Self-Care for Back Pain: Exercises to Help the Healing

When it comes to back pain, your first thoughts may be to take over the
counter pain medication and rest whenever possible. Two bad options.

First, medication is only going to temporarily relieve the pain, if at all, and
may be accompanied by various unpleasant side effects attributable to
drugs. Second, rest may actually hurt more than help. While you're seeing
your chiropractor, there are a few things you can do at home to help the
healing process. Believe it or not, it's based on the simple principle of

Whenever I see a patient with back pain, I always ask, "What do you do
when you are in pain? What exercises help your pain?" I am continually
surprised that very few patients know what self-care to do when they have
an acute episode of pain. That includes motivated patients and patients I
have seen before and carefully shown the right exercises.

Maybe it is because when you hurt, you stop thinking clearly; or maybe it is
fear that the pain will get worse. Both are valid excuses. Most of them just
rest, ice the area, and use non-steroidal anti-inflammatory drugs (without
realizing that NSAIDs actually block healing). Many of them say, "I hurt too
much to exercise."

Why Movement Matters
The problem with this is that when you stop moving, when you are still,
everything tightens up, circulation slows down, and pain chemicals
accumulate in your muscles and joints. It's like waking up after sleeping in
a cold room on a lousy mattress with a draft. If you get moving, you'll
typically start to feel better.

So, here's the number-one rule to remember: Don't stop moving when
you hurt. I know, you are in pain and afraid to move, and sudden
movements may cause your back to "grab" or spasm.

I am not telling you to ignore the pain. What I am saying is that you need
to find movements that will ease your pain. In many cases, the most
important thing to do when you hurt is to keep moving.

The body often tightens up and limits your motion. If you find a motion
that doesn't hurt you, it will probably help you. When you are hurting, you
may not be able to do your usual activities, but you must keep moving.

Try walking slowly, especially on flat and even ground. Try walking up a hill
(you can walk up a hill without walking down, on a treadmill). Try swimming
or simple motions in chest-deep water. Try basic pelvic tilts, staying within
a pain-free range.

Here are some basic principles. The movement should be pain free (or at
least cause minimal pain while being performed). When you have finished
doing the exercise, your pain should be somewhat diminished. You should
feel that you can move more freely. Your back should feel straighter and
less "kinked."

Basic Exercises for Low Back Pain
Here are two basic examples of self-care exercises that have stood the
test of time. Many of my patients have found variations on these and other
types of movements that act as "reset" buttons for their typical pain. You
are the one living in your body; you are the most likely one to know what
is working for you.

Lower back diagnosis is often very difficult and confusing. For the sake of
this article, let's divide low back pain exercises into two categories:
exercises that make your back feel better when you bend backward, and
exercises that make your back feel better when you bring your leg toward
your chest.

Backward Bending (extension of the lumbar spine)
An exercise called the McKenzie extension is the first thing you should try
if you have sciatica (pain running down your leg). If these exercises work,
your pain will diminish and may centralize, which is a good thing. Centralize
means your pain goes less far down your leg, and you may feel it closer to
the spine.

Bending backward may not feel good at first, but you should feel better
immediately afterward. If you feel worse afterward or the pain goes farther
down your leg, stop, as this is not the exercise for you.

How to Do It: Lie face-down on the
floor, arms bent at your sides (sort
of like a starting push-up posture).
Straighten your arms slowly, lifting
your upper body off the floor as you
do so.

Your legs and feet should stay on the
ground. Hold for 3-5 seconds, then
slowly lower your upper body back
down. Repeat 10 times, as often as
once per hour.

If your pain or restriction is on one side, a variation on McKenzie extension
(lying on a raised surface with one leg on the floor, slightly bent) may be
more comfortable (keep the elevated leg straight).

Flexion Exercises (bringing the leg toward the chest)
People with lower back pain can also feel better with various types of leg
flexion, bringing the bent leg toward the chest, or doing contract-relax
and then bringing the bent leg toward the chest. These people usually
have sacroiliac joint problems. (The SI joints are located on either side
of the spine in the lower back.) These are also called Tigny exercises.

How to Do It: Lie on your back with
one leg bent and then other flat on
the floor. Bring the bent leg up
toward the chest. Wrap your arms
around the leg and then try to lower
it toward the floor for 3-5 seconds,
resisting with your arms. Relax, and
then pull the bent leg up farther toward the chest. Repeat the entire
process three times.

So, here is the bottom line: When your lower back starts to hurt, find one
or more simple movements or exercise that helps. Do the exercise over
and over until you are back to normal. If you are not getting better quickly,
call your chiropractor.

With that said, please use common sense. Stop immediately if you hurt
more during or after doing any exercise. Exercise is not without risks.
These or any other exercises may cause pain or injury. As with any
exercise program, if at any point during your routine you begin to feel
faint, dizzy, or have physical discomfort, you should stop immediately.
To reduce your risk of injury, consult with your doctor before doing these
exercises for the first time, particularly if your pain is new and/or you would
like further explanation of how to perform the exercises correctly.

Video of McKenzie lumbar extension

Sciatica self-care, by Dr. George Best

       Video of flexion exercises

Article by Marc Heller, DC
Marc Heller, DC, maintains a chiropractic practice in Ashland, Ore.
He is a nationally recognized expert in treating tailbone, sacroiliac and lower
back pain.


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