What Causes Lumbar Spine Pain?
The lumbar spine is the part of the lower back that makes up five vertebrae in the lower part of the spine, between the ribs, and the pelvis. The lumbar spine is formed by vertebral bones, intervertebral discs, nerves, muscles, ligaments, and blood vessels. Functions of the lumbar spine include:
- Enabling truncal movements
The lower back is what facilitates movements of the trunk in the directions that it needs to move. These movements include front and back, side to side, and twisting movements. The movements primarily occur in the last two vertebral levels.
- Controlling leg movements
The lumbar spinal nerves that connect to the spinal cord and cauda equina control movements and feelings in the legs.
- Supporting and stabilizing the upper body
The five lumbar vertebrae are quite sizable in comparison to other spinal regions. The vertebrae of the lumbar spine help support the weight of the upper body, such as the head and neck. The lumbar spine is also responsible for moving loads from the upper body to the legs.
- Protecting the spinal cord and cauda equina.
The upper lumbar vertebrae protect the spinal cord in the vertebral arches. The lower vertebrae create an enclosure for the cauda equina nerves that fall from the spinal cord.
There are several structures of the spine that can lead to lower back pain, like the nerve roots that leave the spine, the facet joints, intervertebral discs, vertebral bones, and spinal muscles. The most widespread causes of lower back pain include:
- Degenerated discs
Intervertebral discs are the pads that serve as shock absorbers between the lumbar spine’s vertebrae. When these discs become degenerated, patients experience pain in the disc space. Discs can become degenerated when they are worn down or when they dry out with age. The discs can also become torn in the outer portion because of everyday activities and sports. When a degenerated disc is dehydrated and its normal height is lost, the area of the disc space can reduce. The reduced space can compress a nearby spinal nerve, which causes pain along the path of the nerve.
- Herniated discs
Typical wear and tear, trauma, and heavy lifting can cause the disc to herniate gradually. When the disc herniates, the soft inner contents of the disc push against the outer covering. In serious cases, the nucleus pulposus, which is the soft, gelatinous central portion of the intervertebral disc that moves within the disc along with change in posture, can leak by tearing the fibrous layers of the annulus. The lumbar spine is the area where herniated discs are the most common, and this can inflame nearby nerve roots.
This is the forward slippage of a vertebra over the one below it. This condition most occurs most often in the lower lumbar vertebrae because of the intense mechanical stress it experiences.
Facet joint osteoarthritis is caused by aging and everyday activities in which the cartilage that covers the facets wears down. Excessive wear and tear can create bone spurs and joint inflammation that lead to back pain and limited range of motion.
- Spinal stenosis
Spinal stenosis occurs when there is a narrowing of the spinal canal or intervertebral foramen. The function of the intervertebral foramen is to allow the spinal nerve roots to travel and exit to other areas of the body. If stenosis compresses the spinal cord, patients can experience leg pain and lower back pain.
How to Strengthen the Lower Back
Doing exercises to strengthen the lower back is a great way to alleviate and prevent lower back pain. This process also strengthens the core, leg, and arm muscles. Back rehab exercises will help strengthen the back muscles, reduce pain, and improve overall quality of life. Some back exercises to strengthen the lower back and relieve pain include:
- Pelvic lift
A pelvic lift exercise targets the abdominal muscles, sacroiliac joints, and the lower back. Patients can complete them by lying on the floor, standing with their back to the wall, or while sitting on an exercise ball. In a neutral position, patients should lift the lower back slightly. They should then exhale and gently rock the hips toward the head, and stay in that position for a few breaths.
- Hip bridge
The hip bridge exercise strengthens the posterior muscles in the back, legs, and hips. A patient should complete the exercise by lying on their backs with their feet flat on the floor. They should contract the buttock muscles before raising the hips off the floor until they form a straight line between the hips and shoulders. Patients should stay in this position for 20 to 30 seconds.
- Bending over
Patients should practice bending their back in a way that protects it and keeps it straight. In order to accomplish this, they should bend their neck and chest, and bend further down, keeping the lower back bent as they reach towards their toes. The next step is to lift up the body without using the hands. This will effectively strengthen the core and help patients become accustomed to bending.
- Upper-body lifts
In order to do an upper-body lift, a patient should lie on their stomach and place their arms behind their head while lifting their upper body and arms. Patients should keep their feet on the ground during this exercise.
- Bird dog
The bird dog is a simple core exercise that improves a patient’s stability, promotes a neutral spine, and helps relieve lower back pain. To do a bird dog exercise, a patient should begin on all fours in the tabletop position. Throughout the exercise, they should remember to maintain a neutral spine by engaging the abdominal muscles and draw the shoulder blades together. Patients should begin the exercise by raising their right arm and left leg, keeping the shoulders and hips parallel to the floor. They should then lengthen the back of the neck and tuck the chin into the chest so that they are looking down at the floor. We recommend holding this position for a few seconds and repeating on the other side.
- Leg slides
Leg slides can be done to tone the abdominal and leg muscles, which helps to alleviate lower back pain. Patients should lie flat on their back and bend their knees slightly. While inhaling, they should slide their leg into a straight position, then exhale and return to the starting position and repeat with the other leg.
- Wall sits
Although wall sits are a fairly simple exercise, patients should follow specific steps when completing them. If done correctly, the wall sit exercise builds muscular endurance and lessens symptoms of fatigue. In order to do a wall sit, patients should begin with their back against the wall and their feet shoulder width apart. They should engage their abdominal muscles and slide their back down the wall until their thighs are parallel to the ground and put their feet in a position so that the knees are directly above the ankles. The back should stay flat against the wall throughout the exercise. Patients should hold this position for 20-60 seconds, and slide slowly back up the wall to a standing position when they are finished.
This is another simple exercise that patients can complete fairly easily. Patients who do not walk enough often experience stiffness in the muscles and joints of the lower back. Those with ongoing instances of lower back pain should implement walking as a low-impact form of exercise. Aerobic exercise, including walking, is one of the ways to reduce the incidence of low back pain.
- Back extensions
The purpose of a back extension is to stretch and strengthen the lower back, making it ideal for patients with lower back pain. To do this exercise, the patient should position themselves on the back-extension machine with their hips on top of the cushioned pads and their feet secured under a leg anchor. Next, they should place their arms behind their head or hold onto a kettlebell. The patient should lift their back up a few inches and squeeze the glutes for a few seconds, and then one rep will be complete.
- Partial crunches
Partial crunches are an excellent way to strengthen the lower back and abdominal muscles. To do this exercise, a patient should lie on their back with their knees bent and their feet flat on the floor. Next, they should put their hands behind their neck and slowly lift their shoulders off the floor without the help of their hands or elbows. When raising the upper back, hold that position for roughly a second and then return back down and repeat.
Access Spine Rehabilitation Specialists
For those who are struggling with lumbar pain or spinal pain of any kind, ProFysio offers customizable, state-of-the-art treatments. We will begin by thoroughly evaluating your condition and determining a movement diagnosis. Your physical therapist will collaborate with you to develop a program that is designed to help you reach your rehabilitation goals. Whether that includes the exercises above or a combination of different exercises, you can trust that we will create the best treatment for you. At ProFysio, we focus on bringing healing to our patient’s physical health. That’s why we emphasize individual and attentive care to each patient, and each patient can trust that they will receive the unparalleled level of care they deserve.
If you are experiencing lower back pain or any kind of spinal issues, we have the spine rehabilitation programs your body needs. Call us at (732) 812-5200 or contact us online to learn more.