A surgeon tells how stretching may help you avoid surgery
Of the 30 million Americans who suffer from low back pain, only about 10% of the cases are caused by conditions that require surgery, such as pinched nerves or a slipped disk. For the overwhelming majority of back pain sufferers, the culprit is tight, inflamed muscles.
Surprising: This inflammation usually is not caused by strain on the back muscles themselves, but rather a strain or injury to the spine—in particular, to one of five “motion segments” in the lower back.
Each segment, which is constructed to bend forward and back and side to side, consists of a disk (the spongy cushion between each pair of spinal vertebrae)…the two vertebrae directly above and below it…and the facets (joints) connecting the vertebrae to the disk.
Unfortunately, the segments’ disks or facets can be injured in a variety of ways—by lifting something the wrong way, twisting too far, sitting too long or even sneezing too hard—causing the surrounding muscles to contract in order to protect the spine from further damage. This contraction and the muscle inflammation that it produces is what causes the intense lower back pain that so many Americans are familiar with.
WHEN BACK PAIN STRIKES
Low back pain caused by inflammation usually subsides on its own within three to six weeks. However, the healing process can be accelerated significantly by taking over-the-counter ibuprofen (Motrin) for several days after injury to reduce inflammation if you don’t have an ulcer (follow label instructions)…and getting massage therapy to help loosen knotted muscles and increase healing blood flow to them. (If you suffer from severe back pain or back pain accompanied by fever, incontinence or weakness or numbness in your leg, see a doctor right away to rule out a condition that may require surgery, such as serious damage to disks, ligaments or nerves in the back.)
Also important: Perform the simple stretching routine described in this article. In my more than 16 years of practice as an orthopedic spine surgeon, it is the closest thing I’ve found to act as a “silver bullet” for back pain.
How it works: All of the muscles stretched in this routine attach to the pelvis and work in concert to stabilize the spine. Stretching increases blood flow to these specific muscles, thereby reducing the inflammation that leads to painful, tightened back muscles.
In preparation for the back stretch routine described here, it’s important to learn a simple approach that systematically stimulates and strengthens your core (abdominal, back and pelvic muscles). This is one of the best ways to protect your spine. Although there are many types of exercises that strengthen the core, abdominal contractions are the easiest to perform.
What to do: Pretend that you have to urinate and then stop the flow—a movement known as aKegel exercise. Then while lying on your back, place your hands on your pelvis just above your genitals. Now imagine that someone is about to punch you in the stomach, and feel how your lower abdomen tightens protectively.
To do a full abdominal contraction, combine these two movements, holding the Kegel movement while tightening your lower abdomen. Then, continuously hold the full abdominal contraction during all of the stretches described in this article.
7-MINUTE STRETCHING ROUTINE
Do the following routine daily until your back pain eases (start out slowly and gently if you’re still in acute pain). Then continue doing it several times a week to prevent recurrences. Regularly stretching these muscles makes them stronger, leaving your lower spine less prone to painful, back-tightening strains.
1. Hamstring wall stretch. Lie face-up on a carpeted floor (or on a folded blanket for padding), positioning your body perpendicular inside a doorframe. Bend your right leg and place it through the door opening. Bring your buttocks as close to the wall as possible and place the heel of your left foot up against the wall until it is nearly straight. Next, slide your right leg forward on the floor until it’s straight, feeling a stretch in the back of your left leg. Hold for 30 seconds. Repeat twice on each side.
2. Knees to chest stretch. Lie on your back with your feet flat on the floor and your knees bent. Use your hands to pull your right knee to your chest. Next, try to straighten your left leg on the floor. While keeping your right knee held to your chest, continue the stretch for 20 seconds, then switch sides and repeat. Finally, do the stretch by holding both knees to your chest for 10 seconds.
3. Spinal stretch. While on the floor with your left leg extended straight, pull your right knee to your chest (as in exercise #2), then put your right arm out to the side. Next, use your left hand to slowly pull your right knee toward your left side so that your right foot rests on the back of your left knee. Finally, turn your head toward your right side. Hold for 20 seconds, then reverse the movements and repeat.
4. Gluteal (buttocks) stretch. Lie on your back with your feet flat on the floor and your knees bent. Cross your right leg over your left, resting your right ankle on your left knee. Next, grab your left thigh with both hands and bring both legs toward your body. Hold for 30 seconds, then switch sides and repeat.
5. Hip flexor stretch.Kneel on your right knee (use a thin pillow for comfort) with your left leg bent 90º in front of you and your foot flat on the floor. Place your right hand on your waist and your left hand on top of your left leg. Inhale and then, on the exhale, lean forward into your right hip, feeling a stretch in the front of your right hip. Hold for 30 seconds, then switch sides and repeat.
6. Quadriceps stretch. While standing, hold on to the back of a sturdy chair with your left hand for balance. Grasp your right foot with your right hand and gently pull your right leg back and up, with your toes pointing upward. Be sure to keep your right knee close to your left leg. Hold for 30 seconds, then switch sides and repeat.
7. Total back stretch. Stand arm’s length in front of a table or other sturdy object and lean forward with knees slightly bent so that you can grasp the table edge with both hands. Keep your arms straight and your head level with your shoulders. Hold for 10 seconds.
Next, stand up straight with your left hand in front of you. Bring your right arm over your head with elbow bent, then bend your upper body gently to the left. Hold for 10 seconds, then switch sides and repeat.