Lower back pain is incredibly common. Most adults (up to 80%) are expected to experience it at some point in their lives. An NHIS survey found that one-third of adults in the US had experienced back pain within just a three-month period.
Considering the statistics, you’d think we’d all know more about our backs. But most people treat their lower back pain with painkillers, never knowing what caused it, and never really getting to the root of the injury. Unfortunately, How to Keep Your Back Healthy and What Causes Lower Back Pain aren’t covered in most school systems. Enter Jenna Ellis, our resident physical therapist. To close our knowledge gap and get us ready for her Lower Back Pain Relief Program, she gave us a crash course. The key learnings are captured below.
What is our lower back and why is it so important?
Your lower back, also known as your lumbar spine, is made up of five lumbar vertebrae (small bones that stack up to form your “backbone”) and discs (essentially little rubbery cushions between the vertebrae). You have nerves coming out both sides of each vertebra from the spinal cord and there are many muscles that hold it all together.
Your lower back connects your upper torso to your pelvis. Its job is to stabilize the spine and support both your upper and lower body. With the help of muscles, a healthy lower back can move forward and backward, twist side to side, and bend left and right.
That makes your lower back crucial for everyday movements like sitting in a chair, standing up from a seated position, walking, bending, lifting, and twisting. In our programs, your lower back is active when doing Primal 7 squats, hip hinges, and bridge.
What causes lower back pain?
DISCLAIMER: This blog post is meant to be informative, not diagnostic. If you’re experiencing pain, it is best to see your doctor or physical therapist.
Are you picturing someone bending over to pick something heavy off the floor? This is a common cause of back pain, but the idea that you need to be lifting something heavy is a misconception. Back pain can be caused by an array of things, including something as simple as bending forward to tie your shoes or put your socks on. You could even herniate a disc just by sneezing!
Though there are many nuances to lower back pain, most injuries can be grouped into one of these two main buckets: generalized or nerve-related. Nerve related lower back issues tend to be characterized by sharp, shooting, and/or electric-feeling pains that can go beyond your lower back, into your butt or leg, for example. General lower back pain tends to be achy, sometimes throbbing, and usually is contained to the lower back. In this blog post, we’ll focus on generalized lower back pain, aka Lumbago. (We’ll be publishing another blog post all about lower back nerve pain soon!)
Common causes for generalized lower back pain are:
1. Pulled (Strained) Muscles
A lot of lower back injuries happen when we bend forward or twist side to side and strain the lower back muscles. When we are bending forward our muscles are stretched to their full length and it’s much harder to pull the body upright. This gets more challenging if we’ve added weight, like when picking up a child or heavy box from the floor. Like we mentioned earlier though, there doesn’t need to be weight involved –– you can pull a muscle in your back just by stretching your muscles beyond their flexibility, even if you’re not lifting anything at all. If you have a pulled muscle, you’ll feel a specific part of your lower back is tender when you touch it. Usually, it is one-sided and doesn’t result in shooting pain.
2. Degenerative Disc Disease
Spinal discs provide cushioning between the vertebrae (bones) in our spines. They’re like little shock absorbers. But as we age, they can dry out and crack. This will happen to all of us to some degree but it does not always result in pain. When it does cause pain, these changes are referred to as Degenerative Disc Disease (DDD). The pain associated with DDD is achy and usually spreads wide across the lower back and beltline. Though the pain tends to stay near the beltline and doesn’t shoot up or down much, it is common for the pain to be throbbing and really uncomfortable.
3. Osteoarthritis or Facet Joint Arthritis
Arthritis essentially means joint inflammation. There are over one hundred types of arthritis but the most common one is Facet Joint Arthritis, also known as Osteoarthritis of the Spine or degenerative joint disease. This type of arthritis is tied to Degenerative Disc Disease because when your discs are worn down, the lack of cushioning puts extra stress on your facet joints (the joints that connect the bones in your spine). Basically, without the discs, you end up with bone-on-bone movement which can be quite painful. Since this type of arthritis is linked to degenerative disc disease, the pain presents similarly: achy, spread across the lower back and beltline, sometimes throbbing, rarely shooting up and down.
How can we relieve generalized lower back pain?
Disclaimer: If you feel you’ve really injured your back, please see a doctor or your physical therapist so they can properly diagnose you. We can give you helpful tips here but this is not meant to diagnose or replace your doctors’ advice.
Flexion and neutral based exercises are best for generalized lower back pain. That means exercises where our back is straight (neutral) or bending forward (flexion of the lumbar spine).
