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Generalized LBP and exercises

Page history last edited by James McCann 11 years, 7 months ago

First Author: Colby Helffrich

Second Author:  James McCann

Lower Back Pain


and Exercises  


Background of Lower Back Pain


  • Lower back pain is most common cause of disability and inability to work.
  • 90% of the worlds population will be affected by lower back pain at some point in their life.
  • Condition can worsen over time, becoming a chronic disorder.[1]
  • Several studies show that about 17.6% of all American adults report having at least one period of acute severe low back pain within the past year, and that one out of every four adults reported having low back pain within the past three months.[2]
  • Low back pain, occurs in the lumbar area of the spine, and this is the most common site for pain because it supports the majority of your weight.



Risk Factors associated with Lower Back Pain

  • Being older than 34 years old
  • Degenerative diseases such as arthritis or osteoporosis
  • Family history of back pain or trauma
  • Sedentary Lifestyle
  • Unsatisfied with job
  • Low socioeconomic status
  • Smoking
  • Excessive body weight
  • Negative Psychological factors
  • Frequent lifting, twisting, bending, standing up[3]
  • Pregnancy



Most Common Causes of Low Back Pain


1) Sudden injuries to the back; such as auto accidents, fall, sports, etc.


2) Gynecological conditions; such as menstrual cramps, fibroid tumors, and pregnancy, can cause lower back pain in       women.


3) Muscles, Nerves, or ligaments stressed in lower back.


4) Jobs that require repetitive movements, sitting in chairs that are not shaped properly for your back, or standing for long      periods of time.


5) Bone or joint diseases; such as Arthritis, osteoporosis, osteoarthritis.


6) Being overweight, not getting a sufficient amount of exercise, and being sedentary.


7) Slipped discs, pinched nerves, sciatica, aging, and infections.


8) SMOKING! Physicians where followed for many years after their graduation from medical school, and the research that was collected from them shows that smoking history, hypertension, and coronary artery disease are associated with causing lower back pain.[4]



Diagnosis Chart for Lower Back Pain[5]



Begin here        
1. Did your pain begin after a fall or injury or when you lifted an object? No --> Go to Question 5.*    
Yes, go down        
2. Do you have numbness or pain extending down your leg? Yes --> You may have a HERNIATED DISK. --> See your doctor. Get plenty of rest and use an anti-inflammatory medicine to relieve pain. If your pain is severe, if you have lost feeling or movement, or if you have lost control of your bladder or bowels, see your doctor or go to the emergency room right away.
No, go down        
3. Are you over 60 years of age or do you have arthritis, and are you having severe pain with any movement? Yes --> You may have a FRACTURED SPINE. -->

Call an ambulance right away. Do not try to drive to the emergency room, and try to move as little as possible.

No, go down        
4. Do you have pain when twisting, bending or even sitting? Yes --> Your pain may be from MUSCLE SPASM, a PULLED MUSCLE or a HERNIATED DISK. --> Apply heat, use an anti-inflammatory medicine and get rest. If you don't get better or if your symptoms get worse, see your doctor.
No, go down        
*5. Do you have pain that comes and goes that may have started in your teen years? Yes --> You may have SPONDYLOLISTHESIS, when one vertebra in the spine slips over another, or SPONDYLOSIS, a type of arthritis. --> See your doctor. Use anti-inflammatory medicines to relieve pain.
No, go down        
6. Do you have a fever? No --> Go to Question 8.**    
Yes, go down        
7. Do you have blood in your urine and one-sided back pain along with burning during urination? Yes -->

You may have a kidney infection such as PYELONEPHRITIS. You may also have KIDNEY STONES, which can start a kidney infection and may cause pain, blood and painful urination without a fever.


See your doctor right away.

No --> You may have a viral illness such as the FLU. --> Use analgesics such as acetaminophen to reduce fever and use over-the-counter cold medicines to treat other symptoms. See your doctor if your symptoms don't improve or if they get worse.

