In seems inherent that treatments for lower back pain relief would include stretching. In general, flexibility is a good thing and that’s why activities like yoga are bad for a chiropractic business.
One of the more common questions I get as a chiropractor is what stretches or what exercises should be done for chronic lower back pain. My easy answer is to strongly recommend that the patient get themselves into a yoga program and give it a try for several weeks.
To understand the benefits of yoga, you need to understand that the “30-second” warm-up stretch that we have all been taught from gym class in elementary school on is merely an attempt to avoid injury and does nothing to improve flexibility in the long run. And flexibility is so darn important. I’d have to say that almost all of the patients that I see in my office for treatment of chronic lower back pain have very poor flexibility. For lack of something more specific, the lumbar region in these patients is locked up and can’t move the way it needs to.
Without movement, our bodies begin to fail. Pain is inevitable. So this means that stretching for lower back pain should be good for us, right? It seems to be a matter of timing.
I remember hearing a lecturer several years ago mention that he does not have his patients stretch out in the morning. He much prefers to have them stretch out at the end of the day when the tissues have warmed up and have a chance to actually get more flexible. Although this flies in the face of what most practitioners may tell their patients, it really does make sense.
In addition to the tissues being stiff and grumpy first thing in the morning (especially as you and I continue to age…) our vertebral discs are more hydrated in the morning. Yes–you are actually taller first thing in the morning because without weight-bearing, as you lie down the discs of your spine suck up fluid and are thicker when you roll out of bed. This is why patients who have suffered a disc bulge will usually have more leg pain first thing in the morning (or that wakes him or her up at night). The disc bulges more and any pressure on the nerve is going to be greater when the disc is thicker.
(As a little trick-of-the-trade…if this fits you, set your alarm to wake you up a 1/2 hour before the pain would normally wake you up and get up and walk around to squish some of the fluid back out of the bulging disc. This keeps the disc bulge from inflaming the nerve and can speed up recovery.)
This is also why we need to be more careful in the morning–due to the disc being more engorged the likelihood of suffering a disc injury with something like bad lifting techniques. But what about stretching into trunk flexion first thing in the morning? You know the one…reaching down to touch your toes, either as a static stretch or (eeeeekk!) bouncing.
Given the information already given, do you think it might just be a bad idea to start your morning out with stretching into flexion if you suffer from chronic lower back pain? It certainly seems like this might be the case. Just in case you’re still not quite sure, I would suggest you take a look at this particular article. In it, researchers did a follow-up on a group of 60 patients with chronic, nonspecific lower back pain who went through an 8-month study in which they were instructed to restrict bending activities in the early morning. Here’s what they found:
- Days with pain dropped 23% in the treatment group (versus 2% in the control).
- 3 years later 62% of the participants continued to restrict bending activities in the early morning.
- These patients that continued to restrict bending experienced an additional reduction of 10.1 pain days per month (51%) over what they achieved within the study.
This is a pretty spectacular result from such a simple shift in the type of movements you make in the morning. “Morning” pretty much is limited to however long it takes you to begin to move around and warm up. This could be an hour or it could be half the day depending upon your individual situation. Either way, it is a very simple treatment approach that can have big payouts over the long run.