloxham S. 2016). However, individuals experiencing severe lower back pain due to a traumatic injury or medical condition should consult a healthcare provider before starting a regular walking program.
Limit High Impact Activities
High-impact activities like running on hard surfaces or playing sports can exacerbate chronic lower back pain. If there is chronic lower back pain, it is recommended to limit activities that involve: (Al-Otaibi S. T. 2015)
Heavy lifting
Repetitive bending
Twisting motions
Injury Medical Chiropractic and Functional Medicine Clinic
Walking for low back pain relief. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Movement as Medicine
References
Pocovi, N. C., Lin, C. C., French, S. D., Graham, P. L., van Dongen, J. M., Latimer, J., Merom, D., Tiedemann, A., Maher, C. G., Clavisi, O., Tong, S. Y. K., & Hancock, M. J. (2024). Effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomised controlled trial. Lancet (London, England), 404(10448), 134–144. doi.org/10.1016/S0140-6736(24)00755-4
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. doi.org/10.1097/MD.0000000000016173
National Library of Medicine., & InformedHealth.org [Internet]. Cologne, G. I. f. Q. a. E. i. H. C. I. (2022). Low back pain: Learn More – Why movement is so important for back pain. www.ncbi.nlm.nih.gov/books/NBK284944/
Smith, J. A., Stabbert, H., Bagwell, J. J., Teng, H. L., Wade, V., & Lee, S. P. (2022). Do people with low back pain walk differently? A systematic review and meta-analysis. Journal of sport and health science, 11(4), 450–465. doi.org/10.1016/j.jshs.2022.02.001
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. doi.org/10.1097/MD.0000000000016173
Lee, J. S., & Kang, S. J. (2016). The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. Journal of exercise rehabilitation, 12(5), 463–470. doi.org/10.12965/jer.1632650.325
Henry, M., & Baudry, S. (2019). Age-related changes in leg proprioception: implications for postural control. Journal of neurophysiology, 122(2), 525–538. doi.org/10.1152/jn.00067.2019
Sitthipornvorakul, E., Klinsophon, T., Sihawong, R., & Janwantanakul, P. (2018). The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials. Musculoskeletal science & practice, 34, 38–46. doi.org/10.1016/j.msksp.2017.12.003
Zhang, S. L., Liu, H. Q., Xu, X. Z., Zhi, J., Geng, J. J., & Chen, J. (2013). Effects of exercise therapy on knee joint function and synovial fluid cytokine levels in patients with knee osteoarthritis. Molecular medicine reports, 7(1), 183–186. doi.org/10.3892/mmr.2012.1168
Slouma, M., Kharrat, L., Tezegdenti, A., Metoui, L., Ghazouani, E., Dhahri, R., Gharsallah, I., & Louzir, B. (2023). Pro-inflammatory cytokines in patients with low back pain: A comparative study. Reumatologia clinica, 19(5), 244–248. doi.org/10.1016/j.reumae.2022.07.002
Wang, M., Yuan, H., Lei, F., Zhang, S., Jiang, L., Yan, J., & Feng, D. (2024). Abdominal Fat is a Reliable Indicator of Lumbar Intervertebral Disc Degeneration than Body Mass Index. World neurosurgery, 182, e171–e177. doi.org/10.1016/j.wneu.2023.11.066
Choi, S., Nah, S., Jang, H. D., Moon, J. E., & Han, S. (2021). Association between chronic low back pain and degree of stress: a nationwide cross-sectional study. Scientific reports, 11(1), 14549. doi.org/10.1038/s41598-021-94001-1
Bruehl, S., Burns, J. W., Koltyn, K., Gupta, R., Buvanendran, A., Edwards, D., Chont, M., Wu, Y. H., Qu’d, D., & Stone, A. (2020). Are endogenous opioid mechanisms involved in the effects of aerobic exercise training on chronic low back pain? A randomized controlled trial. Pain, 161(12), 2887–2897. doi.org/10.1097/j.pain.0000000000001969
Pocovi, N. C., de Campos, T. F., Christine Lin, C. W., Merom, D., Tiedemann, A., & Hancock, M. J. (2022). Walking, Cycling, and Swimming for Nonspecific Low Back Pain: A Systematic Review With Meta-analysis. The Journal of orthopaedic and sports physical therapy, 52(2), 85–99. doi.org/10.2519/jospt.2022.10612
Gordon, R., & Bloxham, S. (2016). A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel, Switzerland), 4(2), 22. doi.org/10.3390/healthcare4020022
Al-Otaibi S. T. (2015). Prevention of occupational Back Pain. Journal of family & community medicine, 22(2), 73–77. doi.org/10.4103/2230-8229.155370
Incorrect manual handling and lifting is a leading cause of workplace injuries. Can health and safety training help reduce injuries and lost workdays?
