Here are the three best back exercises to do at home. The Sundial chiropractors and physio’s here in Brighton, have 4 decades of experience treating back pain successfully and have found that these simple exercises, that only take a few minutes a day, really help a bad back. Start with the easy ones and gradually build up doing the exercises for longer and longer. If you experience any pain beyond a mild discomfort then stop and go back to an easier exercise. If pain persists then seek help from a healthcare professional.
One of the easiest ways to treat back pain yourself is to do more exercise. But you have to do the right type of exercises. Do the wrong ones and you could make the pain a lot worse!
So what are the wrong sort of exercises for a bad back? Deadlifts, sit-ups (if done wrong) and touching your toes are common culprits. More about that here.
Fortunately, there is a series of simple, safe and effective exercises that can make a big difference if you have chronic back pain.
Our go-to exercises for back pain are:
Bird Dog (sometimes called the Superman)
Dead Bug (extra bonus!)
These exercises target the abdominal core muscles as well as the back muscles to provide strength and stability to most back problems.
As with all new exercises, start gently and gradually build up. If you go at it too hard to start with you can irritate already sore muscles and joints and you will get fed up with these wonderful back exercises very quickly. As a guide, if pain or discomfort on doing the exercise is above a four out of ten – stop – go back to an easier version.
What makes an exercise harder?
Obviously doing more repetitions makes the muscles work harder. So start with five reps.
Doing theses back exercises slowly is often harder as the core muscle have to balance your body for a longer time. Also making your body more unstable increases the impact on the core muscles. You can see this in the two versions of the Bird Dog exercise. The easy one moves one arm or leg at a time but the harder one moves an opposite arm and leg together whilst your weight is supported at just two points. People with chronic back pain often find this exercise quite difficult. If that is you, do the easy one first until you are more confident.
Increasing the load or weight lifted increases the work but these exercises are with your own bodyweight so that is not really an issue.
Give these exercises a go but if you are experiencing consistent pain and live or work in Brighton then come in to see us by booking online above or give us a call for a consultation. It’s free. We solve back pain with a tried and tested three-step process:
Back pain is a global menace. It is the biggest cause of disability worldwide; it affects whole economies, individuals’ health and makes lives a misery. Back pain contributes to obesity, diabetes, osteoarthritis and mental health issues as those with back pain cannot exercise as much as they would wish. The 2020s should see major advances in back care.
Despite not getting the attention or funding that conditions like Alzheimers and cancer receive, there are exciting developments in treatment, policy and back research which will change how we approach back pain over the next decade.
1. Artificial discs
Once a thing of science fiction, man-made discs are looking like a reality. As we get older the discs of the spine wear and although this is mostly painless, in some people it can cause extensive osteoarthritis, nerve or spinal cord entrapment and pain. Not nice!
The standard treatment, if people are beyond chiropractic care, is an operation to remove the old disc and then the adjacent vertebrae are fused together. It doesn’t have a great success rate and complications are high not least of all by accelerating the wear on the other discs in the area.
Primitive artificial discs and cages have been tried surgically but don’t have the strength and mobility that a healthy spine requires. The latest innovation is to inject stem cells into an artificial polymer gel matrix in the lab and top and tail it with foam – mimicking a real disc. These discs have been transplanted into goats successfully and initial reports are that they perform as well as normal discs. You can watch the video – click here.
Whilst the researchers have yet to carry this out in humans it is a huge step in the right direction.
2. Stopping ineffective and dangerous drugs to treat back pain
A class of painkilling drug is increasingly being prescribed, including for back pain despite being ineffective for this sort of pain and is so dangerous that it can kill. In the USA, where the problem is much worse, more than 70,000 people a year are dying from a prescribed opioid class drug. In recent years Tom Petty and Prince died from these legal drugs which are often many times more powerful than heroin. In the UK, figures are harder to come by but in 2018 one drug alone, tramadol, was implicated in 220 deaths. There are many others which go by names such as dihydrocodeine, codeine, oxycodone and morphine.
Doctors are often pressured by patients to prescribe more powerful painkillers when the standard drug treatment of anti-inflammatory medication, such as ibuprofen, is not effective. Most doctors are well aware of the problem so if you have been prescribed these drugs or are taking them without a prescription then talk to your GP.
