Back pain is one of the most common reasons people see a physician. While patients who are already in pain often go to the doctor for treatment (essentially reactive care for a problem), low back pain is an area where preventative care can make a big difference, said Dustin H. Massel, MD, spine surgeon at Endeavor Health.
Physical therapy (PT) as first line of care
Physical therapy is often the first line of care for acute back pain, even pain that has lingered. “I generally recommend a short course of PT for most patients. PT serves as maintenance and rehabilitation and will benefit most everyone in the long run, even those who may ultimately need surgery as a form of prehabilitation,” said Dr. Massel.
A professional physical therapist can identify and teach specific exercises and develop a plan they can continue at home to strengthen their core and the muscles that help support the back, explained Dr. Massel.
“When most people hear core muscles they think of abdominal muscles, but your core also involves abdominal obliques, hip flexors and the low back extensor muscles,” said Dr. Massel. “As we age, the extensor muscles can atrophy over time and predispose a patient to low back pain.”
Experienced physical therapists can help patients develop a home exercise plan designed to strengthen and support the low back. “Ideally, a patient would wake up and perform their low back stretches and, in the evening, go to the gym or perform home strength training every day,” said Dr. Massel.
Additional tips to prevent/heal low back pain
Many chronic conditions like low back pain are often multifactorial and can result from years of progressive stress to get bad enough to send someone to a doctor. Healing and improvements from low back pains often do not happen overnight, cautioned Dr. Massel, who stressed that healing and preventing low back pain takes deliberate effort.
As our population tends to have more sedentary jobs and spend a majority of work hours sitting at a desk, a growing lack of activity takes a toll. Decompensation and low muscular tone often lead to back pain, said Dr. Massel.
“Activity and regular exercise are necessary to maintain low back and core strength and stability,” he added. “Pain is our body’s way of telling us there’s a problem.”
Some ways to prevent or heal low back pain include:
Regular exercise. This does not have to include lifting heavy weights or spending hours in the gym. Most people can use their own body weight or even light household items for a home exercise plan.
“A home exercise plan can be body weight exercises and repetitive activities we perform on a daily basis. Body weight squats, or rising from a seated position in a normal house chair, is a great way to exercise and improve our leg strength and endurance.
Low impact exercises like swimming, yoga and Pilates are also fantastic for stretching and strengthening,” said Dr. Massel.
- Gentle stretching. Regular stretching is key as tight hamstring muscles can exacerbate or lead to low back strain, explained Dr. Massel, who encourages people to gently stretch their hamstrings every day after a few minutes in a warm shower.
- Anti-inflammatory medicine. Sometimes a short course of anti-inflammatory medication for seven to 10 days can help bring inflammation down and allow people to engage in physical therapy and exercises designed to keep inflammation and pain at bay. Ask your doctor before you take any medication.
- Complimentary therapies. Dr. Massel also supports complimentary treatments like massage therapy or acupuncture that can help reduce pain and muscle spasms and increase a sense of relaxation.
“The important thing is to stick with the exercises,” he said. “Sometimes people start feeling better and begin to neglect the exercises that helped them get back to baseline. You have to keep doing the maintenance exercises and make it a daily habit.”
Anyone with severe symptoms like intense back pain, numbness or tingling in the legs, weakness in the legs, numbness or tingling in the groin, loss of urine or stool control should see a doctor immediately.
