Exercises for Back Pain

The best way to deal with back pain is to stay active and continue doing regular exercise.

The advice 20 years ago was to rest, but research has shown that inactivity only makes things worse,” says Dries Hettinga of BackCare, a charity that offers support and information to people with back pain.

“When you’re in pain you may want to stay in bed and not move around, but that results in further [loss of mobility] and will only prolong the pain.”

Staying active means continuing with regular day-to-day activities to avoid becoming sedentary. Examples include walking to the shops rather than taking the car, getting off the bus one stop early, gardening and taking the dog for a walk.

If you experience moderate pain, take painkillers that are available over the counter from your pharmacist or supermarket. Your pharmacist or GP can advise you on how to use your medication effectively.

Exercise program

In addition to maintaining an active lifestyle, try to exercise. You can do any activity that gives your body a good workout.

“It’s important to pick an exercise you enjoy,” says Hettinga. “If you do something you enjoy, you’re more likely to stick with it. There’s no quick fix for back pain so you need to work at it.”

Ideally, your choice of activities should involve elements of endurance, strength and flexibility. Examples include walking, running or jogging, cycling, dancing, swimming, hydrotherapy (exercising in water) and aquarobics.

Consider a variety of exercises as part of a weekly exercise programme, which could include yoga, t’ai chi, working out in a gym and sport in general.

Hettinga says exercise programmes are most effective if performed regularly and over prolonged periods of time.

Aim for at least three to five sessions a week (approximately 30 minutes each session). You may want to build this up over a number of weeks.

Hettinga says an individually designed exercise programme gives the best results. A physiotherapist or exercise professional can help you with this.

Manual therapy

Hettinga suggests combining an exercise programme with a course of manual therapy, especially when the pain is persistent. Manual therapy is provided by chiropractors, osteopaths and physiotherapists.

“Evidence suggests manual therapies can be effective. Your back is examined to see if any joints need to be freed up.

"They can do it with a gentle massage, mobilisation or manipulation. It’s especially helpful if your back is stiff and flexibility is an issue," she says.

Manual therapists are also qualified to advise you on the type of exercises that will be most effective at dealing with your type of back pain.

“You should see improvements after a few weeks,” says Hettinga. “If the pain hasn’t disappeared after a few weeks of treatment, seek further medical advice to explore alternatives.

"There is always something that can be done about back pain, but it requires some work and dedication from you.”

Information about Musculoskeletal Disorders

Physiotherapy is clinically effective and cost effective in the management and treatment of musculoskeletal disorders (MSD). MSDs are on

Physiotherapy

Early intervention with physiotherapy can reduce the amount of time people are off sick and are vital in order to prevent an acute problem becoming chronic.

Two government departments in Northern Ireland provided early access to physiotherapy for staff
with musculoskeletal disorders. 80 per cent indicated that physiotherapy had prevented them from going absent and, of those already off sick, over 80 per cent indicated that physiotherapy had shortened their absence. Respondents indicated that the service shortened their absence by an average of six weeks.(1)

West Suffolk hospital trust, Bury St Edmunds, was commended in the Boorman report for having achieved savings of £170,000 through a system of priority referrals to a local Physio for injured staff. For a cost of £21,000 it had achieved a 40 per cent reduction in lost days through sickness absence and savings of £170,000 in the cost of MSDs.

Based on the latest available statistics from the HSE (3) 227,000 people have an MSD of the back, 215,000 of the upper limbs or neck and 96,000 of the lower limbs. Low back pain is the number one cause of long term absence amongst manual workers and MSDs are the most common reason for repeat consultations with GPs, accounting

For up to 30 per cent of primary care consultations.

Self referral

Self-referral to physiotherapy has been proven to be clinically successful with high patient satisfaction as well as cost effective. The self referral pilots that took place across six
NHS England sites between 2006 and 2008 were found to reduce the number of associated NHS
costs, particularly for investigations and prescribing, with 75 per cent of patients who self referred not requiring a prescription for medicines. In addition
there was no increase in demand for services and self-referral reduced work absence amongst patients.