Correct Manual Lifting Technique
Manually lifting objects using incorrect techniques can lead to acute back injuries, herniated discs, sciatica, and long-term issues like increased risk of reinjury, body misalignment, and chronic back pain. Individuals can prevent spinal disc compression and/or lower back muscle strain by learning to use correct manual lifting techniques. (CDC. The National Institute for Occupational Safety and Health (NIOSH). 2007)
Lifting Guide
Individuals can protect their backs and prevent injury by following simple steps when lifting objects.
Support Base
Ensure there is a healthy support base from which to lift.
Keep feet shoulder-width apart with one foot slightly in front of the other.
Ask For Help
If coworkers or colleagues are available, ask for assistance.
If the load is too heavy, ask for help lifting and moving the object/s.
Use Mechanical Assistant Devices
Use hand trucks, dollies, or pushcarts whenever possible for uneven and heavy loads.
Squat To Lift Object
Bend at the hips and knees only, not the back.
Put one knee on the ground to ensure stability before lifting.
Check Posture
Looking straight ahead, maintain posture upright with the chest out, shoulders back, and lower back slightly arched.
Lift Slowly
Lift with the knees and hips only, gradually straightening the lower back.
Load Positioning
Once upright, hold the load close to the body around the stomach.
Move and Maintain Alertness
Always take small steps.
Maintain alertness as to where you are going.
Keep the shoulders square with the hips when changing directions to avoid twisting and losing or shifting balance.
Rest
If you are fatigued, set the load/object down and rest for a few minutes until you can fully engage in the task.
Squat To Set Object Down
Squat with the knees and hips and set the load down slowly.
Avoid quickly rising and jerking movements, and allow the legs, hips, and back muscles to reset.
Planning and Tips
Lifting anything heavy takes planning to prevent muscle spasms, back strain, and other musculoskeletal injuries. Considerations to keep in mind:
Make a Plan Before Lifting
Knowing what object/s are being lifted and where they are going will prevent individuals from making awkward movements while holding and carrying something heavy.
Set and clear a path.
If lifting something with another person, ensure both agree and understand the plan.
Lift Close to The Body
Individuals are stronger and more stable lifters if the object is held close to their body rather than at the end of their reach.
Make sure there is a firm hold on the object.
It is easier to maintain balance close to the body.
Maintain Feet Shoulder-Width Apart
Keep the feet about shoulder-width apart.
Having a solid base of support is important while lifting.
Placing the feet too close together will cause instability while placing them too far apart will hinder movement.
Take short steps.
Visualize The Motions Involved and Practice The Motions Before Lifting
Think about the motion before lifting.
Practice the lifting motion before lifting the object.
Focus on keeping the spine straight.
Raise and lower to the ground by bending the knees.
Avoid bending at the waist or hips.
Tighten the Stomach Muscles
Tightening the abdominal muscles will hold the back in a healthy lifting position and help prevent excessive force on the spine.
Lift With the Legs
The legs are stronger than the back muscles, so let the leg strength do the work.
Lower yourself to the ground by bending the knees, not the back.
Keep Eyes Up
Looking slightly upwards will help maintain a better spine position and help keep the back straight.
Avoid Twisting or Bending
Face in the direction you are walking.
Stop, take small steps, and continue walking if turning is required.
Back Belts
It has become common for many who work in jobs requiring manual lifting to wear back belts or support. However, research does not show that they decrease the risk of a lifting injury. (CDC and The National Institute for Occupational Safety and Health, 2023) Instead, it is recommended that the belt be thought of as a reminder of where the back muscles are positioned to keep the individual aligned, combined with the correct lifting techniques.
Injury Medical Chiropractic and Functional Medicine Clinic
Training the body and maintaining its optimal health for correct manual lifting techniques requires daily efforts through practice, conscious position corrections, and ergonomics. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Chiropractic Care For Injury Recovery
References
CDC. The National Institute for Occupational Safety and Health (NIOSH). (2007). Ergonomic Guidelines for Manual Material Handling. (No. 2007-131). Retrieved from www.cdc.gov/niosh/docs/2007-131/pdfs/2007-131.pdf
CDC. The National Institute for Occupational Safety and Health (NIOSH) (2023). Back Belts – Do They Prevent Injury? (No. 94-127). Retrieved from www.cdc.gov/niosh/docs/94-127/
Can correcting body misalignments and the elements of unhealthy posture help achieve a healthy posture?
