Submitted by Penrose & Associates Physical Therapy

As a result of being the experts with the spine in our community, I thought I’d write up the best tips and exercises for back pain. 

First of all, pain in your back and pain down your leg (sciatica) does not tell you where the pain is coming from. Back pain can come from your hips, SI joints, the facet joints of the spine, the muscles, the discs, vertebral changes, bone spurs to name a few. Pain down the leg (sciatica) can come from a pinched nerve but it doesn’t tell you what is pinching the nerve. The nerve could be pinched from a bone spur, stenosis, herniated disc, or tight muscles.  This is why you need to make sure you work with an expert that is able to move you through a series of motions and tests to determine which structures are the cause of your pain. 

Physical therapists are trained to do the same orthopedic and neurological screening that orthopedic surgeons and neurosurgeons perform. The wait time to get in to see a physical therapist is usually shorter and we can start helping you the same day. For example, if we think it is a disc pressing on the nerve we can give you exercises and activities that will help decrease the pain.  We can use hands on techniques to decrease tight muscles and mobilize stiff areas. We can also explain what things (exercises, positions, postures) will make the disc irritated and why and what to avoid.  We may also send you to an ortho or neuro specialist if we think you need further evaluation like imaging.  We want the best outcome for you and sometimes physical therapy may not be the right first step or we may need other specialists involved at the same time to make progress faster.

We work with many of the groups in town and it is no problem to get your x-ray report, MRI report, or chart notes from any of the providers in our community to make sure we are all on the same page coordinating your care for the best outcomes.

1. The best thing you can do if you have back pain is to pay attention to what triggers your pain.

What types of motions and movements bring on your symptoms and what relieves it? This will help us figure out which structures are causing the pain and give you the correct exercises to help it.  For example, if you have a herniated disc, it is important for you to know that bending and twisting are the worst things for a disc. So, you should avoid those as much as possible with your spine and learn how to bend and rotate in your hips. Sitting is very compressive to the discs in your spine, so try to stand often and limit your sitting to 10 minutes at a time.

2. A great thing that helps back pain is learning how to do deep diaphragmatic breathing.

This actually can cause the back muscles to relax and it allows the nervous system to go away from “fight or flight” state to a “rest and digest” state.  I did a 30-minute presentation of “How Diaphragmatic Breathing Decreases Your Pain” on my podcast “Stay Healthy South Sound.” Please go listen to it – it’s on Spotify and Itunes and Google Play or on the Penrose Physical Therapy website. Go to “resources” and “podcasts” and scroll down to that Episode.

3. You need a back that has endurance, stamina, and the right amount of stabilization to handle loading/lifting/pushing/pulling.

Many people think they need a strong back. This is simply false. It’s not about strength in the back but instead stabilization/endurance. Instead, you need a strong core and strong hips and legs.

4. Sit ups are really stressful on the discs and should be avoided if you have back problems.

In fact, the literature shows that the best exercises that activate the core are various planks.  If planks hurt than you need experts to show you how to do them correctly. Learning how to strengthen your core, hips, and legs without overusing your back muscles is the number one thing to learn.  If you overuse your lumbar muscles they stay tight and tense and lead to more stress and pain to the spine. Please note that 70% of traditional Pilates Poses are contraindicated for anyone with disc and sciatica issues or soft bone.  We have modified our Pilates to accommodate for these common issues.

5. Give my podcast episode on back pain a listen.

Back Pain, All Things Discs, Stenosis, Sciatica, and My Own Low Back Pain Surgery” on Stay Healthy South Podcast  – it covers so many useful tips!

If you have been suffering with low back pain, we’d be happy to help. In addition to treating low back we offer Pilates classes that are designed to protect the spine and yet work your hips and core. 

We are located across from Big 5 Sporting Goods and Walmart on the 3rd floor of the Harborstone Credit Union building at 1445 Galaxy Dr. NE, Lacey. Visit Penrose Physical Therapy website or call 360.456.1444.

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