Chronic lower back pain is one of the leading causes of absence from work and school. The overall prevalence of lower back pain is 26.4% among general population according to the study conducted by R.A. Deyo (1).
What Causes Lower Back Pain?
Lower back pain is highly prevalent and according to a research report, almost 80 to 85% of all the individuals experience at least 1 disabling episode of back pain in the entire lifetime. There are a number of factors that may lead to back pain. The most common ones are as below:
- Traumatic: Trauma may be assault or accidental injury to the back region as a result of road traffic accident, fall or similar incidents. Traumatic injury may cause back pain due to fracture, collection of blood (or hematoma formation), muscular sprain or ligamentous tear.
- Inflammatory or infectious diseases of back: Inflammatory or infectious diseases involving spinal region may occur in the setting of traumatic injury to back region or may appear independently due to endogenous infections like osteomyelitis.
- Degenerative bone disorders due to aging: Degenerative bone disorders indicate age related wear and tear processes that affect the integrity of bones and joints (leading to vertebral compression fractures, spinal disc prolapse, spinal disc herniation, spinal stenosis and similar bone disorders).
- Metabolic bone disorders: Metabolic bone disorders develop due to deficits in bone mineralization (hormonal/ endocrinological disorders)
- Neoplastic bone disorders: Primary tumors of the bone or in certain situations, secondary metastatic lesions as a result of migration of tumor cells from breast, prostate and lung cancer can also lead to bone damage and destruction that may present as pain, limitation of physical ability and pathological fracture of bones.
Top 12 Stretching Exercise For Lower Back Pain
Stretching exercises are extremely helpful, not only to relieve lower back pain but also neck pain. In vast majority of cases, pain in the axial skeleton is due to poor posture, stress and over-activity and involves widespread areas of spine. According to statistics collected by Deyo, the overall prevalence of neck pain is 13.8%.
- Butterfly Stretching
- Sit on floor and adopt the classic yoga-asin posture (by flexing both the knees and approximating the plantar aspect of both the feet like shown in the picture)
- Use your hands to stabilize your feet and using your elbows, try to press your thighs as closer to ground as possible
- Perform this activity for 5 minutes and if you want to stretch more, you can always extend your arms in the air while stabilizing your legs as closer to ground as possible
- Happy Baby
- Lie flat on your back and flex your hip (while extending your knees at the right angle)
- With your arms on the outer surface of legs, cup your feet with both hands
- Keep your upper body relaxed but try to assume a posture in which your knees are at a lower level than your elbows
- Stay in this position for 8 to 10 seconds and repeat 5 times a day
- Pigeon Stretching
- This stretching exercise involves your left leg extended behind your back and right leg flexed. Make sure to direct your left hip towards the floor and adopt a stable posture by inverting the right foot like shown in the image
- Stabilize your spine and arch your back by using your hands to support your torso
- Hold your breath and position for 5 seconds before returning to basal state
- You can use this stretch to relax your tender muscles
- Double Pigeon Stretch
- Sit on the floor and bend both of your knees by crossing your right and left limbs. Adopt a posture in which your right foot is over your left knee and your left foot on right knee
- Stabilize your back and now it’s time to make this exercise a little more intense by placing your hands on the shin of your legs and stretching your hands as far as possible from your body
- After long day of work, this exercise will stretch all your major group of muscles
- Flexion Stretching
Muscles of your upper body get tensed and tender towards the end of the day. This is due to long hours of physical as well as mental labor (even if you have an office, keeping your head at certain posture while looking at the computer also affects the integrity of muscles). You can perform this exercise at any time of the day anywhere (while taking a break from work or at home in front of the television).