Healthy Posture
Maintaining a healthy posture is more important than ever, as individuals from all walks of life realize how practicing awkward and unhealthy postures can wreak havoc on their bodies and quality of life. Unhealthy postures include rounding the upper and lower back, slouching, and forward head posture. Over time, these postures make daily activities more difficult or painful. Mobility, stability, and strengthening exercises can address unhealthy posture problems and issues, along with practicing correct sitting, standing, and resting postural habits to reinforce proper alignment daily. A chiropractic and physical therapy team can treat and train individuals to restore correct and healthy posture.
Body Alignment
Ideal posture involves correct body alignment or how the structural parts, such as the head, trunk, hips, knees, etc., relate to an individual’s form. Whether standing, sitting, lying down, or moving, body parts need to be balanced in relationship to each other to avoid unnecessary stress on the spine and musculoskeletal system. (Bone Health & Osteoporosis Foundation, 2024)
Posture Types
Posture is considered static when sitting or standing still and dynamic when moving. Both are categorized as active postures as they require the activation of stabilizing muscles to deal with gravity and maintain alignment. Lying down and remaining still is considered an inactive posture, as muscle involvement is minimal. However, both have the potential to be healthy or unhealthy.
Proper Body Alignment
An easy way to check proper alignment while standing is to stand against a wall with the base of the head, shoulder blades, and buttocks flush against the wall, with enough space for a hand wide enough to slide in between the wall and the small of the back. This exercise correctly lines up the head, shoulders, and hips to reduce or eliminate undue stress on the spine. Body balance is the foundation for active and inactive postures concerning workstations, industrial ergonomics, daily activities, and sports. (Mayo Clinic, 2023) Healthy alignment is a standard position in which all body joints are centered and balanced and the most mechanically efficient position for static or dynamic activities. Biomechanical efficiency (the ability to use the body’s muscles and joints to perform movements while minimizing energy use and maximizing output) enables the muscles surrounding the joints to work in balance and efficiently activate, which, in turn, helps reduce strain, tension, and injury. Balanced muscles also conserve energy, leading to better daily stamina.
Development of Imbalances
Individuals develop position and movement habits in joint positioning that have led to imbalanced muscles. When this is the case, some muscles can be chronically stretched, and others become chronically tight, all to hold the body up or move around, which can lead to postural conditions like upper crossed (Physiopedia, 2024) or lower crossed syndrome (Physiopedia, 2024) which often leads to pain and/or mobility issues.
Posture Assessment
The recommended way to determine if one’s posture is healthy or poor is by conducting a posture assessment. The examination looks at joint positions and gathers visual information about the planes into which parts of each joint move and the axes around which those movements occur (Singla D. and Veqar Z., 2014) (Debra Coglianese et al., 2006). In a posture assessment, body alignment is compared with the ideal standard, a plumb line, usually a string with a small weight attached to the bottom to help maintain straightness. The other end of the string is affixed to the ceiling to be used as an accurate reference for correct alignment. (Singla D. and Veqar Z. 2014) During a posture assessment, the patient stands next to the plumb line while the doctor or therapist compares the relative positions of the following areas:
Ears
Shoulder joint
Spine
Hip joint
Knee joint
Ankle joint
Feet
Any areas that don’t match the reference can indicate misalignments in one or several regions.
Making Corrections
Chiropractic care can help correct unhealthy posture by realigning the spine and strengthening the musculoskeletal system:
Spinal Adjustments
Chiropractors use their hands or instruments to apply controlled force to the spine to realign the vertebrae. This can help relieve pressure on muscles, ligaments, and nerves, which can improve posture.
Corrective Exercises
Chiropractors can create custom exercises to strengthen postural muscles and maintain proper alignment.
Massage Therapy
Chiropractors can use massage therapy to work on strained ligaments and soft tissue.
Guidance and Training
Chiropractors can teach patients how to move to encourage a neutral spine and provide strategies for maintaining healthy posture.
A posture corrector or brace can also help teach and engage the correct muscles to achieve proper alignment. However, it should not be relied on long-term because promoting and activating one’s stabilizing muscles is important rather than relying on a brace for prolonged periods.
