Strengthening and back pain relief exercises
There are two primary forms of back exercise for strengthening
and/or back pain relief that tend to be used for specific
conditions: McKenzie exercises and dynamic lumbar stabilization
exercises. When appropriate, the two forms of physical
therapy exercise may also be combined.
1. McKenzie exercises
for back pain relief
These back exercises are
named after a physical therapist in New Zealand who
noted that extending the spine through exercise could
reduce pain generated from the disc space. Theoretically,
extension exercises may also help reduce a herniated
disc and reduce pressure on a nerve root.
For patients who are suffering
from leg pain due to a disc herniation (a radiculopathy),
extending the spine with McKenzie back exercises
may help reduce the leg pain by "centralizing" the
pain (moving the pain from the leg to the back).
For most patients, back pain is usually more tolerable
than leg pain, and if a patient is able to centralize
the pain, they may be able to continue with conservative
treatment (such as exercise) and avoid a surgical
discectomy.
When the pain is acute, the
exercises should be done frequently (every one to
two hours). Patients should also try to avoid flexing
the spine (bending forward) during exercising.
McKenzie exercises may also be helpful for those
individuals who have back pain due to degenerative
disc disease. While sitting or flexing forward can
accentuate low back pain for patients with degenerative
disc disease, extending the spine can serve to relieve
the pressure on the disc. Note that the opposite is
true in elderly patients who have facet osteoarthritis
and/or lumbar stenosis (extending the spine jams the
facet joints on the back and increases pressure across
the joints, so these patients will typically feel
better sitting, and have more pain with extension).
2. Dynamic lumbar stabilization
exercises
for back pain relief
With this back exercise technique, the physical
therapist first tries to find the patient’s "neutral" spine,
or the position that allows the patient to feel most
comfortable. The back muscles are then exercised to
teach the spine how to stay in this position. This
back exercise technique relies on proprioception, or
the awareness of where one’s joints are positioned.
Performed on an ongoing basis, these back exercises
for pain relief can help keep the back strong and
well positioned.
These stabilization exercises may also
be done in conjunction with McKenzie exercises. The
McKenzie exercises serve to reduce back pain, and
the stabilization exercises help strengthen the back.
Stabilization exercises can be rather rigorous and
therefore may not be well tolerated by all patients.
It may be advisable for elderly patients or patients
in significant pain to use other less strenuous means
of physical therapy and back exercise.
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