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Exercises to Relieve Lower Back Pain: A guide to the use of physical exercise to alleviate lower back pain

About the Authors

Ryon M. Hennessy, M.D. Dr. Hennessy graduated from Rush Medical School in 1991. He completed his residency in orthopedic surgery at Rush-Presbyterian St. Luke's Medical Center in 1996. He subsequently completed a one year fellowship in spinal surgery at Rush-Presbyterian St. Luke's Medical Center and Chicago Shriners Hospital. In addition to the practice of general orthopedics, Dr. Hennessy has a special interest in spinal surgery and joint replacement as well as sports medicine.

Steven Sapoznik, DPT Steven received his bachelor's degree in Kinesiology with a focus in Athletic Training from Northern Illinois University in 2006. He became a Certified Athletic Trainer in September 2006 and his athletic training experience includes both collegiate and high school athletics. His sports medicine background and desire to further his knowledge of rehabilitation brought him to West Virginia University, where he graduated with a Doctorate in Physical Therapy in 2011.

Paul Hagen Paul received his bachelor’s degree from George Mason University, and his Master’s in Business Administrations from Boston University. He is a Service Disabled Veteran of the United State Marine Corps and founder and CEO of VacuPractor. Paul won the Zino Life Science Award for Best New Invention.

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Lower Back Pain: More Common than the Common Cold? Nearly everyone at some point will experience back pain that interferes with work, routine activities, or recreation. In fact, back pain is the second most common neurological ailment in the United States – second only to the headache – and it is the number one cause of job-related disabilities. And lower back pain is costing us more than just lost productivity. American consumers spend about $50 billion each year on lower back pain treatments. Symptoms of Back Pain Symptoms of back pain range from muscle aches to shooting or stabbing pain, limited flexibility and/or range of motion, or an inability to stand up straight. “Acute” back pain generally lasts from a few days to a few weeks and is commonly the result of trauma. Back pain is “chronic” when it persists for more than three months. Anatomy of the Back 101 The back is an intricate structure of bones, muscles, and other tissues that form the posterior of the body’s trunk from the neck to the pelvis. The lower back, or “lumbar region,” is where the most pain is typically

felt. The centerpiece of the back is the spinal column, which not only supports the body's weight but also houses and protects the spinal cord. The spinal column is comprised of multiple vertebrae that are stacked on top of each other, protecting the spinal cord inside. Bands of tissue, known as ligaments and tendons, hold the vertebrae in place and attach the muscles to the spinal column. Between the vertebrae are spaces through which nerves enter and emerge from the spinal cord. These spaces are filled with round, spongy pads of cartilage known as intervertebral discs. These discs allow for flexibility in the lower back and act like shock absorbers throughout the spinal column to cushion bones as the body moves. If the spine becomes overly strained or compressed, a disc may rupture or bulge outward. This rupture may put pressure on one of the more than 50 nerves rooted to the spinal cord that control body movements and transmit signals from the body to the brain. When these nerve roots become compressed or irritated, back pain results.

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The Role of Aging Age, combined with the rigors of daily life, increases our risk of experiencing back pain. As people age, bone strength and muscle elasticity tend to decrease. Discs also begin to lose fluid and flexibility, decreasing their ability to cushion the vertebrae. In this deteriorated state, pain can occur even when performing routine activities. Lifting a slightly heavy object or stretching a little too far suddenly results in a sprain, strain, or spasm.

Muscle Strain

While back pain tends to increase with age, it often begins to affect us during the prime of our lives between the ages of 30 and 50. This is due in part to the general aging process, but also is rooted in what is typically a more sedentary lifestyle during our prime working years. For many Americans in this age group, the week is spent sitting at a desk followed by more strenuous physical activity on the weekends. Our bodies are simply not

stretched and toned to handle this change in physical activity. Young are not Immune While the risk of experiencing lower back pain generally increases with age, children also are affected. In the year 2000, approximately 13,000 mostly young patients were medically treated for injuries related to carrying backpacks (source: U.S. Consumer Product Safety Commission). Other Causes of Back Pain Back pain can also result from degenerative conditions such as arthritis or disc disease. Less commonly, lower back pain may be the result of nerve or muscle irritation or bone lesions.

Bone Lesion

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Conditions Requiring Medical Care Bulging or Protruding discs occur when the disc extends outside the space it should normally occupy. Invision a hamburger that's too big for its bun. When the bulge extends into the space containing the spinal cord or a nerve root, pain results. Bulging is part of the normal aging process of the disc and is common to see on MRIs of people in almost every age group.