Injury Medical Chiropractic and Functional Medicine Clinic
Achieving and maintaining proper posture requires consistent work and development. Retraining the body and maintaining its optimal health requires daily efforts through exercise, conscious position corrections, and ergonomics. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Singla, D., & Veqar, Z. (2014). Methods of postural assessment used for sports persons. Journal of clinical and diagnostic research: JCDR, 8(4), LE01–LE4. doi.org/10.7860/JCDR/2014/6836.4266
Coglianese, D. (2006). Muscles: Testing and Function With Posture and Pain, ed 5 (with Primal Anatomy CD-ROM). Physical Therapy, 86(2), 304-305. doi.org/https://doi.org/10.1093/ptj/86.2.304
Lower back leg pain depends on specific symptoms and their duration. Can having a better idea of symptoms help individuals inform their medical providers to develop an effective treatment plan?
Low Back Leg Pain
Lower back leg pain, sciatica, and weakness of the lower-extremity muscles are often diagnosed as a herniated (compressed or ruptured) disc. Nerves surrounding the spine are sensitive to irritation and pressure caused by a disc shifting out of position or physical damage to the disc and surrounding area, ranging from mild to severe. This is why it is important to be evaluated by a healthcare provider. Treatment depends on the type of spinal disc herniation and the severity, but getting an early medical evaluation helps ensure optimal outcomes. Non-surgical conservative treatments are often effective, but some cases may require more aggressive treatment, especially if the pain persists.
Spine and Nerves
Spinal discs are the shock absorbers between vertebrae. They consist of a tough outer layer, annulus fibrosis, covering a soft gel core, nucleus pulposus. When a disc is damaged, it can bulge and irritate surrounding nerves. In more severe cases, the annulus fibrosis can weaken and tear, allowing the material to leak and compress the spinal cord or nerves. As the nerves are not functioning properly, abnormal signals may be sent to and from the brain. The most common lower back herniations occur in the lumbar region, where five vertebrae near the base of the spine are classified from top to bottom as L1 through L5. (Dydyk A.M. et al., 2023) Pain resulting from an injury to this part of the spine can be debilitating because it may involve sciatic nerve irritation. Herniated disc causes are generally a combination of age-related degeneration, being overweight/obese, trauma, a sedentary lifestyle, and overloading of the spine. (Cleveland Clinic, 2021)
Symptoms
The most common symptoms include:
Back Pain
Caused by nerve irritation, muscle spasms, and inflammation.
Radiculopathy
Abnormal signaling of the nerves.
Electrical Shooting Pain
Nerve pressure can cause abnormal sensations, commonly experienced as electric shooting pains.
For low back herniations, the shocks go down one or both legs.
Tingling – Numbness
There are often abnormal sensations such as tingling, numbness, or pins and needles down one or both legs.
Muscle Weakness
Nerve signals may be interrupted, causing lower-body muscle weakness. (Dydyk A.M. et al., 2023)
Bowel – Bladder Symptoms
These symptoms may signal cauda equina syndrome, a rare condition resulting from a herniated disc between the L5 vertebrae and the first vertebrae of the sacrum.
Diagnosis
Diagnosing a herniated disc as the cause of low back leg pain involves testing sensation, muscle strength, and reflexes. MRI also aids this process (American Association of Neurological Surgeons, 2024). MRIs can often show herniated discs and other abnormalities, especially in older patients.
Treatment
A herniated disc treatment plan is based on patient symptoms, physical examination findings, and imaging results. Most herniated disc symptoms resolve themselves in four to six weeks. Lower back pain is generally treated conservatively through:
Topical pain ointments or creams for muscle spasms.
Non-surgical decompression relieves pressure, activates healing, and restores circulation and nutrients.
Chiropractic adjustments realign the spine and musculoskeletal system.
Massage loosens the muscles and maintains their relaxation.
Total rest is never recommended, even if movement is challenging,
Exercise and stretching help avoid muscle degeneration and strengthen the muscles.
Relaxation techniques and other natural pain therapies can help manage symptoms and restore overall health.
Pain-blocking injections which can include anesthetics or corticosteroids at the source (Cleveland Clinic, 2021)
Surgery is recommended only when conservative treatments are ineffective after six weeks, if there is significant muscle weakness from nerve damage, or if motor functions are compromised. (American Association of Neurological Surgeons, 2024)
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic therapy is among the more conservative treatment options and may be tried first before proceeding with surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to integrate a treatment plan to improve the body’s flexibility and mobility and resolve musculoskeletal issues.