**8. Is your back stiff and sore in the morning and are other joints stiff, sore, swollen or red? Yes --> You may have ANKYLOSING SPONDYLITIS, a form of arthritis that affects the spine. Other forms of ARTHRITIS can also cause back pain. --> Use an anti-inflammatory medicine and apply heat to the affected area. If you do not improve, or if your pain is severe or gets worse, see your doctor.
No, go down        
9. Are you pregnant? Yes --> PREGNANCY causes stretching of the ligaments around the uterus and pressure on the lower back. --> Apply mild heat to the back only. See your doctor if the pain continues or if fever or bleeding accompanies the pain.
No, go down        
10. Is the pain centered in the lower spine and do you have pain down your leg? Yes --> You may have a HERNIATED DISK or SPINAL STENOSIS. --> See your doctor. Get plenty of rest and use an anti-inflammatory medicine to relieve pain. If your pain is severe, if you have lost feeling or movement, or if you have lost control of your bladder or bowels, see your doctor or go to the emergency room right away.
No, go down        
For more information, please talk to your doctor. If you think the problem is serious, call your doctor right away.






Strengthening Exercises for Low Back Pain Prevention



                             (1)  Back Extension                 (2)  Back Extension on Ball         (3)  Reverse Hyper-Extension on Ball             (4)  Good Mornings



  1. Back Extension: Lie face down on a mat and place the hands on the floor or behind the head (more advanced).  Contract the abs and keep them contracted throughout the exercise.  Squeeze the back to lift the chest a few inches off the floor. Lower and repeat for 1-3 sets of 10-16 reps total on each arm.
  2. Back Extension on Ball: Lie down with the ball under the belly and hips, legs straight out behind you (or knees bent for a modification).   Place the hands behind the head or under the chin - you can also keep the hands resting on the ball if you need a modification.  Round down over the ball and then squeeze the lower back to lift the chest off the ball.  Raise up until the body is straight (don't hyper-extend), lower down and repeat for 1-3 sets of 10-16 reps.
  3. Reverse Hyper-Extension on Ball: Lie down with the ball under the torso and hips and rest the forearms on the floor.  Legs should be straight out behind you, toes resting on the floor in an upside down V. Keeping the legs together (and the knees straight, if you can), lift the legs up until they're level with the hips.  Lower back down, lightly touching the floor, and repeat for 1-3 sets of 10-16 reps.
  4. Good Mornings:  Stand with your back straight and legs slightly bent. Slowly bend forward, making sure to keep your back straight and abs contracted. Stand up straight slowly, while still maintaining ab contraction and repeat for 1-3 sets of 10-16 reps.  [6]


Video of Exercises to Relieve Low Back Pain

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Exercise to Relieve and Help Prevent Low Back Pain


McKenzie Exercises: These the McKenzie exercise method is a process of different exercises that is done in a progression to help relieve low back pain. Each position/exercises is done for two minutes and the exercises that include movement are held for ten seconds, then you relax for two seconds and repeat the movement. Once the progression is finished end by repeating the first position/exercise (laying flat on stomache). The progression goes as followed:



1)         2)         3)      4)         5)        6)


1) Lay Flat on Stomach

2) Rest on Elbows, then lay flat; repeat

3) Push yourself up, resting on hands, lay flat; repeat

4) Lay flat on Back

5) Lay flat on Back, bend your knees, then straighten your legs; repeat

6) lay flat on Back, bring your knees to your chest, then straight your legs; repeat

**Do these exercises with your abs contracted, making sure not to strain your back. [7]


  1. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1950501
  2. http://www.medicalnewstoday.com/articles/84279.php
  3. Fahey, T. D., Insel P. M. & Roth, W. T. (2009), Fit & Well: Core concepts and labs in physical fitness and wellness. McGraw-Hill, New York: New York. (pg.147-148)
  4. http://womenshealth.about.com/cs/backaches/l/aa031203a.htm
  5. http://familydoctor.org/online/famdocen/home/tools/symptom/531.html
  6. http://exercise.about.com/library/blbackexercises.htm
  7. http://www.spine-health.com/wellness/exercise/pain-relief-mckenzie-treatment

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