An analysis of self-referral in Scotland found that the average cost of an episode of care was established as £95.48 for a self-referral, £113.24 for a GP-suggested referral and £126.17 for a GP referral. The average cost benefit to NHS Scotland of self-referral was identified as being approximately £2.5 million per annum.

Doncaster and Bassetlaw Trust piloted a successful self-referral Physio service for 6500 staff in
2005. The service was

Made permanent after
an evaluation identified
potential savings of more
than £330,000. It is
used by employees from
all corners of the trust,
and it offers an average
waiting time of 2.8 days.
More than half the users say
they would have taken time off
work if the service were not available.

In Cambridge, self-referral for MSD outpatient services has reduced costs due to less GP use of prescribing and diagnostic tests. 75 per cent of patients who self- referred did not require a prescription for medicines, giving an average saving of £12,000 per GP practice.

Telephone assessment and support

Assessing the severity of a patient’s condition over
the telephone has been found to be very resource efficient. This telephone triage saves patient and physiotherapist time as well as costs and ensures those needing the most urgent treatment are prioritized.

Where appropriate, follow up support by telephone has also been found to be a clinically and cost effective way of enabling patients to self manage their condition, helping to prevent relapses.

An occupational health physiotherapy service used telephone triage and follow up support as part of a program to tackle MSDs experienced by staff of NHS Lothian. Over £300,000 was saved in salaries alone by reducing sickness absence and there was a 74 per cent reduction in recurrence of MSDs nine months following the program

Conclusion

Speedy Access to physiotherapy for people with MSDs is clinically and cost effective for the health service, including GPs, for employers and for society. Physiotherapist has helped to pioneer innovative ways of providing speedy access within existing services.

A Simple Exercise Program To Reduce Back Pain

The best way to deal with back pain is to stay active and continue doing regular exercise.

The advice 20 years ago was to rest, but research has shown that inactivity only makes things worse,” says Dries Hettinga of BackCare, a charity that offers support and information to people with back pain.

“When you’re in pain you may want to stay in bed and not move around, but that results in further [loss of mobility] and will only prolong the pain.”

Staying active means continuing with regular day-to-day activities to avoid becoming sedentary. Examples include walking to the shops rather than taking the car, getting off the bus one stop early, gardening and taking the dog for a walk.

If you experience moderate pain, take painkillers that are available over the counter from your pharmacist or supermarket. Your pharmacist or GP can advise you on how to use your medication effectively.

Exercise program

In addition to maintaining an active lifestyle, try to exercise. You can do any activity that gives your body a good workout.

“It’s important to pick an exercise you enjoy,” says Hettinga. “If you do something you enjoy, you’re more likely to stick with it. There’s no quick fix for back pain so you need to work at it.”

Ideally, your choice of activities should involve elements of endurance, strength and flexibility. Examples include walking, running or jogging, cycling, dancing, swimming, hydrotherapy (exercising in water) and aquarobics.

Consider a variety of exercises as part of a weekly exercise program, which could include yoga, T’ai chi, working out in a gym and sport in general.

Hettinga says exercise program are most effective if performed regularly and over prolonged periods of time.

Aim for at least three to five sessions a week (approximately 30 minutes each session). You may want to build this up over a number of weeks.

Hettinga says an individually designed exercise program gives the best results. A physiotherapist or exercise professional can help you with this.

Manual therapy

Hettinga suggests combining an exercise program with a course of manual therapy, especially when the pain is persistent. Chiropractors, osteopaths and physiotherapists provide manual therapy.

“Evidence suggests manual therapies can be effective. Your back is examined to see if any joints need to be freed up.

"They can do it with a gentle massage, mobilization or manipulation. It’s especially helpful if your back is stiff and flexibility is an issue," she says.

Manual therapists are also qualified to advise you on the type of exercises that will be most effective at dealing with your type of back pain.

“You should see improvements after a few weeks,” says Hettinga. “If the pain hasn’t disappeared after a few weeks of treatment, seek further medical advice to explore alternatives.

"There is always something that can be done about back pain, but it requires some work and dedication from you.”

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Exercise and Physiotherapy

Exercise and Physiotherapy

Most people with MS, regardless of their degree of disability, can benefit from some exercise. Many have some degree of ability. The right kind of exercise can bring positive physical and psychological health benefits.

