By Nathan Wei

Low back pain is second only to the common cold as a reason to visit a physicians office. Low back pain is a common problem because of our upright stance, the demands placed on us by our daily routines, as well as our habits, many of which can aggravate back pain.

It is essential to always warm up prior to getting started with a days activity. Warm up should consist of exercises that increase heart rate as well as exercises that help stretch muscles, joints, and other connective tissue. Heart rate increasing exercises will also increase the rate and depth of your breathing which will contribute to overall conditioning. Stretching connective tissue will help avoid strain and sprain. This will reduce the likelihood of injury.

Low impact aerobic exercise is good because it improves heart and lung function. In addition, the improvement in circulation will help improve the health of ligaments, tendons, and discs in the low back, thoracic spine, and neck. Exercise also improves joint mobility as well as strength and tone in muscles.

In addition to thing you should do, there are many things you shouldnt do. For instance, avoid activities that require impact or twisting. Examples of activities that fall into this category include high impact aerobic exercise, rowing, tennis. Patients with disc disease should avoid high impact exercises of any type. Always start a new exercise program slowly. Gradually increase the intensity and duration over time.

After exercise, it is important to cool down properly. Gentle stretches, drinking cool drinks of hydrating fluids, conversation, and general overall relaxation will help you get the most out of your exercise.

Here are some specific back exercises to help you get started:

1. Lying pelvic tilt. Lie on the floor on your back with your hands over your head. Use a pillow to support your head. Tighten up your stomach muscles and tilt your pelvis up so that the hollow in the low back goes away. Your low back should remain in contact with the floor. Hold for 5 seconds, then repeat. Try 5 repetitions to start and increase over time.

2. Knee hugs. While on your back with a pillow under your head for support, bring your left knee up to your chest. Hold it with your hands and pull your knee to your chest. Hold it for 5 seconds. Then repeat this exercise with your right knee. Do 3 repetitions.

3. Leg rolls. Dont do this if you have sciatica. Lie on your back with a pillow under your head. Stretch your arms out to the side. Bend your knees and keep your feet flat on the ground. Roll your knees gently to the right as far as they will go until you feel a stretch in your low back. Hold it for three seconds. Dont force it. Then repeat the exercise while going to the left. Do three reps each side.

4. Spinal stretch in a chair. Sit in a chair with a straight back. Sit tall with your stomach muscles tight. Put your hands on your lap. Slowly curl forward and gently stretch your spine and hold it for 10 seconds. Make sure your pelvis stays locked and do not rock forward. This should be a gently movement. Hold for 10 seconds then return to your starting point. Do this one time and gradually increase repetitions as you feel better.

5. Seated side stretch. While sitting upright in a chair without arms, gently lean to the left and move it towards the floor. Do not tilt your pelvis and dont twist the spine. Breathe out as you stretch down. Hold for two seconds then return to the upright position and do the same to the opposite side.

6. Flexion. While standing, tuck you chin to your chest and gently curl forward starting with the upper back and continue through your lower back. Hold for five seconds then return to your starting position.

7. Extension. Stand erect. Then slowly arch your spine backwards, starting with your shoulders. Pull your shoulders up and back while imagining your spine lengthening as it bends backwards. Dont arch too far. Hold for five seconds then return.

8. Trunk rotations. Stand with your hands on your hips. Gently rotate your trunk to the right while keeping your pelvis facing directly in front of you. Hold it for three seconds. Return to baseline and do the same exercise to the opposite side.

9. Shoulder shrugs. Stand straight up. Take a deep breath in and lift your shoulders to your ears and hold for three seconds, then drop your shoulders slowly. And stretch then stretch your shoulders down towards your feet. Repeat 4-5 times.

10. Supine stretch. While lying supine, place your hands over your head. And bend your right knee slightly. Stretch your arms above your head and feel the stretch extend from your fingers all the way to your low back. Take a deep breath and hold the stretch for 15 seconds. Repeat with the left leg bent.

Other tips:

Use good posture. Imagine theres a string connecting the top of your head to the ceiling.

Keep your shoulders back with your chin tucked.

Always sit with good support for your low back. Keep your knees higher than your hips. Dont twist when you move. Do not slump and avoid sitting for more than one hour at a time. Sleep with a pillow between the knees. Or if you sleep on your back, put the pillow under the knees.

About the Author: Nathan Wei, MD FACP FACR is a nationally known board-certified rheumatologist. For more info:

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and

Tendonitis Treatment Tips

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