Physical Therapy for the Lower Back: How to Prevent and Treat Lower Back Pain

Lower back pain is one of the most common causes of job-related disability and why some people miss work. It is also the second most common neurological ailment in the United States, second only to headache. In fact, approximately 80% of adults in Western countries have, at some point, experienced lower back pain.

For some fortunate people, pain in the lower back may be resolved by itself or with the aid of medication within two to four weeks. However, there are some cases of lower back pain that may last for more than a few weeks, during which case the condition is termed as “chronic” and “progressive,” meaning it can only grow worse over time.

Moreover, 60-80% of those patients who suffer their first episode of lower back pain may experience recurring pain within one year.

According to current research, there are certain muscles in the back that work to stabilize the spine. When the spine or the back suffers an injury, these muscles are reflexively inhibited or shutdown. Worse still, these muscles do not spontaneously recover, and this is true even if patients do not feel pain and are able to return to normal activity levels.

As a result of the inhibition of these muscles, called lumbar multifidi and the transversus abdominus, lower back pain occurs. However, there are steps you can take to prevent the same thing from happening to you.

Lower Back Pain and Physical Therapy

One way to prevent the inhibition of the lumbar multifidi and transversus abdominus is through a series of physical therapy exercises.

Designed to strengthen the muscles of the lower back and keep the spine healthy, these physical therapy exercises may range from back stabilization exercises to muscle strength development and several wide variety of techniques.

In addition, a physical therapist may also recommend such methods as heat therapy, ultrasound, massage, mobilization, and education about posture and body mechanics in order to prevent lower back pain from recurring.

Some of these methods will be discussed later on. You will also find some practical self-help tips provided by experts to help you avoid lower back pain or prevent the condition from worsening.

However, before we head on to learning how lower back pain is treated through physical therapy, it is important that we first understand what causes lower back pain.

Lower Back Pain: CAUSES

There are actually many types of back pain, but the most common is pain in the lower back. Why? You might ask. The reason is simple: you carry most of your weight in the lower back. Thus, it is highly likely that a person would suffer pain in that area.

There is no definitive cause of lower back pain. Sometimes, the causes of the condition are so complex that it is difficult to pinpoint just a single one.

However, physical therapists and other healthcare professionals have observed that lower back pain is often a result of strained back muscles and ligaments due to any of the following activities:

o Improper posture

o Heavy lifting

o Sudden awkward movement

o Muscle spasm

o Stress

We could all be guilty of the above activities. We may not suffer any back pains now, but it is likely that as we get older and the degree of inhibition of the back muscles as a result of these activities increases, back pain becomes a very distinct possibility.

In addition to these common activities, lower back pain may also result from specific conditions, such as:

o Herniated disk (when the disk material presses on a nerve)

o Sciatica (when a herniated disk presses on the sciatic nerve. The condition causes sharp, shooting pain through the buttocks and the back of the leg.)

o Spinal stenosis (when the space around the spinal cord and nerve roots becomes narrow. This is caused by arthritis and bone overgrowth, the pain resulting from when a nerve gets pinched in the narrow space.)

o Spondylosis (a type of arthritis affecting the spine due to degenerative changes brought on by aging)

o Spondylolisthesis (when one vertebra in the spinal column slips forward over another)

Lower Back Pain: TREATMENT

The treatment of lower back pain depends on several factors, including the specific type of lower back pain (whether it is chronic or acute) and the purported cause.

For instance, acute lower back pain is commonly treated with pain relieving drugs, such as analgesics, or some forms of exercises that can help relax the muscles.

On the other hand, chronic back pain – or one that lasts for more than two weeks and is progressive – may be caused by some underlying condition, during which case the treatment plan may consist of resolving the underlying condition to treat the back pain.

Lower Back Pain and Physical Therapy Exercise

Physical therapy exercise is one of the most common methods of treating lower back pain. In fact, many home remedies for lower back pain consist of exercise, because the general theory is that if you remain active, you remain healthy. This is true in most cases.

However, for purposes of this article, the exercises featured here will be those that are practiced by physical therapists to treat patients with lower back pain.

Generally, in physical therapy exercises, the exercise program for back pain should encompass a set of stretching exercises, strengthening exercises, and low impact aerobics. Read below for more on these exercises:


The back of a person is composed of the spinal column and contiguous muscles, ligaments and tendons. All these are designed to move in consonance with each other so that any limitation in the range of motion in any of these components of the back result in back pain.

Stretching for lower back pain specifically targets soft tissues, such as muscles, ligaments and tendons, found in the back and around the spine. By stretching, the spine and soft tissues are mobilized, increasing motion and thus, relieving pain.

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Exercises to Stop Back Pain Now

Your back hurts. It hurts a lot. You ask, “What are the exercises to stop the back pain now?” or you plead, “Give me information on back pain exercise!”

Surprisingly, too much rest during an encounter of back pain will often make the condition worse. A day or two of rest should be followed by specific back pain exercise for complete recovery.

