Take a deep breath and exhale slowly, repeat if you liked the feeling. Now let us get on with the article.
If you have read the about page of the website, you would know that in 2022 I decided to undergo lumbar fusion surgery for my decade old sciatic pain (lumbar radiculopathy) from Prolapsed Intervertebral Disk. The decade long coping with lower back pain and sciatica with activity and postural modifications and the recovery from my surgery through rehab to return stronger gives me the unique ability and perspective to help others in similar circumstances. The right techniques to lift heavy objects off the floor and from the trunk of your car, vacuuming and mowing have been hard wired into my brain. For principles of ergonomics click here. Let us look at the incidence of low back pain.
Per the British Medical Journal Low back pain (LBP) is the leading cause of long-term disability worldwide. The lifetime incidence of low back pain is 58-84%, and 11% of men and 16% of women have chronic low back pain. Back pain accounts for 7% of GP consultations and results in the loss of 4.1 million working days a year. More than 30% of people still have clinically significant symptoms after a year after onset of sciatica. Per the Lancet studies have found that more than 60% of individuals with mechanical low back pain will continue to have pain or frequent recurrences 1 year after onset. For new-onset lumbar radiculopathy, between 15% and 40% of people will have chronic pain or frequent relapse.
Poor posture and ergonomics, long sitting hours combined with inadequate to no exercise has led to an alarming number of people having lower back pain. Genetics also has a role to play but is not the only factor determining an adverse outcome. This list of people also includes me. In this post I would be highlighting the Yoga poses and core exercises that will help LBP. Most of the occupations today have us bend the spine forward (flexion) which causes the intervertebral discs to bulge posteriorly. There are hardly any occasions during the day where we extend the back (extensions are backward bends as opposed to flexions). This is the reason most of the exercises for LBP involve extensions like the Cobra Pose or Bhujangasana. Please note the most popular Yoga exercise ‘Surya Namaskar’ is not recommended since it involves extreme flexion of the spine. For back pain unlike other injuries where ice is recommended during the first day or two heat helps even in the first 48 hours. Check out this article on why you should increase core strength for a healthy life
If you want to learn about core muscles, please see the below YouTube Videos.
Yoga poses beneficial for people having herniated lumbar disc and sciatica.
- Ustrasana or Camel pose
- Natarajasana or Dancer king pose
- Salabhasana or Locust pose
- Setu Bandhasana or Bridge pose
- Virabhadrasana I, II and III or Proud warrior I, II and III pose
- Dhanurasana or Bow pose
- Paripurna Navasana or Full Boat Pose
- Supta Virasana or Supine hero pose
- Urdhva Mukha Svanasana or Upward facing dog pose
- Virasana or Hero pose
- Vrksasana or Tree pose
- Utkatasana or Chair pose
The Core exercises listed below are typically prescribed by physiotherapist as part of core strengthening exercises. All the exercises are to be performed with an engaged core (draw your belly button towards your spine) and some involve squeezing your gluteal muscles as well.
- Prone Plank holds
- Prone Planks with single leg raise
- Prone Planks with side foot taps
- Side Planks with Arm raises
- Superman/ Alternating Superman
- Back Extensions on Swiss ball
- Bridge Pose and its variations on the Swiss ball
- Hamstring Curls
- Dead Bug
- Bird Dog
- Wood chops with medicine ball
- Wood chops in lunge position/ Chop Lift in half kneeling
- Posterior Pelvic Tilt
- Ball Pass Ab exercise.
- Sit-ups are hard on your back — they push your curved spine against the floor (read disc bulge). Sit-ups also work your hip flexors, the muscles that run from the thighs to the lumbar vertebrae in the lower back. When hip flexors are too strong or too tight, they tug on the lower spine which can be a source of lower back discomfort.
- Planks recruit a better balance of muscles on the front, sides, and back of the body during exercise than sit-ups, which target just a few muscles. Your core goes far beyond your abdominal muscles, see major core muscles listed below.
- Planks prepare the body for daily activities, sports, and recreational pursuits that require coordinated muscle effort. Through dynamic patterns of movement, a good core workout helps strengthen the entire set of core muscles — the muscles you rely on for daily activities as well as for sports and recreational activities.
There are certain stretches as well that help lower back pain such as the hamstring stretch, calf stretch, quadricep stretch, figure of four, knee to chest, child’s pose, butterfly. For more information on stretching please see the YouTube video below.
If you are interested in knowing about the core muscles, please read on:
The major core muscles include:
- Pelvic floor muscles – These muscles support the pelvic organs and help to control urination and bowel movements.
- Transversus abdominis – This muscle is deep in the abdomen and helps to stabilize the spine.
- Multifidus – This muscle is a group of small muscles that run along the spine and help to stabilize it.
- Internal and external obliques – These muscles are located on the sides of the abdomen and help to flex the spine, rotate the torso, and compress the abdomen.
- Rectus abdominis – This muscle is the “six-pack” muscle and helps to flex the spine.
- Erector spinae – This muscle is a group of muscles that run along the back of the spine and help to extend the spine.
- Diaphragm – The diaphragm is a dome-shaped muscle that separates the thoracic (chest) and abdominal cavities in mammals. It is the principal muscle of respiration. The diaphragm helps to maintain good posture. When the diaphragm is strong and healthy, it can help to keep the spine in alignment.
Minor core muscles are the latissimus dorsi, gluteus maximus and trapezius. These muscles work together to stabilize the spine, maintain good posture, and provide a foundation for movement. They are also important for activities such as lifting, carrying, and twisting.
Since you have reached the end of this post, I would like to present you with ‘The Back Book’. The booklet is a short introduction to managing back pain for people who have newly developed back problems.