Disc Herniation
References
Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK441822/
Can incorporating these 7 exercises help individuals dealing with back pain help promote a healthy spine and functionality?
Introduction
Many individuals have dealt with back pain in their body’s upper, middle, and lower portions, which can correlate with other issues in the upper and lower body extremities. This is due to how many environmental factors affect a person’s daily routine. From stressful days that impact a person’s day to physical inactivity or even spinal issues that have developed over time can cause back pain. When individuals decide to make changes in their health and wellness journey to not only reduce back pain but also improve how they present themselves. Many individuals can start with exercises to reduce back pain and help their spinal health by making sure that they are doing it correctly to prevent injuries. Today’s article looks at how spinal issues correlate with back pain and how these seven simple exercises and stretches can help reduce lower back pain and help you have a healthy spine. We talk with certified associated medical providers who provide our patients’ information to assess back pain correlated with their spine. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce back pain by integrating exercises to help reduce the pain and promote wellness. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
Spinal Issues Correlating To Back Pain
Do you feel stiffness or muscle aches in your back’s upper, middle, or lower areas? Have you noticed that your posture is hunched more than normal when looking at the phone or being on the computer for an extended period? Or does your back ache from lifting a heavy object or sleeping incorrectly? More often than not, these pain-related scenarios are associated with back pain combined with spinal issues. As one of the leading causes of disability, loss of productivity, and more visits to a health clinic, back pain can impact the body and cause individuals to be miserable. (Bang et al., 2021) Back pain can be specific or non-specific and can cause a person’s spine to degenerate through the spinal disc. The spinal disc provides stability, flexibility, and mobility to the spine, which then helps keep the host upright. However, as the body ages, so does the spine, as lower back pain is multifactorial. When the spinal disc degenerates, the spine has a reduced capacity for intrinsic self-repair within the tissues. (Mohd Isa et al., 2022)
At the same time, when many individuals are dealing with low back pain, depending on the severity of the issue, theywill often change their gait mechanics by adapting different strategies to mitigate the loading on the primary muscles associated with the locomotion that protects the pain-producing tissues. (Smith et al., 2022) When that happens, the pain from the lower back muscles can aggravate the spine further and lead to more chronic issues; however, there are ways to reduce the effects of lower back pain and to help keep the spine healthy.
Can Core Exercises Help with Back Pain?-Video
The 7 Exercises To Incorporate For Back Pain
When it comes to making sure that lower back pain can be reduced and to help with keeping a healthy spine, many people often seek out physical therapy to reduce the pain. Since low back pain is costly in a clinical approach, physical therapy is cost-effective, non-invasive, and can help individuals get a kick start in their health journey. Physical therapy involves whole-body movement that emphasizes breathing coordination, reducing pain from the lower back, and helping stabilize the lumbar spine to improve physical function. (Li et al., 2023) By going through a treatment plan that incorporates physical therapy, many individuals will begin to notice their pain is improving and their quality of life is getting better. (Fischer et al., 2021) Additionally, stretching and core stability exercises can activate the deep and superficial spinal muscles by strengthening them and help stretch out sore muscles affected by low back pain to help many individuals recover. (Calatayud et al., 2019) Below are seven exercises that can help reduce back pain and, when done correctly and consecutively, can help many individuals have a healthier spine while being more mindful of their bodies.
Knee-To-Chest Exercise
This knee-to-chest exercise can help stretch the lower back muscles and can be done in the morning or evening.
Lying on your back with knees bent and feet flat for stability.
Pull one knee up with both hands and press it towards your chest.
Keep the stomach muscles tight while pressing your spine to the floor, holding for at least 30 seconds before returning to position.
Repeat with the other knee and do each stretch 2-3 times.
Lower Back Rotational Stretch (On the Floor)
This lower back rotational stretch can help stretch tight muscles in the lower back.
Laying on the mat, ensure you are on your back with knees bent and feet flat.
Make sure the shoulders are firmly on the floor, and slowly roll the knees to one side until 45 degrees.
Hold that position for 30 seconds before slowly rotating the knees back to the starting position.
Repeat on the other side and do each stretch 2-3 times.
Lower Back Flexibility Exercise
This lower back flexibility will help stretch and strengthen the lower back and core muscles.
Lay flat on the mat. For stability, make sure that the knees are bent with feet are flat on the floor.
Tighten the stomach muscles so the lower back can be pulled away from the floor.
Hold the position for 5 seconds and relax, slowly lowering to the floor.