The chiropractic profession, particularly in the US and Canada, has been proactive in raising awareness of this problem. Research has shown that opioid use is much lower amongst back sufferers who go to a chiropractor than those who go to medical doctors alone. People who saw a chiropractor were 64% less likely to use opioids than people who didn’t, researchers report in the journal Pain Medicine.
As the problem becomes more widely recognised, the next decade should see a steady reduction in opioid prescriptions for back pain and the devastating harm associated with them.
3. Chiropractors on the NHS
Physiotherapy in the NHS is not keeping pace with the levels of back pain. Waiting times are huge in some areas, and when you do finally get to see a physio’ you are often given a sheet of exercises and told to go home and do them. Part of this is due to funding but it is also due to the fact that most NHS physiotherapists are not back experts and most doctors are not back specialists either.
The incidence of back pain is likely to rise over the next decade, in line with the ageing population. If the latest government promises are to be believed, then funding on the NHS should rise. But spending more on services where the skills are poor is not going to be the solution.
In a handful of locations around the UK chiropractors and osteopaths are employed by the NHS in a variety of diagnosis and treatment roles, often as first contact practitioners. Such a system also works in the USA, Canada, Switzerland and Denmark. If the NHS is going to improve back care then it will have to look at existing expertise and use chiropractors and others embedded in hospitals, GP surgeries and in community practices, many of which are up and running already. This sort of approach exists already with NHS and private dentists and podiatrists (thank goodness they changed their name from chiropodists!).
4. Back sufferers finally given a diagnosis
If you go to a doctor with a pain in your back, if you don’t have any serious disease or injury, you are most likely to be told that you have non-specific back pain. What this means is that they don’t know which bit of you back is causing the pain and are just going to treat the pain, not the cause. This is a non-diagnosis.
As chiropractors become more common within the NHS patients should be told what the cause of their back pain is likely to be. Differentiating a muscle spasm from sciatica, a disc problem from a pelvic problem is straightforward if you have the training and experience to do so. This improves access to the right treatment and helps people get better faster.
Chiropractors have these diagnostic skills and have been shown in study after study to provide effective back pain treatment. Access to MRI and other imaging techniques directly for the few who need them will speed up diagnosis and free up the GPs to do what they do best – treating things other than back pain.
5. Ending these dangerous exercises
Deadlifts, touching toes and leg press exercises are amongst the drills that will be recognised by the fitness industry as contributing to back pain and will be phased out. Currently, there is a mismatch between most, but not all, spine care experts and gym and yoga instructors. As more up to date research makes its way to the courses for these professions practise will change and fewer back injuries will result.
I hope that these predictions are more than my benign, post-Christmas fug and that they will come to pass. They are all feasible but some are more likely than others. All will improve the lives of the thousands suffering from back pain.
Back pain recurs when the stresses and strains on your back overcome your body’s ability to deal with them. Daily activities like bending, lifting and long periods of sitting with poor posture can put a strain on the spine which it can normally cope with very well. Unfortunately, if there is an underlying issue which reduces your ability to manage these forces then the back muscles, joints or discs can get irritated and start to hurt.
Back pain often comes and goes. If you have a mild episode of back pain it will often get better by itself over a few days or week or two. Even though the pain may be gone, however, the underlying dysfunction which caused the problem in the first place may still be lurking. When this happens a simple movement may strain something in the back and the pain flares up again.
As each episode of back pain strikes the more likely it is that you will have another back attack. These episodes often get worse the longer the problem is unresolved and get more and more frequent and last for longer each time. So what can you do about it?
There are three things that help reduce recurrent back pain:
Take regular exercise
Staying active is the single most important thing to prevent back pain from returning. Whilst back muscle or core exercises are very useful in the treatment of low back pain, no one particular exercise regime has been shown to be better than any other when it comes to prevention. This means that any sort of regular moderate exercise can help prevent back pain. It’s probably more important to do something that you enjoy and is easy to get to so that you keep doing it.
Watch your posture and movement
Well known simple things make a big difference like bending your knees when you bend and lift; not sitting at your desk or on a sofa for too long and making sure your normal back curve is maintained by putting a cushion in the small of your back. Sometimes you will need to avoid deep soft sofas too. Being aware of these things is often enough to improve your posture sufficiently to take the strain off your back.
Get stiff spinal joints sorted out
Even though the low back pain may have gone, silent spinal joint dysfunction can persist. Improving the mobility of these joints has been shown to prevent future bouts of pain. That’s why we recommend a periodic check-up by one of our chiropractors every few months if you are prone to recurring back pain. It can make a big difference and can save time and money in the long run.