Exercise helps you do the things you want to do and helps to prevent complications that can result from inactivity. It can improve flexibility, fitness, strength and stamina, circulation, muscle tone and mood. It can also help with the stimulation of fluids and excretion of waste products.

Many people with MS think they cannot do any exercise because they will become too fatigued but the strange fact is that it can actually give you energy rather than take it away from you – as long as you exercise sensibly and know your levels of ability. It is important to balance the exercise with rest.

You may wish to only undertake short sessions so you can avoid overheating. Remember, over-exercise can lead to weakness, fatigue, pain and spasticity. Therefore it is sometimes better to build up your exercises slowly.

Even if you are quite inactive, simple exercises like calf muscle lifts and stretches can be done at home on a daily basis. Passive exercisers are useful and there are many good products on the market, which can be used sitting down. If you suffer with spasticity a Physiotherapist can do assisted movements with you.

Good Forms of Exercise:

Physiotherapy

It is quite important to see a neurologically trained Physiotherapist as early on as possible. MS patients are often referred too late. Your G.P. or Neurologist should supply a referral. You can also receive Physio at one of the many MS Therapy Centers around the country, where the number of sessions are not rationed.

If you suffer with spasticity a Physiotherapist can do assisted movements with you and also help you to stand and balance properly, stand up from sitting and lying, walk better, position yourself to sleep, co-ordinate your movements better and help with posture etc.

It is a good idea to speak with your Physio if you are thinking of undertaking any of the under mentioned therapies and also ask their advice on any exercise machines available.

Swimming

Swimming is especially helpful because the water supports your bodyweight – the water will help to stabilize someone with balance problems. Weakened muscles can operate in this environment and will strengthen from the resistance. As swimming involves many muscles in your body, it can help to increase co-ordination.

There are now many more swimming pools and leisure centers having special sessions for people with disabilities or those who require special help and it may be worth trying one of these sessions first.

As a precaution it is best to ascertain the temperature of the water beforehand as many people with MS find water that is too hot or too cold a problem. The most comfortable temperature is about 30°C (86°F).

Pilates

Pilates is a type of exercise program based on correct body alignment. The focus is on co-ordination, moving properly and “core strength”. Good breathing patterns are important also.

As a holistic method of body maintenance, it prioritizes general fitness and body awareness, which contributes positively to rehabilitation.

In MS, Pilates can improve posture, boost the immune system, reduce stress, increase energy and bone density, improve circulation and respiration, improve muscle tone and balance.

T’ai Chi

T’ai Chi is meditation with movement. It concentrates on relaxation and correct breathing while performing graceful, circular, flowing exercises, sometimes to music. It is especially helpful for people with MS who no longer have the stamina to exercise at a high speed and another advantage is that you can exercise without overheating.

Really you need to be able to stand to be able to cope with all the range of moves. However, it is possible, according to the teacher, to do some of the moves sitting down, e.g. the arm movements and breathing exercises.

T’ai Chi can help in MS by improving balance, combating fatigue and giving you more energy. It can also help with spasms, exercises muscles and is very relaxing. Regular practice can also help with depression and maintain a calm and more serene inner state. T’ai Chi is a good method of self-development, focusing the mind and giving people with MS a sense of well being.

Yoga

Yoga is widely used by many people with MS and there are now specialist centers and teachers. It is a unity of mind and body and is as much about your breathing and your outlook on life as it is about postures. It can calm the mind and energies the body as well as helping to counteract stress, fatigue and depression.

It has a good effect on the endocrine glands, circulatory and respiratory systems and improves wellbeing. Yoga also tones the digestive organs and other glands in the body such as the thyroid and adrenals.The main concern with yoga and MS is that you should work well within your limitations in a relaxed way and be careful not to push yourself too far or raise your body temperature, as this may increase fatigue.

Vibration training

Vibration training is becoming more widely used amongst people with MS. You stand on a platform that sends vibrations through the body to tone up muscles, increase blood flow and bone density. This can also be done from a seated position by just placing the feet onto the platform. It helps to make leg muscles stronger, improves flexibility, aids circulation and helps balance by increasing the core stability.

