Have you ever experienced low back pain? What is low back pain? Low back pain is defined as pain felt anywhere between the first lumbar vertebrae down to the gluteal fold1(figure 1). This is a large span of the human body and can be attributed to numerous body parts, joints, muscles, tendons and/or ligaments. Things that can be defined as low back pain include sciatica, stenosis, arthritis, piriformis syndrome, and even hip pain or gluteal pain. Low back pain is experienced at some point in almost every person’s life in the US. While usually self-limiting and resolving itself within 6 months from time of onset, some pain sticks around1. This article will be talking more specifically about nonspecific low back pain (back pain not attributed to a known pathoanatomical cause).
Nonspecific low back pain (NSLB) essentially means back pain with no known cause or reason. Within this category there can be 3 subcategories. Acute pain is pain lasting less than 3 months, sub-acute lasting between 3-6 months, or chronic lasting more than 6 months. As stated before, most people will experience back pain at some point in their life. About 80-90% of NSLB can be categorized in chronic low back pain2.
So, what do we do about it? Many studies point to exercise as the most effective treatment in reducing pain, improving function, and reducing debility at 6 and 12 month follow-up post physiotherapy treatments2. More specifically, things like motor control exercise, exercises targeting pelvic control and stability, and lumbar stabilizers can improve pain scores and return to function quicker than general exercise or no intervention. Pilates is also found to be just as helpful2.
You can begin stability activation starting now while reading this article! One way to target stability is to properly turn on the bottom most layer of your abdominal muscles. From top to bottom there are the rectus abdominus (6 pack muscles), the external oblique, the internal oblique, and the transversus abdominus (figure 2). To engage the transversus abdominus (TA), imagine pulling in your stomach using your stomach and not your diaphragm. Use your stomach muscles to pull your belly button in towards your spine. Can you hold this without holding your breath? Can you hold it for 5sec? 10sec? Start with a 5sec hold, rest, and repeat. Perform multiple times per day and progress slowly to the point you are activating this muscle all the time every day with every motion.
For proper performance or assessment, visit your trusted healthcare professional or physiotherapist!
References
- Casiano, Vincent E., and Nikhilesh K. De. “Back Pain.” PubMed, StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK538173/.
- ZHANG, Chanjuan, et al. “Effectiveness of Motor Control Exercise on Non-Specific Chronic Low Back Pain, Disability and Core Muscle Morphological Characteristics: A Meta-Analysis of Randomized Controlled Trials.” European Journal of Physical and Rehabilitation Medicine, vol. 57, no. 5, Nov. 2021, 10.23736/s1973-9087.21.06555-2. Accessed 17 Nov. 2021.