Stress affects back pain
Other things can also increase the likelihood of another bout of back pain. Stress, anxiety and depression have been associated with persistent or recurrent low back pain. A post on this is coming soon.
Back pain often comes on apparently without reason. In fact, one possible cause might stretch all the way back to childhood. Hove dentist, Pieter Grobbelaar, tell us how teeth and jaw problems can be behind chronic pain.
The jaw joint (TMJ) and pelvic joints (sacro-iliac joints) both work in conjunction with one another, compensating for one another when either joint becomes misaligned writes Pieter Grobbelaar. With an abnormal bite the TMJ becomes dysfunctional and this creates instability at the weight bearing sacro-iliac joint in the pelvis. This leads to poor body posture which can cause low back pain, neck pain, headaches and other health problems.
The majority of children (75%) now have crooked teeth, incorrect jaw development and other orthodontic problems, which is evident from 3-5years of age, are not caused by big teeth in small jaws or hereditary factors. However, rather than blame genetics for crooked teeth and poor jaw development, modern research has produced evidence that points to other causes.
Concordia dental healthcare has recognised that Soft Tissue Dysfunction or poor myofunctional habits such as mouth breathing, incorrect tongue position, reverse swallowing and thumb sucking are the real causes of malocclusion and poor cranio-facial development.
The restricted development limits the space available for erupting teeth and prevents them from emerging into their natural position.
75% of growing children are affected and most commonly will presents with crooked teeth, undeveloped facial and jaw bones, TMJ (Temporomandibular joint) dysfunction and poor body posture.
Mouth breathing is abnormal and is one of the causes of Sleep Disorder Breathing (SDB) problems.
SDB in children has been recognised as causing widespread health, developmental and behavioural problems, including snoring, gasping, cessation of breathing such as Obstructive Sleep Apnoea (OSA) and interrupted sleep, which can result in drowsiness during the day as well as behavioural problems in children. Additionally, as well as being detrimental to the development of the face, jaws and teeth, if left untreated paediatric SDB can lead to significant and serious health problems causing poor quality of life later in adulthood.
If a child breathes through their mouth during the day or while sleeping at night, the tongue drops to the bottom of the mouth, which results in upper and lower jaw development problems. Allergies, asthma and open mouth posture also cause the jaws to develop incorrectly.
Incorrect dental and facial development can be detected at an early age, but so often no treatment is recommended. It is well known that the majority of our children do not develop their jaws and face correctly. This results in crowded teeth and underdeveloped faces.
Braces and extracting teeth in teenage years does not solve the underlying problems behind the causes of crooked teeth and incorrect facial development.
The balanced cranium provides the anchor points for the tension membranes which support the brain. The rhythmic pulsing of the brain as it expands and contracts, when breathing, provides the basis for the sacro-occipital pump which circulates cerebo-spinal fluid.
One of the most important aspects of normal cranial function is the position of the jaw. When the lower jaw (Mandible) comes in contact with the upper jaw (Maxilla) the movement should be symmetrical, simultaneous and even. This constitutes normal cranio-dental function. When the jaw becomes distorted the entire balance of the cranium is put in jeopardy.
A misaligned jaw will change the bite plane and ultimately the bite, affecting the cranium, TMJ, muscle balance, normal spinal mechanics and pelvic stability.
Good cranial development is needed for optimum neurological development.
The cranium consists of 28 bones, any distortion will affect transmission within the brain, cranial nerves and ultimately the nervous system.
Cranial development is 65% completed at age 8 years and 95% completed at 12 years of age, therefore it’s essential that intervention occurs as early as possible assisting cranial development to its optimum genetic potential.
Most back exercises are great for the back and it doesn’t seem to matter much what exercises you do as long as you stay active. But some exercises can be harmful and actually damage your back. So whether you like the gym, Pilates, yoga or a sport it is important to know the good and the bad. Matthew was recently interviewed about just this topic by Stu Girling from Love Yoga Anatomy. Stu trains yoga teachers and practitioners on safe ways to do yoga.
One of the exercises that does more harm than good is forward bending despite the fact that lots of people do it to stretch their back. As we bend forward huge pressure builds on the lower discs. As you bend from the waist, if the lumbar spine is held in neutral, with its natural forward curve, the pressure on the disc is reduced. If you round your lower back as you bend forwards then the discs are vulnerable. The jelly inside the disc gets forced backwards and can cause cracking in the outer disc wall. If this carries on it can cause a disc bulge or a “slipped disc”.