Flatten the back as your belly button starts to go towards the floor, and hold the position for 5 seconds before relaxing.
Do five repetitions a day to slowly work up to 30 reps.
Bridge Exercise
The bridge exercise can help with core stability and help strengthen core muscles.
Laying flat on your back on the floor, with knees bent and feet flat. Make sure that your shoulders and head are relaxed.
Tighten the core and glute muscles while slowly raising from the hips to form a straight line from the knees to the shoulders.
Stay in that position for 30 seconds while taking deep breaths.
Slowly go down to the floor and relax.
Do five repetitions a day to slowly work up to 30 reps.
Cat-To-Cow Stretch
The cat-to-cow stretch helps with shoulders, upper back, and lower back muscles.
On your hands and knees, hip-width apart on the mat, be in a neutral spine position.
Slowly arch your back by pulling your belly towards the ceiling and your head down for 30 seconds.
Then, slowly let the back and belly sag towards the floor as the head rises for 30 seconds.
Return to the neutral spine position and repeat about 3-5 times twice daily.
Lower Back Rotational Stretch (Seated)
This lower back rotational stretch is seated if the floor is uncomfortable for individuals with severe back pain.
Sitting in an armless chair or stool in a seated upright position, cross one leg over the other.
Then, place the left elbow against the outside of the right knee and twist and stretch the side.
Hold the postion for 10 seconds before slowly returning to a seated position.
Repeat the stretch on the opposite side.
Do this stretch 3-5 times on each side to stretch tight back muscles about twice daily.
Shoulder Blade Squeeze
This shoulder blade squeeze helps individuals properly posture while stretching and strengthening tight upper back and shoulder muscles.
Start in a seated upright position on an armless chair or stool.
Slowly pull the shoulder blades together in the upright position and hold for 5-30 seconds.
Relax, return to the upright position, and repeat 3-5 times twice daily.
References
Bang, A. A., Bhojraj, S. Y., & Bang, A. T. (2021). Back pain and musculoskeletal pain as public health problems: Rural communities await solution. J Glob Health, 11, 01007. doi.org/10.7189/jogh.11.01007
Calatayud, J., Escriche-Escuder, A., Cruz-Montecinos, C., Andersen, L. L., Perez-Alenda, S., Aiguade, R., & Casana, J. (2019). Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain. Int J Environ Res Public Health, 16(19). doi.org/10.3390/ijerph16193509
Fischer, S. C., Calley, D. Q., & Hollman, J. H. (2021). Effect of an Exercise Program That Includes Deadlifts on Low Back Pain. J Sport Rehabil, 30(4), 672-675. doi.org/10.1123/jsr.2020-0324
Li, Y., Yan, L., Hou, L., Zhang, X., Zhao, H., Yan, C., Li, X., Li, Y., Chen, X., & Ding, X. (2023). Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis. Front Public Health, 11, 1155225. doi.org/10.3389/fpubh.2023.1155225
Mohd Isa, I. L., Teoh, S. L., Mohd Nor, N. H., & Mokhtar, S. A. (2022). Discogenic Low Back Pain: Anatomy, Pathophysiology and Treatments of Intervertebral Disc Degeneration. Int J Mol Sci, 24(1). doi.org/10.3390/ijms24010208
Smith, J. A., Stabbert, H., Bagwell, J. J., Teng, H. L., Wade, V., & Lee, S. P. (2022). Do people with low back pain walk differently? A systematic review and meta-analysis. J Sport Health Sci, 11(4), 450-465. doi.org/10.1016/j.jshs.2022.02.001
Can individuals dealing with back pain find treatment to reduce gut pain associated with SIBO to improve body health?
Introduction
Many individuals have noticed that when it comes to improving their health and well-being, many will incorporate small changes into their daily routines. From exercising for at least 30 minutes to incorporating healthy nutritional foods into their diet, many people don’t realize that the best way to have a healthy style starts with the gut. The gut system helps the body digest food and nutrients to be transported to the body, helps regulate growth and metabolism, and provides immune support to all the organ systems. However, when harmful pathogens and environmental factors start to impact the gut, it can cause the development of harmful pathogens inside the gut system and, over time, cause overlapping risk profiles in the body. This leads to gut dysfunction and musculoskeletal issues in the individual and can cause pain and discomfort if not treated right away. Luckily, numerous ways exist to improve gut health and reduce musculoskeletal issues. Today’s article focuses on a gut issue known as SIBO, how SIBO is correlated with back pain, and what treatments can help reduce SIBO. We talk with certified associated medical providers who provide our patients’ information to assess and identify how SIBO is correlated with back pain. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce the effects of SIBO and help restore gut health. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
What is SIBO?