Here are three exercises that help relieve generalized lower back pain:
1. Hamstring Stretch
Your hamstring is “the group of three muscles that run along the back of your leg, from your hip to just below your knee”*. It’s important to stretch this group of muscles because if they are tight, they will tug on the pelvis, tilting it backward. This is called posterior tilt and it is the opposite of what happens when you have tight quads. It puts more strain on the lower back muscles and can cause a flattening of the lumbar spine over time. When this happens, the gentle forward curve in our lumbar spine can eventually reverse backward and cause a lot of pain. For a mental image of what a reversed lumbar spine curve looks like, picture someone slouching forward. Tight hamstrings can also cause knee and leg issues.
How to stretch your hamstring with a Primal 7 system:
Stand under the anchors and behind the band. Place your right heel in the middle of the band and lightly grab the straps. Press your right leg out, straightening the knee until you feel a gentle pull in the back of your thigh. Make sure you are standing upright and not hinging forward at your hips. Keep your hips square and chest upright. Hold this position for ten seconds then switch legs. Do three ten-second sets for each leg. Eventually, you want to work your way up to thirty-second holds, but it is best to start slow and really learn how this stretch feels.
If you don’t have a Primal 7 system, try this instead:
Grab a belt before getting started. Then lay down on the floor, flat on your back with your legs straight out. Make a loop with the belt and place it around your right foot. Keeping your knee straight, pull the belt up until you feel a gentle stretch in the back of your thigh. Hold for ten seconds and repeat three times on each leg. Eventually, you want to work your way up to a thirty-second hold, but it is best to start slow and learn how this stretch feels.
2. Knees to Chest Stretch
This exercise will help you lengthen and stretch out the muscles in your lumbar spine (lower back) as well as your glutes (butt muscles). When your lumbar spine muscles and glutes get too tight, they tend to make you feel stiff, like you can’t bend forward to put your socks and shoes on. Sometimes that stiffness will make it feel like you can’t rotate side to side. The Knees to Chest Stretch gently pulls the pelvis into a neutral position while taking pressure off the joints in the lumbar spine and the nerves exiting the spinal column. This release of pressure makes it an especially great stretch for people dealing with arthritis in the lower back – it’s frequently prescribed in physical therapy.
How to do the Knees to Chest Stretch:
Lay flat on your back with knees bent, feet flat on the floor. Bring your knees in towards your chest placing your hands either on top of your knees or underneath them. (If you have bad knees and don’t want to compress them, Jenna recommends putting your hands underneath your knees.) Keeping your back flat on the floor, use your arms to pull your knees towards your chest. Stop when you feel a gentle stretch in your butt and lower back. Hold for thirty seconds, rest on your back, and then repeat another two times.
3. Bridge
Bridge is a great exercise to strengthen your glutes (butt muscles) and hamstrings (muscles in the back of your upper leg). Both strong glutes and hamstrings are key for keeping your pelvis supported and in alignment. Since they’re all connected, a balanced pelvis is key for not only your lower back but also your hips and knees. Looking beyond the pelvis, strong hamstrings and glutes help us with everyday movements like walking and getting up from a seated position. When weak, you may find you don’t have the push, drive, or oomph needed to propel yourself up and forward.
How to do bridge with a Primal 7 system:
Lay flat on the floor and place both heels in the Primal 7 band, about a hips-width apart. If you need to, scoot your body back until your knees are straight. Before moving, make sure to tighten your abs and squeeze your butt. With both your abs and glutes engaged, lift your hips off the floor until your body is parallel with your feet. Hold for ten seconds and then return to start. Make sure you are keeping your abs and butt squeezed during the entire movement to avoid stress on your lower back. Make sure not to overextend your hips past parallel. When you’re just getting started one ten-second hold is a good place to start. After you feel confident with that, begin working your way up to repeat it five times.
If you don’t have a Primal 7 system, try this instead:
Lay flat on the floor and place your heels on a couch cushion or object that's about 6-8 inches off the floor. Straighten out your knees, squeeze your abs and butt. Keeping both tight, lift your hips up to parallel, hold for a second, and then return to start. If you don't get to parallel, don't worry! You can make that a goal to work towards at your own pace. Another option is to lay down with your back and feet flat on the floor, your knees bent, arms resting straight at your side. If you can touch your fingers to your heels, you’re in a good starting position. Like with the other version of this exercise, you’ll want to squeeze your abs and butt tight and lift your hips up off the floor until your hips and torso are parallel to your thighs. Pause, hold it for ten seconds, then lower to the start position again. Over time, work your way up to doing five reps.
We hope those three movements will provide you some relief. For more exercises, easy-to-follow routines, and guidance, keep an eye out for our free Lower Back Pain Relief Program*. In the meantime, if you have any questions about general lower back pain, please post them in the comments below. Jenna will be responding to any lower back pain questions that we get this week.
*If you’re not already subscribed to our newsletter, sign up to be alerted when our Lower Back Pain Relief program launches!
Sources: CDC, Hopkins Medicine, WebMD, ACA, PubMed / NIH