If you bend, as in a yoga forward fold, over and over again then it can cause injury. It is like repeatedly bending a credit card, a white line appears and ultimately it breaks.
Many people with back pain feel that their back is too stiff and want to stretch it. A better goal for exercises is the right mix of flexibility and stability. If your back is too stiff and this causing pain then the solution is to unlock the spinal joints with chiropractic manipulation or mobilisation. If, however, your problem is too much flexibility then we work to stabilise your spine.
Back pain is not one condition but several conditions causing similar symptoms. A muscle spasm, disc derangement and a spinal joint dysfunction all cause low back problems that can refer pain down to the buttock and leg and a skilled chiropractor or physio can tell which problem it is likely to be. Whilst several conditions can co-exist an accurate diagnosis is important because the treatment is different for all three.
The diagnostic confusion is made worse by the different experts who treat back pain because they often use different terminology to describe the same thing, recommend different treatment based on their area of expertise and frequently ignore the evidence that their approach has been shown to be ineffective and so leave you, the patient, in pain and more confused about what is wrong.
Most back pain is caused by irritation to:
nerves of the spine.
This irritation happens with repetitive minor trauma such as bending and lifting or, more rarely, by a single traumatic injury such as a fall or accident. It can also be caused by inactivity which causes the joints of the spine to stiffen up and the back support muscles to become weak such as sitting at a desk for long periods.
If the joints of the lower back get stiff they are less able to carry out normal movements and this can lead to further joint irritation, stiffness and pain. This is often called Facet Joint Syndrome. The nerves around the stiff joints get irritated too and fire off alarm signals into the nervous system which can cause further symptoms such as tingling and pain referred down to the hips and legs. This can mimic sciatica.
Occasionally, the nerve irritation can cause muscles in the legs to weaken and this can lead to problems in the hips and knees. How this occurs isn’t clear but anyone with hip or knee problems seeing us here at Sundial will get a thorough muscle and spine check-up.
We treat back pain with an effective step by step programme to rebuild strong and healthy backs so you can lead an active and fulfilling life.
The sun is shining; it’s warmed up; time to take your clothes off!
If you are suffering from ongoing back pain, then you could be deficient in Vitamin D. This hormone is responsible for a wide range of processes in the body including bone and muscle function. A commonly missed cause of back pain is Vitamin D deficiency, especially over a long winter. At least 50% of people in the UK show signs of vitamin D deficiency and many will have increased back pain as a result.
Common signs of vitamin D deficiency
muscle and bone aching
pain sensitisation, lower pain threshold
muscle soreness after exercise
Vitamin D is essential for bone formation as it helps your body absorb calcium from food. If you don’t have enough Vitamin D you can get a condition called osteomalacia. The dull, aching pain associated with osteomalacia most commonly affects the lower back, pelvis, hips, legs and ribs. This pain can be worse at night, or when you’re weight bearing. Vitamin D deficiency may cause morning back pain in some people too.
How much Vitamin D is enough?
There are various ideas about what the minimum blood levels for Vitamin D are required. This is a measure in nanomoles per litre of blood (nmol/L). Severe deficiency is anything below 25nmol/L, but anyone below 50nmol/L is considered deficient. Optimum health is often thought of a being above 85 nmol/L although more than 125nmol/L can be required for some people.
How can you get enough Vitamin D?
Fortunately, it is easy to get enough Vitamin D for free as you make it in your skin. Sunlight contains ultraviolet (UVB) rays that stimulate Vitamin D production. UVB rays also cause sunburn, however, so it is important to avoid over-exposure. If you cover up or use sunscreen, you will not produce Vitamin D so only aim for short exposure.
A sensible approach is to aim for 10-30 minutes exposure on as much bare skin as you dare, depending on how sensitive your skin is, several times a week when the sun is strong enough; in the UK that is from April to September. Full body sun exposure with no sunscreen will produce up to 20,000iu (500 μg) in 30 minutes. More importantly, once you have made enough Vitamin D your skin stops producing it so you can’t get too much.
Vitamin D supplements
Over the winter or for if you are severely deficient then supplements are the only way to go. In your diet oily fish such as salmon, mackerel and sardines provide some vitamin D but you would, for example, need to eat 20 tins of salmon a day to get 5000iu.