Many People with MS have used these machines and found a reduction in some of their symptoms. Mainly with a reduction of muscle spasms and spasticity. An increase in blood circulation helps provide warmth to the legs and feet as well as reducing swollen ankles. Sessions should ideally be overseen by a trained professional and started with only short sessions so to not overload the body.

More physiotherapy and rehabilitation centers are using the vibration trainers as part of their treatment.

Simple Neck Exercises

 This article focusses on quick, simple and easy neck exercises. The pictures and text below make it easy.

Neck Range Of Motion Exercises, Neck Exercises

One very powerful way of controlling your neck pain is to do daily range of motion exercises, putting your neck through full movement several times a day. This prevents stiffness developing and stretches all the attached muscles, making them less vulnerable to sudden demands.

Please note that exercises can make your pain worse as well as better so please consult the simple exercise guidance before getting on with them. If you have any doubts, please consult your physio, other manual therapist or medical practitioner.

These exercises are meant to maintain range of motion or regain loss of movement in the neck region and to help control pain. Regular performance of movements can help with pain problems. They are simple and not magical in any way. If you have long term neck pain with some disability these exercises may help mobility or allow you to tolerate more activity but may not be very effective against pain.

Do each movement slowly five times, resting a short time in between each set of movements. Do two or three times a day although more often can be useful. Work out how much you should do by slowly increasing the frequency until you are doing enough or start to have problems.

Neck flexion

This is the movement of bringing the head forward so that the chin hits the chest and your face is staring straight down at the floor. Do slowly five times.

This exercise stretches the structures at the back of the cervical spine, which are often kept in a tight position in normal day to day postures. They can then become shortened and stop the neck moving naturally.

To make this more difficult you can retract the neck slightly to start with (see below) and then flex the head forward, increasing the stretch on the neck.

Neck extension

This is the movement of allowing the head to go back until the face is looking directly at the ceiling. Don’t do this movement fast or forcefully as it forces all the small joints at the back of the neck into an extreme position. This won’t do them any harm but might increase your pain.

Allow your neck to ease back steadily as you do this, leaving your neck at the end of the movement for a few seconds.

NB If you feel dizzy when you do this leave it out. Dizziness, especially if you are older, might indicate that the blood vessels in your neck are being squeezed by the position.

Rotation

Turn your head slowly round to one side until it cannot easily go any further. Once you have done five to one side do the other. Do not go from one side to the other in the individual movements or roll your neck about.

Hold your neck at the end of the movement for a few seconds as this is the most valuable part of the movement to maintain or increase your movement.
NB If you feel dizzy when you do this leave it out. Dizziness, especially if you are older, might indicate that the blood vessels in your neck are being squeezed by the position.

Side flexions

Keep your head facing straight forward and try and tip your ear down towards the same shoulder. It’s difficult to do this well and without
rotating to one side. She’s doing pretty well in the picture, just lifting her chin up a little more than ideal.

This movement is quite severe on the neck joints so don’t go hard at the exercise. Don’t move from side to side in the movement as that stops you getting to the ends of the neck range and may aggravate your joints.

Neck Retraction (Chicken Tuck)

This is one of the most useful neck movements as it counteracts the tendency we all have of allowing our heads to poke forwards in a poor posture. She’s showing the extreme position of “poking chin” here.

When we sit, which many of us do a lot of the time, we tend to slump and to keep our heads up so our eyes are horizontal we arch our necks backwards slightly

This gives a continual flexion (bending) posture to the lower neck and an extension (arching) posture to the upper neck. Over time the tissues can shorten and give us stiffness and pain. Typical pains are in the neck, upper shoulders, but this posture can also give you headaches.

Here’s the end point of the movement. Keep your face straight on during the whole movement, drawing the head back and the chin down slightly.

If you get it right, you will look funny, rather like a sergeant-major in an exaggerated military neck posture. If you do it in public people will either laugh or give you funny looks!

The whole movement is like the forward and back movement that chickens make. Hold the movement at the extreme of the backward posture for a few seconds.

Upper Neck Nodding

This movement particularly moves the upper cervical joints. In our bad postural habits we tend to poke our chins forward which puts our upper neck joints into extension (arching).

The nodding movement flexes these joints and can help with upper neck pain and headaches of joint origin. This is the neutral starting position for the movement.

