One Size Does Not Fit All With Regard To Lower Back Pain Exercises
So, you have low back pain and are wondering what exercises should you do to “fix” it..? And your car has broken down, what should you do..? Different questions yes, but same answer. Not all broken down cars will be the result of the exact same mechanical fault, just as not all lower back pain is the result of the exact same cause. I have long since lost count of the number of times friends and family have mentioned in passing “my back’s a bit sore, what should I do?” Now it is true that there are some very general and typically safe low back pain exercises that could probably be safely and effectively prescribed in the majority of situations that may be of benefit to the majority who do them. However, there is no one exercise that will solve all low back pain for all people is just isn’t that simple. Just as there is no one single mechanical adjustment or replacement part that will fix all cars…
The Human Body Is More Complex Than You Could Imagine
The internal mechanics of a car are very complex and the human body even more so. Therefore fixing any “mechanical” issue with your back requires of a number of things…
Firstly getting an appreciation of the pain and the area through assessment:
- Developing an understanding the history of the pain and how it is behaving.
- Assessment of both static and dynamic postures.
- Accurate assessment of movement and strength both locally and of any areas considered relevant such has the hips.
- Forming a working diagnosis based on clinical reasoning relating to the information gathered during the above assessment.
- The implementation of a treatment plan, including the prescription of any relevant low back pain exercises.
- Following this with reassessment to gauge the impact any applied treatment and/or low back pain exercises are having.
A Physiotherapy Approach To Low Back Pain
The above, briefly lays out a fairly standard summary of an approach to treatment a physiotherapist may take when looking to assist someone suffering from lower back pain. The emphasis on the role of assessment means that simply prescribing a few low back pain exercises to “fix” what is typically a multi-factorial and complex issue is quite likely to be ineffective at best, and potentially riddled with negative consequences at worst. Without an understanding of the actual origins and causative factors of the condition prescribing lower back pain exercises will typically yield fairly poor results. To beat the same drum and draw parallels again to fixing an engine, you wouldn’t expect your mechanic to tell you exactly what needs to be done to fix your car without actually looking under the hood (or these days plugging it in and running diagnostics). So giving the mechanic only the information that “my car doesn’t work” is never going to be enough for them to ascertain what is wrong, the same applies with spinal complaints. Sadly there is no magic wand exercise, where what works for one, works for all.
Everyone’s Sore Back Is Unique Requiring Individualised Lower Back Pain Exercises
Taking advice from someone who has had a “similar” pain experience with their back and suggests doing the exercises they were prescribed because they helped them will lead to mixed results. The exercises they were prescribed will (ideally) have been prescribed based on their specific individual circumstances and are relevant to them. Even more pertinent is that the exercises prescribed were deemed relevant to them for that particular episode of low back pain and it is possible they may not even apply to them in the future as changes associated with aging, lifestyle or any subsequent bouts of pain occur impacting their relevance.
Just as older cars are more likely to have particular mechanical failings and issues that are in many ways different to those of younger cars, cars driven differently will also be plagued with different mechanical issues. Henceforth two similar model cars, having done comparable mileage may be in vastly different conditions depending on the strain they were put under whilst being driven. Spines just as cars in this situation will require a different approach and ultimately will respond differently to any treatment they may receive.
Common Complaints Occur Commonly
It stands to reason that the saying “common complaints occur commonly” rings true. Therefore with a brief understanding of the onset and behavior of any lower back pain, coupled with someone’s age, activity levels and general body type there will tend to be both trends and patterns regarding causative mechanical structures and severity. In these circumstances generic lower back pain exercises may be both relatively safe and effective, however there are always exceptions to any rule. Exceptions hidden away, waiting there ready to trip you up if your aren’t thorough and mean assuming someone is fitting a classical pattern and treating them as such may lead to unsatisfactory results.
Drum Roll Please. The Best Lower Back Pain Exercises Are…
So what lower back pain exercises should you use to fix your back??? It should be pretty obvious by this stage that I am going to say you need to be properly assessed by your doctor, physiotherapist, chiropractor, osteopath or similarly skilled health practitioner. And I am not going to write a list of 5 exercises that are great for your back as across the board it doesn’t work like that. Your chronological age, physical activity history, injury history, coupled with current physical capabilities and the causative factors both lifestyle and physical need to be considered. All this makes answering the question what is the best lower back pain exercise? A somewhat impossible question to answer accurately and safely.
Posture, Posture, Posture
I will however leave you with this, as a young, impressionable and enthusiastic newly graduated physiotherapist back in the 90’s I was on a McKenzie therapy course with Robin McKenzie a famed New Zealander in the physiotherapy world known nationwide and world wide for the McKenzie Method and to a lesser degree in the general public as the author of the “Treat Your Own Back” book. When asked “if you could have patients do one thing to fix their back pain what would it be?” Robin answered “improve their sitting posture”. The prone lumbar extension stretch, known by many in the physiotherapy world as the Mckenzie press (or the cobra in yoga) is a movement with which Robin Mckenzie helped make his name and really put him on the map in the low back pain treatment world. The Mckenzie method is a brilliant and complex (yet methodical) approach to the assessment and management of mechanical musculoskeletal complaints throughout the body. Yet for many in the industry he will forever be labeled as the “McKenzie press man”. Despite this before his passing, even he didn’t advocate this “McKenzie press” as the savior for all sufferers of low back pain.
Clearly as a lower back pain guru Robin McKenzie appreciated that no two people are the same and as a result their treatment requirements are equally unique. Who am I to argue with him regarding the importance of maintaining good sitting posture and the role this plays in reducing low back pain in the lion’s share low back pain sufferers. One thing I will add to this is that movement is also key. Not to undermine the importance of sitting with good posture in the fight against low back pain but also just MOVE. Sit well, when sitting, but move more! I really believe that these two simple things will go a really long way in helping a lot of people living the Sydney office life and I think Covid-19 has highlighted how the work from home lifestyle with less movement and frequently worse ergonomic set ups has really been a causative factor for many people developing general non specific low back pain.
If you have any questions about our specific low back pain experience and want to understand what low back pain exercises may be most appropriate for you then book in with one of our physios in our Sydney or Randwick practice.
Disclaimer: This information is provided as an educational service and is not intended to serve as a substitute for personalized medical advice. Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned in this post. Anyone seeking specific advice, or assistance regarding a “Lower Back Pain Exercises” should consult his, or her physiotherapist, orthopaedic surgeon, general practitioner, sports medicine specialist, or otherwise appropriately skilled medical practitioner.