Here at Sundial we recommend a liquid Vitamin D supplement which is highly absorbable and inexpensive. The chewable calcium based supplements from ordinary shops are often too low in Vitamin D to help much.
Vitamin D deficiency is common and can cause back pain
Safe sun exposure on bare skin from April to September is beneficial
Taking a good quality supplement over the winter prevents deficiency
During pregnancy your body changes to adapt to your growing baby. These changes happen fast and you can experience pain and discomfort in your pelvic and lower back area.
Hannah came to me here at Sundial during her 4th month of pregnancy because she was experiencing pelvic pain for few weeks and the intensity of pain was increasing with time. She was also suffering with pubic pain for the last few days.
She would feel more pain turning in bed, walking and going up or down stairs. Being a nurse Hannah needed to be on her feet most of the day and she desperately needed relief.
After an examination I explained to Hannah that she was experiencing pain because of a sacroiliac dysfunction, a lack of movement in the joint of the pelvis.
These types of pain are very common during pregnancy. In fact 20% of pregnant women suffer with pelvic pain and 50 to 85% with low back pain. This is mainly due to the hormonal changes during pregnancy as your body starts to produce relaxin, the hormone that relaxes your ligaments in order to increase the space for your baby and birth. Also mechanical changes occur as the pregnancy goes along. As your tummy gets bigger the curve of your lower back increases and creates pressure on your back joints and muscles too.
We started working on this sacroiliac dysfunction using very gentle techniques to free up the joints and also working on the ligaments and muscles of the pelvis with gentle pressure. I also gave Hannah stretches and exercises to stabilise her core muscles and pelvis at home.
I saw Hannah regularly throughout her pregnancy in order to maintain the right sort of movement in her pelvis and, fortunately, she didn’t experience pelvic pain anymore!
Does arthritis, specifically osteoarthritis, cause low back pain? In this video Brighton chiropractor and back pain expert, Matthew Bennett, reveals the answer and explains what osteoarthritis of the spine actually looks like.
A new study on back pain in the prestigious medical journal, the Lancet, roundly criticises medical treat of low back pain. Researchers from all over the world took part and looked at how back pain is treated and they concluded that there is “inappropriately high use of imaging, rest, opioids, spinal injections, and surgery.” They go on to say that “Doing more of the same will not reduce back-related disability or its long-term consequences.”
Back pain is now the number one cause of disability globally and rates have continued to rise in spite of increased spending on treatment. The authors make a plea for more sense and evidence based treatment. They call for a new direction which encompasses emerging treatments alongside effective solutions that exist already.
Effective treatment for back pain
Guidelines exist for doctors to follow on the most effective sorts of treatment but often these are ignored or not implemented properly. Here in the UK, NICE has issued guidelines and these are mentioned in this study as being helpful and they echo the findings in this paper. The evidence points to a biopsychosocial model of care which looks at the behavioural, psychological, and social factors as well as the anatomical structures which play a role in the persistence of pain and disability. What does this mean for you if you have back pain?
It means that there is greater emphasis on self-management, physical and psychological therapies, and some forms of complementary medicine, and less emphasis on pharmacological and surgical treatments. So staying active, doing gentle exercises, getting some manual therapy as well dealing with stress, anxiety and depression, especially negative feelings around pain and disability, are very helpful. Some guidelines also recommend massage and acupuncture. One thing the guidelines in the US Denmark and UK agree on is that spinal manipulation is helpful. Which is good news because that’s what we do here at Sundial.
The report goes on to highlight the differences in standards of care throughout the world and it is clear that there is huge variance in practise and approach. For instance in the USA only half of back sufferers are prescribed exercises and in Sweden, USA and Australia electrical modalities like ultrasound are routinely used in spite of being ineffective.
Back pain is not one condition
This review is an excellent summary of the worldwide management of low back pain but has its limitations. Back pain is not one condition but several conditions causing a similar group of symptoms. A muscle spasm, disc derangement and a spinal joint dysfunction all cause low back that can refer pain down to the buttock and leg and a skilled clinician can tell which problem it is likely to be. Whilst several conditions can co-exist it is clear that an accurate diagnosis is important because the treatment is different for all three. Here at Sundial we make sure we make an accurate diagnosis and agree a treatment plan that is the most likely to get the best results.
If you would like a free check up to see if we can help your back pain please give us a call or book online above
Prevention and treatment of low back pain: evidence, challenges, and promising directions