Bulging Disc

Herniated, Ruptured, or Slipped Discs are conditions that result when a crack in the tough outer layer of cartilage allows some of the softer inner cartilage to protrude out of the disc. The protrusion usually happens in one distinct area of the disc, whereas a bulging disc usually occurs along a large component of the disc. Studies have shown that most herniated discs occur in the lower (lumbar) portion of the spinal column. A more serious complication of a herniated disc occurs when disc material is pushed into the spinal canal and compresses the bundle of lumbar and sacral nerve roots. Permanent neurological damage may result if the condition is left untreated.

Herniated Disc

Sciatica is a condition in which a herniated or ruptured disc presses on the sciatic nerve, which is the large nerve that extends down the spinal column to its exit point in the pelvis and carries nerve fibers to the leg. This pressure causes shock-like or burning low back pain combined with pain through the buttocks and down one leg to below the knee, occasionally reaching the foot. In extreme cases, when the nerve is pinched between the disc and an adjacent bone, the symptoms involve not pain, but numbness and some loss of motor control over the leg due to interruption of nerve signaling. This condition could also be caused by a tumor, cyst, metastatic disease, or degeneration of the sciatic nerve root.

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Sciatica Spinal degeneration is present when disc wear and tear leads to a narrowing of the spinal canal. A person with spinal degeneration may experience stiffness in the back upon wakening or may feel pain after walking or standing for a long time.

Spinal Degeneration

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Treatments for Lower Back Pain Surgery involves serious risks and is usually the last resort for treating lower back pain. Fortunately, most lower back pain can be treated successfully without surgery.

Surgery

Simple rest can have positive results, particularly when back pain is associated with muscle strain or inflammation. However, for most of us, rest is not enough to alleviate our back pain. Medications, both prescription and over-the-counter, are commonly used to treat back pain. Medications can be helpful, but in many cases provide only temporary relief without addressing the underlying cause of the back pain. Moreover, some pain medications have harmful side effects, are unsafe to use during pregnancy, or may interact negatively with other medications.

Traction involves the use of weights to gradually pull the skeletal structure into better alignment. Traction should only be used in cases of chronic back pain.

Traction

Acupuncture/Dry Needling: involves the insertion of needles along precise points and/or trigger points throughout the body. Research has demonstrated this causes the release of naturally occurring painkilling molecules called peptides and normalizes the body's natural chemical environment. Clinical studies have demonstrated the effectiveness of needling techniques in treatment of back pain.

Acupuncture

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Spinal manipulation, as performed by a chiropractor uses leverage and a series of exercises to adjust spinal structures and restore back mobility. Some clients have reported good success in managing back pain through chiropractic care.

Spinal Manipulation

Therapeutic massage, particularly when performed by a specially trained massage therapist, can be beneficial in treating both chronic and acute lower back pain by relaxing the muscles and increasing blood flow to the area.

. Massage

Exercise is proving effective in managing lower back pain, both in speeding recovery and in preventing recurrences. Recommended exercises include those designed to strengthen the back and “core” abdominal muscles. Back-healthy exercises, such as those found in yoga, help to improve posture and maintain proper muscle balance.

Exercise

The VacuPractor –Lumbar Traction is a revolutionary patented device for the self-treatment of lower back pain. The user lies on the device, creating a natural vacuum effect to gently pull the spine and stretch the muscles in the lower back area. Pain is relieved in as little as five to ten minutes of use. VacuPractor can be used at home, and it can be combined with other pain treatments as part of a patient's total care.

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EXERCISES TO MANAGE AND

PREVENT LOWER BACK PAIN

1. The Warm Up:

Lie down with your back on the floor.

Raise the knees in a bent position

and place feet flat on floor. While

lying in this position, stiffen your

stomach muscles as if preparing to

be hit in the belly. Hold for five

seconds then release.

2. The Partial Curl-Up

Using the same position as in the

warm-up, with arms down at the

sides, tighten the lower stomach

muscles and slowly raise your chin

toward the knees. Extend the chin

forward only to the point that your

shoulders are raised off the floor.

Imagine you are “curling-up” with

the apex of the curl being a point in

the back centered in the area of the

shoulder blades. Hold for the count

of five.

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3. The Pelvic Tilt

Using the same position as above,

flatten your back against the floor by

tightening the stomach muscles and

bending the pelvis up slightly. Hold

for the count of ten.