- Sit straight and flex your neck without moving your trunk
- Now bring your chin slowly to touch your chest and go down as much as possible
- You can also flex your neck along the right and left aspect of your shoulder by touching your ear with your shoulder blade on the right side and then on the left side
- Back Flexion Exercise
- Lie flat on your back and bend your knees in such a way that your knees touch your chest
- Flex your neck and try to touch your knees with your nose
- This stretch is one of those exercises that strengthen and stabilize all muscles of your body, starting from pelvis, lower limb and hip to your neck and cervical spine
- Knee To Chest Stretch
- Lie straight on a clean space
- Bend or flex your right knee while your left feet are resting on the floor
- Lift your head above the ground surface and touch your right knee with your nose
- Relax the limb and repeat the same with your left knee, when your right feet is on the floor
- This stretch is for limbs, hip and pelvic muscles and joints
- Upper Limb Workout
- Sit unsupported on floor or mat with your hip and knee both flexed
- Lift your upper limbs up in the air and stretch fully and maintain the position for 30 seconds
- You can also extend your arms on your sides (at right angle to your body)
- This stretch is excellent for your shoulder and upper limb muscles. In addition, it also releases pressure from your spine after long hours of office work or inactivity
- Tummy Time
- Lie flat in your stomach on the clean floor or mat
- Now bend your knees and try to touch the heels with your buttocks
- You can also try to touch your heels by your hands (gives you a complete body stretch)
- Standing Stretch
- Stand straight unsupported on floor
- Try to extend your neck towards your back as much as you can
- For better support, you can put your hands on your waist
- This stretching exercise relieves pressure from your lumbar muscles and relaxes your spine. It also helps in realignment of your spine and improves blood circulation of your spinal tissue. People who experience lower back pain due to spinal disc herniation should perform this stretch with caution
- Praying Mantis Stretch
- This simple stretching exercise involves sitting on your knees in such a way that your buttock rests on your heels
- Now flex your body and bring your face closer to the ground while extending your arm as forward as possible on the ground (in this position your knees must touch your chest and heel must touch your buttocks)
- This stretch will release tension from your upper limb muscles and shoulder region
- Hamstring Stretch
- Stand straight with your arms lying by the side of your body
- Now lift your arms up in the air and bend forward to touch your feet with the tip of fingers
- This exercise will stretch your hamstrings, back muscles and upper limb muscles (Refer to Illustration A)
- Hamstring Stretch 2
- Sit straight with your legs wide apart
- Now bend your body forward and try to cup your right foot with your both hands
- Hold the position for a few seconds, return to base-line position and repeat the process with left foot (if you are experiencing any difficulty in stretching with both lower limbs extended, you can flex your left knee while stretching the right hamstrings and vice versa)
- This stretching exercise is primarily designed for your hamstrings and lumbar muscles (Refer to Illustration B)
What Are Some Helpful Tips To Perform Optimal Stretching?
- Make sure to choose a clean and spacious area for stretching that has excellent ventilation and light exposure
- Choose clothes that are loose, comfortable and does not disturb or limit the mobility of flexibility of your body
- Make sure to perform exercises by acting in the direction of muscle motion and not against the natural form or muscle tendency (that may lead to pain and muscle tearing)
- Always perform stretches for brief duration (at least 15 to 20 seconds) for each type of stretching to achieve muscle release effect
- Avoid performing difficult postures and positions that destroy the purpose of stretching
Research conducted by Jill A. Hayden (5) concluded that stretching and strengthening exercises that are performed by individuals under supervision of registered healthcare providers (ideally physical therapists) is helpful in relieving chronic and refractory lower back pain.
Similarly, research conducted by Michele Crites Battié (6) suggested that 45% of all the patients who visit physical therapist’s office report chronic lower back pain. After interviewing 293 therapists, it was concluded that the most promising treatment method practiced by physical therapists is stretching exercises and aerobics.
1. Deyo, R. A., Mirza, S. K., & Martin, B. I. (2006). Back pain prevalence and visit rates: estimates from US national surveys, 2002. Spine, 31(23), 2724-2727.
2. Deyo, R. A., & Tsui-Wu, Y. J. (1987). Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine, 12(3), 264-268.
3. Biering-Sørensen, F. (1983). A prospective study of low back pain in a general population. I. Occurrence, recurrence and aetiology. Scandinavian journal of rehabilitation medicine, 15(2), 71.
4. Griffith, J. F., Kumta, S. M., & Huang, Y. (2011). Hard arteries, weak bones. Skeletal radiology, 40(5), 517-521.
5. Hayden, J. A., Van Tulder, M. W., & Tomlinson, G. (2005). Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Annals of internal medicine, 142(9), 776-785.
6. Battié, M. C., Cherkin, D. C., Dunn, R., Ciol, M. A., & Wheeler, K. J. (1994). Managing low back pain: attitudes and treatment preferences of physical therapists. Physical Therapy, 74(3), 219-226.