Lying flat on your back for this movement is the easiest way to start this movement. You can be flat on the surface like she is in the picture or have a pillow if you don’t like your head down flat on a surface.

This is the end position of the exercise. Think of your head as a bowling ball which you rotate forward to rock the neck. You should not lift the head off the surface at all. You may feel a pull in the upper neck which is often tight.

This exercise should be done with caution as you could increase your pain if you push it too hard. When you get good at the movement you can do it standing up or sitting but it is harder to get the pure joint movement than in lying down.

Related movements which may be useful

When we have neck problems it is rarely just the neck which is the problem, the pain usually involves the thoracic spine and the shoulder girdle. It is good to do shoulder girdle exercises as well to loosen up this area.

1. Shoulder shrugs
Shrug your shoulders as far up as you easily can then downwards further than normal.

Shoulder bracing (retraction)
Bring your shoulders to the front as if you are trying to get them to meet at the middle then brace them right back, pulling your shoulder blades together. Make it a large, slow, repeated movemen

Frequently asked questions related to Physiotherapy

Today's post is dedicated to those frequently asked questions have about physiotherapy.

Q: What is physiotherapy?

Physiotherapy uses a variety of techniques to help your muscles and joints work to their full potential. It can help repair damage by speeding up the healing process and reducing pain and stiffness.

Physiotherapists also have an important role in rehabilitation, for example, helping people who have had strokes to relearn basic movements. However, physiotherapists don't just offer treatment, their advice can help you prevent problems returning or even happening in the first place.

Q: What types of problem can physiotherapy help?

Virtually any condition that affects your muscles, joints or nerves. Common problems that can be helped by physiotherapy include:

•   Painful conditions such as arthritis

•   Back and neck pain, including whiplash

•   Problems affecting children including cerebral palsy

•   Pregnancy related symptoms such as back pain and stress incontinence

•   Upper limb work related problems, also known as repetitive strain injury (RSI)

•   Asthma and other breathing difficulties

•   Sports injuries

•   Strokes and other neurological problems

•   Symptoms of stress and anxiety.

Q: What does the treatment involve?

Before any action is taken, the physiotherapist will assess your condition, diagnose the problem and help you understand what's wrong. They will work with you to develop an effective treatment plan that takes into account your lifestyle, leisure activities and general health. This will include advice on how you can help yourself, for example, you may be shown exercises that you can do between treatment sessions. Where appropriate, physiotherapists also advise carers how they can help.

Physiotherapists use a variety of treatments. For example:

•   Exercise programs - designed to improve mobility and strengthen muscles

•   Manipulation and mobilisation - to reduce pain and stiffness

•   Electrotherapy - for example, ultrasound to speed up the healing process

•   Acupuncture - used by some physiotherapists qualified to practice this technique

•   Hydrotherapy - exercise in water

•   Massage.

Q: What should I do if I injure myself? Do I need to be referred by a MD, or can I make an appointment to see a physiotherapist immediately?

If the nature or extent of your orthopedic injury is unclear, you must make an appointment for a consultation with your personal medical physician or specialist. The specialist may in turn recommend x-rays, medication or any other course of action, which is deemed appropriate, including perhaps physiotherapy.

If, however, you are very familiar with your injury, and you know that a physiotherapist can address it, you may choose to skip the medical consultation and make an appointment directly with our physiotherapy services. But remember, when in doubt about the nature of your injury, consult a physician. These consultations are fully covered by Medicare, so there's no need to gamble.

Q: How effective is physiotherapy?

Physiotherapists measure their clinical effectiveness by the same standards applied to other health professionals, including doctors and nurses. This is done through independent research to prove that physiotherapy works. For example, studies show that exercise-based cardiac rehabilitation, led by physiotherapists, results in a reduction of sudden death rates after a heart attack by 25 per cent. There is also strong evidence that physiotherapy is an effective treatment for back pain.

To ensure physiotherapists in Quebec apply equally high standards, the Order des Physiotherapeutic du Quebec, the professional body representing physiotherapists, circulates guidelines based on research to all its members.

Thanks you reading our post. If there is anything we left out please feel free to comment your question below, we'd be happy to help you.