4. Quadruped Pelvic Tilting

Assume the cat position, with hands

and knees on floor. Hands should be

shoulder length apart and knees

should be hip-width apart. As you

inhale, gently stretch the spine

downward toward the floor while

tipping the head up slightly toward

the ceiling. Now exhale and gently

bend the spine up into an arch while

moving the chin down and in

toward the chest. Try not to move

your arms or legs during this exercise.

Instead, invision pushing/pulling the

bellybutton down and up.

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5. The Plank

Get down on your knees and hands.

Place forearms flat on mat/floor. The

arms and forearms should form a 90

degree angle. Now extend both

legs straight behind you and lift your

body by shifting all the weight onto

the tips of the toes and the forearms.

Keep the face/head down in order

to form a straight line, like a plank,

extending from the neck to the

lower back. Do not lift the buttocks.

Hold for 5 seconds and release.

6. The Side Plank

Using a mat for comfort, lie on your

side with legs straight, one on top of

the other. The upper arm should rest

on top of the upper leg. The lower

arm will be used for lift and balance

by placing the forearm on the mat

at a 45-90 degree angle from the

shoulder. Using the forearm, lift the

upper part of the body while

keeping both legs together and

straight. Only the edge of the lower

foot should still be touching the

mat/floor. The body should be rigid

like a plank. Hold position for five

seconds, then repeat with the

opposite side.

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7. Hamstring Stretch

Lie on your back with knees bent

and feet flat on the floor. Lift one leg

straight up, with the foot facing the

ceiling. Do not point the toe. Gently

lift the leg in toward the chest. As

you do this, you should feel the

hamstring stretching behind the

upper thigh. Place both hands

behind the thigh and walk the hands

up toward the ankle to further

stretch the hamstring. Hold for 15

seconds. Repeat the exercise with

the other leg. Tips: Keep buttocks

on the floor. Do not allow the back

to curl. Do not force the leg to be

pulled. Flexing the foot during the

exercise will also stretch out the calf.

8. Gluteus Stretch

Lying flat on your back, use your

hands to pull one bent knee up to

the shoulder on the opposite side.

Hold this stretch for the count of ten

and release. Repeat with other

leg/knee. (Note:

SportsInjuryClinic.net reports that

stretching this region can relieve

pain and pressure on the sciatic

nerve.)

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9. Quadruped Alternating Extremities

Get down on all fours (the knees and

hands) with the head facing down

so that .a continuous straight line is

formed along the spine and neck.

While holding the spine in this straight

line, extend one arm straight out in

front of the body while also

extending the opposite leg straight

out from behind. Hold for the count

of five and repeat with opposite arm

and leg.

We hope you can use some of these tips to efficiently and effectively decrease your lower back pain and that we make a contribution to you goals of getting out of pain. If you have any comments or feedback on these tips, we would love to hear from you at [email protected]

The exercises provided in this book are for educational purposes only, and are not to be interpreted as a recommendation for a specific treatment plan, product, or course of action. Exercise is not without its risks, and this or any other exercise program may result in injury. They include but are not limited to: risk of injury, aggravation of a pre-existing condition, or adverse effect of over-exertion such as muscle strain, abnormal blood pressure, fainting, disorders of heartbeat, and very rare instances of heart attack. To reduce the risk of injury, before beginning this or any exercise program, please consult a healthcare provider for appropriate exercise prescription and safety precautions. The exercise instruction and advice presented are in no way intended as a substitute for medical consultation. We disclaim any liability from and in connection with this program. As with any exercise program, if at any point during your workout you begin to feel faint, dizzy, or physical discomfort, stop immediately and consult a physician.

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mailto:[email protected]


GLOSSARY OF TERMS

Acute - having a sudden onset, sharp rise, and short course Chronic - marked by long duration or frequent recurrence Cupping - an operation of drawing blood to the surface of the body by use of a glass vessel evacuated by heat Intervertebral disc - any of the tough elastic disks that are interposed between the centra of adjoining vertebrae and that consist of an outer fibrous ring enclosing an inner pulpy nucleus Ligament - a tough fibrous band of tissue connecting the articular extremities of bones or supporting an organ in place Lumbar - of, relating to, or constituting the loins or the vertebrae between the thoracic vertebrae and sacrum Mechanical - caused by, resulting from, or relating to a process that involves a purely physical as opposed to a chemical or biological change or process MRI - a procedure in which magnetic resonance imaging is used Muscle - a body tissue consisting of long cells that contract when stimulated and produce motion Nerve - any of the filamentous bands of tissue that connect parts of the nervous system with the other organs, conduct nerve impulses, and are made up of axons and dendrites together with protective and supportive structures Nervous system - the bodily system that in vertebrates is made up of the brain and spinal cord, nerves, ganglia, and parts of the receptor organs and that receives and interprets stimuli and transmits impulses to the effector organs