How often do you feel general aches or pain in your gut or around your lower back? Do you constantly feel tired throughout the day, even after a full night’s rest? Or have you been constantly feeling constipated or bloated after eating a meal? Many of these scenarios are associated with a gut issue known as SIBO or small intestinal bacterial overgrowth. Before diving into what SIBO is, it is important to see the gut’s main function to the body. Known as the second brain of the body, the gut system is home to trillions of good bacteria that help with food digestion and protect the body from bad bacteria. When environmental factors like poor dieting, physical inactivity, or inflammatory effects affect the body, the gut’s delicate ecosystem is also affected. This can cause gut dysfunction to the body and, over time, when it is not being treated, lead to SIBO.
SIBO is the presence of excess bad bacteria in the small intestines, which causes protective barriers that help the small intestines weaken. (Sorathia et al., 2024) Additionally, SIBO can correlate with conditions as it can accompany other gut issues by stimulating the immune system. (Banaszak et al., 2023) When the immune system becomes hyperactively stimulated by SIBO, it can cause the inflammatory cytokines to mass produce and cause a ripple effect on the entire body. Since inflammation is the body’s natural response to remove harmful pathogens that cause issues, mass production of inflammatory cytokines in the gut can cause toxins and bad bacteria to enter the bloodstream and travel to different body areas to cause pain. At the same time, SIBO can disrupt the gut-brain axis, which leads to intestinal motility changes and secretion, thus causing overlapping risk profiles like back pain to affect the body. (Carter et al., 2023)
Eating Right to Feel Better- Video
How Does Back Pain Correlate With SIBO?
Now, many people are wondering how back pain is correlated with SIBO. Since SIBO causes the immune system to be hyperactive and mass-produce inflammatory cytokines to reduce the integrity and function of the gastrointestinal barrier, it can cause chronic inflammation and induce pain, which includes musculoskeletal conditions like back pain. (Hui et al., 2023) Additionally, the gut-brain axis being over-runed by SIBO and chronic inflammation being an overlapping risk factor can cause negative influences on the gut microbiome composition, and how the individual reacts to the changes can lead to abnormal bone growth and reabsorption due to the excess bacteria. (Geng et al., 2023) The excess bacteria produced by SIBO can affect intervertebral disc homeostasis and, when combined with environmental factors, can further enhance the inflammatory damage to the back muscles. (Yao et al., 2023) However, there are ways to not only reduce the back pain but also treat SIBO from causing more issues in the gut.
Treatments To Reduce SIBO
When it comes to treating SIBO, it depends on what treatment a person will be combined. The main goals for creating a treatment plan for SIBO are:
Reducing the bad bacteria
Bio-transform the gut
Preventing a relapse
Additionally, many individuals can make small changes in their routine by making dietary changes that can modify the intestinal microbiota. (Souza et al., 2022) This, in turn, helps promote gut health and replenish the nutrients while restoring the good bacteria to the gut. Regarding back pain associated with SIBO, chiropractic care can help individuals decrease or alleviate musculoskeletal symptoms by realigning the spine while massaging the muscles. This can help increase circulation while soothing the inflammatory effects caused by SIBO. Chiropractic care can be implemented as part of a person’s customizable treatment plan through a whole body approach by incorporating lifestyle changes and restoring gut health. By making these small changes with the right treatments to manage the overlapping symptoms caused by SIBO, many individuals can make these small changes to their routine to prevent SIBO from reappearing and causing issues in the body.