How Can Exercise Stop Back Pain?

Careful, thoughtful back pain exercise will help distribute nutrients up and down your spinal column, feeding your muscles, ligaments, nerves, and joints. Specific back pain exercise will stretch you back, making it supple. Other back pain exercise will strengthen your back, and make it strong. Weakness and stiffness, increased by rest, can be overcome by back pain exercise.

Exercises to stop the back pain now will also prevent future back pain, since you will be increasing your back’s ability to handle extra stress or injury.


Before you begin back pain exercise, check with your health care provider. Not every back pain exercise will be right for you. If your injury is sever, a spine care specialist will recommend specific exercise techniques to meet your need. Your back pain exercise program should work the entire body, even though your primary target is the back.

What Are the Exercises to Stop Back Pain Now?

Once you decide that back pain exercise is essential, you will want to choose appropriate exercises. We recommend a doctor’s advice, and suggest that you show your doctor these possibilities.

1. Back Pain Exercises – Stretching

Stretching muscles, ligaments and tendons is essential for back health. Whether or not you are currently experiencing back pain, regular stretching of the back will give strength to overcome or prevent injury and trauma to the back. If yours is chronic back pain, plan on regular, daily stretching for as much as six months to give your back the flexibility and strength it needs. You may want to schedule more than one stretching session per day, but work carefully. Eventually, you will find that back pain exercise keeps back pain from recurring.

Set goals (expectations with due dates) for each muscle group. Decide a date by which you want each of these muscle groups to be strong. Write down each date, and determine to meet it.

Warm Up First for Safe, Efficient Back Pain Exercise!!
If there is any pain, stop or take it more slowly.
Cool down after your back pain exercise.

* Gluteus muscles. The muscles in your buttocks support flexibility in your hips as well as your pelvis. Back pain exercise should include these muscles daily.

The gluteus stretch. Sit in a straight back or folding chair. Move your bottom only forward several inches from the chair back. In that position, lightly press your feet against the floor. Now squeeze your gluteus muscles together, and hold for 5 minutes. This stretch allows you to get back pain exercise while watching TV.

* Hamstrings. Located in the back of each leg, your hamstrings help give you correct posture.

The hamstring stretch. Place one foot on a chair, keeping the other leg straight. Bend over until your chest touches the knee of the foot on the chair. Keep your chest on the elevated leg as you slowly back the other leg away from the chair. Hold your stretch for 20 to 30 seconds. This stretch gives good back pain exercise without equipment.

* Piriformis. The piriformis syndrome is caused by the piriformis muscle irritating the sciatic nerve. You feel pain in the buttocks, and referred pain from the back of your thigh to the base of the spine. Many people call this lower back pain “sciatica”.

The piriformis stretch. Lie on your back, right hip and knee flexed. Grasp your right knee with your left hand, and pull the knee towards your left shoulder. In this position, grasp just above the right ankle with the right hand, and rotate the ankle outwards. Repeat with your left side. You might want to do this back pain exercise with gentle music.

* Psoas Major. Lower back mobility can be greatly limited by a tight Psoas Major. This muscle often causes back pain that makes it difficult to kneel on both knees, or to stand for extended periods.

The Psoas Major stretch. Kneel on your right knee, left foot flat on the floor, left knee bent. Rotate the right leg outward. Place your hand on the right gluteus muscle and tighten the muscle. Lean forward through your hip, careful not to bend the lower spine. You should feel the stretch in the front of your right hip. Hold for about 30 seconds. Repeat with your left leg. If you have young children, include them in your back pain exercise.

2. Back Pain Exercises – Strengthening

Back pain can be stopped now, and greatly avoided in the future, by decreasing lower back stress. These exercises develop critical muscles in the abdomen, lower back, and gluteus. Both of these back pain exercises are learned better when working with a trained physical therapist, but if you are careful, you can learn them alone. Although you may do daily stretching back pain exercises, it is important to take a few days off each week from strengthening back pain exercises.

Lower Back strengthening. Begin by lying flat on your back on the floor. Do not push your back down on the floor. Bend both knees. Pull your navel (belly button) in toward your back while keeping your back relaxed. As you breathe out, stretch your arms upward as though you are reaching for an overhead chandelier. Gradually raise head and shoulders from the floor until your shoulder blades are barely touching the floor. Hold the position one to two seconds. Repeat 8 to 12 times. If you feel pain with this back pain exercise, stop or try to do it more gently and slowly.

3. Back and Leg strengthening. This is one of the McKenzie Exercises, named after a New Zealand physical therapist. Lie on your stomach, and push up off the floor with both hands, raising only your chest. Keep your pelvis flat on the floor. Raise your back to a comfortable stretch and hold for 8 to 10 seconds. Repeat 8 to 12 times. You should feel no pain with this back pain exercise, only a pulling up of the spine.

It is strongly suggested that any back pain exercise be done only after seeking professional medical advice.

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