Neurology - the scientific study of the nervous system especially in respect to its structure, functions, and abnormalities Pelvis - a basin-shaped structure in the skeleton of many vertebrates that is formed by the pelvic girdle and adjoining bones of the spine Sacral - of, relating to, or lying near the sacrum Sciatica - pain along the course of a sciatic nerve especially in the back of the thigh Spinal column - the axial skeleton of a vertebrate that consists of an articulated series of vertebrae which extend from the neck to the tail and protect the spinal cord Spinal cord - the cord of nervous tissue that extends from the brain lengthwise along the back in the vertebral canal, gives off the pairs of spinal nerves, carries impulses to and from the brain, and serves as a center for initiating and coordinating many reflex acts Tendon - a tough cord or band of dense white fibrous connective tissue that unites a muscle with some other part (as a bone) and transmits the force which the muscle exerts Trauma - an injury (as a wound) to living tissue caused by an extrinsic agent Vacuum - a degree of rarefaction below atmospheric pressure Vertebrae - one of the bony or cartilaginous segments composing the spinal column

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Copyright Information

Copyright © 2015 by VacuPractor

All rights reserved.

Photos Provided by: Paul Hagen

No part of this book may be

reproduced in any form or by any

electronic or mechanical means

including information storage and

retrieval systems, without permission in

writing from the author.

Printed in the United States of America

First Printing: March 2015

The exercises provided in this book are for educational purposes only, and are not to be interpreted as a recommendation for a specific treatment plan, product, or course of action. Exercise is not without its risks, and this or any other exercise program may result in injury. They include but are not limited to: risk of injury, aggravation of a pre-existing condition, or adverse effect of over-exertion such as muscle strain, abnormal blood pressure, fainting, disorders of heartbeat, and very rare instances of heart attack. To reduce the risk of injury, before beginning this or any exercise program, please consult a healthcare provider for appropriate exercise prescription and safety precautions. The exercise instruction and advice presented are in no way intended as a substitute for medical consultation. We disclaim any liability from and in connection with this program. As with any exercise program, if at any point during your workout you begin to feel faint, dizzy, or physical discomfort, stop immediately and consult a physician.

References:

1. Deyo RA; Tsui-Wu YJ. Descriptive epidemiology of low-

back pain and its related medical care in the United States.

Spine 1987 Apr;12 (3): 264-8.

2. Hayden JA; van Tulder MW; Malmivaara AV; Koes BW.

Meta-analysis: exercise therapy for nonspecific low back

pain. Ann Intern Med 2005 May 3;142 (9):765-75.

3. Banwell, B, Hoehing, P. Physical Interventions, Exercise,

and Rehabilitation. In: Soft Tissue Rheumatic Pain:

Recognition, Management, Prevention, 3rd ed, Sheon, RP,

Moskowitz, RW, Goldberg, VM (Eds), Williams & Wilkins,

Baltimore 1996.

4 Journal of Strength and Conditioning Research, 2007, 21

(3): 979-985

5 Journal of Strength and Conditioning Research, 2007, 21

(3): 979-985

6Panjabi MM. Low back pain and spinal instability. In:

Weinstein JN, Gordon SL, eds. Low Back Pain: A Scientific

and Clinical Overview. Rosemont, Ill: American Academy of

Orthopaedic Surgeons; 1996: 367-384.

7 Panjabi MM. Low back pain and spinal instability. In:

Weinstein JN, Gordon SL, eds. Low Back Pain: A Scientific

and Clinical Overview. Rosemont, Ill: American Academy of

Orthopaedic Surgeons; 1996: 367-384.

8 Stuart McGill. Low Back Disorders. 2007.

9 Arch Phys Med Rehabil 2009 (90): 118-126

10 Phys Ther 2005; 85: 209-225

11 J Strength Cond Res. 2009 Oct 24

12 Arch Phys Med Rehabil 2009 (90): 118-126

13 Furlan AD, van Tulder MW, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. The Cochrane Database of Systematic Reviews. 2005, Issue 1. 14 Langevin HM, Churchill DL, Fox JR, Badger GJ, Garra BS, Krag MH. Biomechanical response to acupuncture needling in humans. J Appl Physiol. 91:2471-2478, 2001.

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