Low Back Pain Treatment Options, Anatomy, Causes and Exercise Modifications

help clients prevents low back pain through exercise and stretching

Best Exercise Modifications When Training Clients with Lower Back Pain

Personal trainers, fitness instructors, and yoga instructors (as common examples) need to know about low back pain causes, treatments, and exercise modifications to ensure their clients get well and reduce pain. 

Low back pain is one of the most common musculoskeletal complaints affecting people of all ages. It is a significant cause of disability and loss of productivity globally. The lower back, also known as the lumbar region, is a complex structure made up of bones, muscles, ligaments, and nerves. The lumbar region is responsible for supporting the weight of the upper body and providing mobility for daily activities such as walking, hiking, bending, and twisting. This article will discuss the anatomy of the lower spine, common causes of low back pain, how tight hip flexor muscles contribute to low back pain, how chiropractors treat low back pain, how physical therapists help low back pain, which exercises are common for low back pain, using a foam roller for low back pain, when to use ice or heat for low back pain, and what personal trainers need to know about exercise modification for clients with low back pain.  Here is more detailed information about common dysfunctions of the spine.

Anatomy of the Lower Spine

The lumbar region of the spine is located between the rib cage and the pelvis. It consists of five vertebrae labeled L1 through L5. The vertebrae are separated by intervertebral discs that act as shock absorbers. The lumbar region has a natural inward curve, which is called lordosis. The spine is supported by muscles, ligaments, and tendons that attach to the bones. The spinal cord and nerves that control the lower body pass through the spinal canal, which is a hollow space in the center of the vertebrae.

Common Causes of Low Back Pain

Low back pain can have several causes, and it can be challenging to diagnose the exact cause. Some common causes of low back pain include:

  1. Poor posture: Poor posture can put excessive pressure on the lumbar region, leading to pain and discomfort.
  2. Muscle strain: Overuse or sudden twisting or lifting can lead to muscle strain in the lower back.
  3. Herniated disc: A herniated disc occurs when the inner part of the intervertebral disc protrudes through the outer layer, putting pressure on the surrounding nerves and causing pain.
  4. Degenerative disc disease: As we age, the intervertebral discs can wear down, leading to degenerative disc disease. This can cause pain and stiffness in the lower back.
  5. Spinal stenosis: Spinal stenosis occurs when the spinal canal narrows, putting pressure on the spinal cord and nerves. This can cause pain and numbness in the lower back and legs.
  6. Osteoarthritis: Osteoarthritis can cause the breakdown of cartilage in the joints of the spine, leading to pain and stiffness.

How Tight Hip Flexor Muscles Contribute to Low Back Pain

The hip flexors are a group of muscles that connect the hip to the thigh bone. Tight hip flexor muscles can pull on the lumbar region, causing an excessive curve in the lower back. This can lead to low back pain, hip pain, and even knee pain. Sitting for extended periods can cause the hip flexor muscles to tighten. Athletes who participate in activities that require repetitive hip flexion, such as running and cycling, may also experience tight hip flexors.

The iliopsoas musculotendinous unit consists of three muscles: iliacus, psoas major, and psoas minor. Anatomy. The iliopsoas musculotendinous unit is part of the inner muscles of the hip and forms part of the posterior abdominal wall, lying posteriorly at the retroperitoneum level.

The rectus femoris flexes the hip along with the sartorius and iliopsoas and extends the lower leg at the knee, working in conjunction with the other three quadriceps muscles. The rectus femoris muscle antagonizes the hamstring muscles at the knee and the hip.

Learn how proper posture can help reduce back pain.

How Chiropractors Treat Low Back Pain

Chiropractors are healthcare professionals who focus on the diagnosis and treatment of musculoskeletal conditions, including low back pain. They use manual manipulation to realign the spine, restore mobility, and alleviate pain. Chiropractic adjustments involve the use of controlled force to move the joints beyond their usual range of motion. This can help to relieve pressure on the nerves, reduce inflammation, and improve overall spinal function.

How Physical Therapists Help Low Back Pain

Physical therapists are healthcare professionals who focus on the diagnosis, treatment, and prevention of movement dysfunction and pain. They use a variety of techniques to improve muscle strength, flexibility, and mobility. Physical therapists can develop customized exercise programs that focus on improving the strength and stability of the muscles that support the lumbar region. They may also use modalities such as heat, ice, ultrasound, and electrical stimulation to alleviate pain and promote healing.

Which Exercises Are Common for Low Back Pain?

Exercise is an essential component of the treatment plan for low back pain. The goal of exercise is to improve the strength and flexibility of the muscles that support the lumbar region. Some common exercises for low back pain include:

  1. Core strengthening exercises: The core muscles are essential for stabilizing the lumbar region. Core strengthening exercises such as planks, bird dogs, and bridges can improve core strength and stability.
  2. Stretching exercises: Tight muscles can contribute to low back pain. Stretching exercises can improve flexibility and reduce muscle tension. Hamstring stretches, hip flexor stretches, and piriformis stretches can help to alleviate low back pain.
  3. Aerobic exercise: Aerobic exercise such as walking, swimming, and cycling can improve cardiovascular health and reduce the risk of low back pain. Also, repeated and lower “pressure” exercises can simply help a person work through the stiffness of an injury.

Using a Foam Roller for Low Back Pain

Foam rolling is a form of self-massage that can help to alleviate low back pain. Foam rollers are cylindrical devices made of foam that can be used to apply pressure to tight muscles. When using a foam roller for low back pain, it is important to avoid rolling directly on the lumbar spine. Instead, focus on rolling the muscles surrounding the lumbar region, such as the glutes and hip flexors.

When to Use Ice or Heat for Low Back Pain

Heat and ice can both be effective for reducing low back pain. Heat can help to relax muscles, improve circulation, and reduce stiffness. Ice can help to reduce inflammation and alleviate pain. It is important to use heat and ice appropriately to avoid further injury. In general, heat is more effective for chronic low back pain, while ice is more effective for acute low back pain.

What Personal Trainers Need to Know About Exercise Modification for Clients with Low Back Pain

Personal trainers play an important role in helping clients with low back pain to exercise safely and effectively. When working with clients with low back pain, personal trainers should:

  1. Focus on form: Proper form is essential for avoiding further injury and maximizing the benefits of exercise. Personal trainers should ensure that clients maintain proper form throughout each exercise.
  2. Modify exercises as needed: Some exercises may be too challenging for clients with low back pain. Personal trainers should modify exercises as needed to ensure that clients can perform them safely and without pain.
  3. Emphasize core strengthening: Core strengthening exercises can help to improve stability and reduce the risk of low back pain. Personal trainers should incorporate core strengthening exercises into their clients’ exercise programs.

Low back pain is a common and often debilitating condition that can have a significant impact on quality of life. Understanding the anatomy of the lumbar region, common causes of low back pain, and the role of healthcare professionals such as chiropractors and physical therapists can help to alleviate pain and promote healing. Exercise, foam rolling, and the appropriate use of heat and ice can also be effective for reducing low back pain. Personal trainers have an important role to play in helping clients with low back pain to exercise safely and effectively. By focusing on form, modifying exercises as needed, and emphasizing core strengthening, personal trainers can help their clients to manage low back pain and improve their overall health and well-being.

Understanding biomechanics at a high level will ensure you give your clients the best possible service and results.  You will want to review the NESTA Biomechanics Specialist Certification.