References
Banaszak, M., Gorna, I., Wozniak, D., Przyslawski, J., & Drzymala-Czyz, S. (2023). Association between Gut Dysbiosis and the Occurrence of SIBO, LIBO, SIFO and IMO. Microorganisms, 11(3). doi.org/10.3390/microorganisms11030573
Carter, J., Bettag, J., Morfin, S., Manithody, C., Nagarapu, A., Jain, A., Nazzal, H., Prem, S., Unes, M., McHale, M., Lin, C. J., Hutchinson, C., Trello, G., Jain, A., Portz, E., Verma, A., Swiderska-Syn, M., Goldenberg, D., & Kurashima, K. (2023). Gut Microbiota Modulation of Short Bowel Syndrome and the Gut-Brain Axis. Nutrients, 15(11). doi.org/10.3390/nu15112581
Geng, Z., Wang, J., Chen, G., Liu, J., Lan, J., Zhang, Z., & Miao, J. (2023). Gut microbiota and intervertebral disc degeneration: a bidirectional two-sample Mendelian randomization study. J Orthop Surg Res, 18(1), 601. doi.org/10.1186/s13018-023-04081-0
Hui, J., Chen, Y., Li, C., Gou, Y., Liu, Y., Zhou, R., Kang, M., Liu, C., Wang, B., Shi, P., Cheng, S., Yang, X., Pan, C., Jia, Y., Cheng, B., Liu, H., Wen, Y., & Zhang, F. (2023). Insight into the Causal Relationship between Gut Microbiota and Back Pain: A Two Sample Bidirectional Mendelian Randomization Study. Adv Genet (Hoboken), 4(4), 2300192. doi.org/10.1002/ggn2.202300192
Souza, C., Rocha, R., & Cotrim, H. P. (2022). Diet and intestinal bacterial overgrowth: Is there evidence? World J Clin Cases, 10(15), 4713-4716. doi.org/10.12998/wjcc.v10.i15.4713
Yao, B., Cai, Y., Wang, W., Deng, J., Zhao, L., Han, Z., & Wan, L. (2023). The Effect of Gut Microbiota on the Progression of Intervertebral Disc Degeneration. Orthopaedic Surgery, 15(3), 858-867. doi.org/10.1111/os.13626
Are there blood tests for individuals with chronic and severe back pain symptoms that can help healthcare providers diagnose?
Blood Tests To Help Diagnose Back Pain
If a healthcare provider suspects an infection or inflammatory arthritis is the cause of back pain, blood tests may be used to diagnose. When trying to find the cause of back pain, a healthcare provider will examine the patient’s medical history, perform a physical examination, and, if necessary, order diagnostic tests. (Dansie E. J. and Turk D. C. 2013) For example, the National Institute of Arthritis and Musculoskeletal and Skin Diseases says that MRIs can reveal abnormalities in the spine. Still, a person may not feel pain or experience any other symptoms. The NIAMS also says healthy, pain-free individuals can have elevated SED levels. A high sedimentation rate or sed rate, also known as an erythrocyte sedimentation rate (ESR) test, can indicate inflammation in the body. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)
Commonly Used Tests
Blood tests that can help diagnose back pain include:
Complete Blood Count – CBC
This test can indicate inflammation or infections.
Sed Rate or Erythrocyte Sedimentation Rate
This test measures inflammation by analyzing how red blood cells settle through plasma.
If the SED rate indicates that inflammation is present, the possibility of an underlying cause may be some form of arthritis or a tumor, which is rare.
A genetic marker in the blood that is more common in individuals with ankylosing spondylitis and reactive arthritis. (McMichael A. and Bowness P. 2002)
This marker may be tested if the healthcare provider suspects either disease.
Ankylosing spondylitis is an inflammatory arthritis affecting the sacroiliac joints, hips, and spine. (Sieper J. et al., 2002)
Injury Medical Chiropractic and Functional Medicine Clinic
At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain and restore function. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. Our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, severe sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness and nutrition, Functional Medicine Treatments, and in-scope care protocols. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.
Integrative Medicine Approach
References
Dansie, E. J., & Turk, D. C. (2013). Assessment of patients with chronic pain. British journal of anaesthesia, 111(1), 19–25. doi.org/10.1093/bja/aet124
Harrison M. (2015). Erythrocyte sedimentation rate and C-reactive protein. Australian prescriber, 38(3), 93–94. doi.org/10.18773/austprescr.2015.034
Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Frontiers in immunology, 9, 754. doi.org/10.3389/fimmu.2018.00754
McMichael, A., & Bowness, P. (2002). HLA-B27: natural function and pathogenic role in spondyloarthritis. Arthritis research, 4 Suppl 3(Suppl 3), S153–S158. doi.org/10.1186/ar571
Sieper, J., Braun, J., Rudwaleit, M., Boonen, A., & Zink, A. (2002). Ankylosing spondylitis: an overview. Annals of the rheumatic diseases, 61 Suppl 3(Suppl 3), iii8–iii18. doi.org/10.1136/ard.61.suppl_3.iii8
Hamdulay, S. S., Glynne, S. J., & Keat, A. (2006). When is arthritis reactive?. Postgraduate medical journal, 82(969), 446–453. doi.org/10.1136/pgmj.2005.044057
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