Welcome to your LOW BACK PAIN treatment guide You are receiving this guide because you have recently experienced low back pain. Back pain is one of the most common musculoskeletal problems treated in medicine today. Our goal at Concord Hospital Rehabilitation Services is to assist you with updated information and resources so that you can make healthy decisions regarding your care. This guide serves as a brief overview of what you can do to improve self-care and pain management. This is not intended to replace individualized, professional medical advice. This may be the first time you ve experienced back pain. It is good to know the spine is inherently strong and has many different structures that protect it. Oftentimes you may experience pain that is not related to a spinal structure. Most often back pain can be the result of overstretched muscles or ligaments which can heal on their own. It is important to choose to stay active versus staying in bed as movement has been shown to promote further healing allowing you to get back into your regular activities. We ve included some exercises in this guide to get you started. Adopting a regular exercise routine can help prevent prolonged or recurrent back pain along with providing other health benefits. We have provided a resource list covering everything from local yoga and exercise classes to self-help books. It is important to follow these prevention and treatment principles described in this guide. Your physical therapist contact is Melanie Bieniek, DPT, Board Certified Orthopedic Clinical Specialist, and Rehabilitation Manager at our Concord Medical Offices East location: 603-736-6222 or at mbieniek@crhc.org (Please leave a message with a convenient time to reach you) Hours of operation: Monday-Friday 7am 6pm A Physical Therapist will be following up with you shortly to check on your progress and to answer any questions you might have.
Low Back Pain: Take Control and Get Moving Again! Low back pain affects most of us at one time or another. It can be very intense even if nothing is broken or damaged in your spine. Your primary care provider has found that it is safe for you to help the recovery process by using these strategies. Exercises designed to restore normal function in your low back are usually the best way to get things feeling normal again. Watch a four minute video demonstrating exercises you can do for low back pain at: http://www.concordhospital.org/services/rehabilitation/ During these exercises, some soreness is expected, but pain that worsens with repetition is a warning sign that you should stop. If your movement starts to decrease instead of increase, that is also a sign that you should stop. In addition to these movements, a daily walking routine can be one of the best forms of therapy for low back pain. Start with a comfortable distance and add just a few minutes each day. Studies have shown that light aerobic activity can actually speed up healing and recovery. You can also use ice or heat to reduce symptoms as to stay active. If these efforts are making your pain worse or you have any concerns, ask your provider for a referral to Physical Therapy. For additional information, call Melanie Bieniek, DPT at (603) 736-6222 or e-mail: mbieniek@crhc.org Rotation stretches lying down: Lying on your back with knees bent and feet together, rotate legs to the right and then the left. Start small and move slowly. Repeat 10 times each direction, twice a day. Seated Trunk Movement: Sitting near the edge of a chair with feet flat on the floor, allow your low back to round into a slouched position. Then restore the arch by sitting up as tall as possible. Repeat 10 times, twice a day. Return to a comfortable sitting posture afterward. Sit to Stand: Begin in sitting position. Scoot to the edge of the chair. Tighten your abdominal and bottom muscles. Keep head facing forward and keep back straight. Slowly stand straight up. Repeat 10 times. Use technique as you move from sit to stand throughout the day. Standing 3 way kicks: Begin in a standing position. Tighten your abdominal muscles while squeezing your buttocks together. Hold this position while slowly kicking your leg out to the side and back in again. Keep your back straight. Repeat 10 times then repeat to the other side. Repeat forward and backwards 10 times to each side, stopping if you experience any lower back discomfort.
Body Mechanics for Common Activities Using proper body mechanics can prevent back injury, help speed up recovery if you are already injured, and prevent further injury after your back has healed. The following are some suggestions for activities that you may use with daily activities. When getting out of a car, swing your legs out to the side and pivot keeping your back straight. Do not twist your low back. Scoot forward and place feet under the hips, lean forward, and push up through your feet to a standing position. To sit down, reverse the procedure. Many activities require standing for a while such as brushing your teeth, ironing, washing dishes, or folding laundry. When standing, place one foot on a step or ledge. Do not bend at the waist; instead bend at the knees and keep back straight. To provide support, use one hand to brace yourself. Always try to do the activity at a comfortable height. To move from lying on back, bend knees up and roll to your side. Slide legs off edge of bed with knees bent. Push up with your arms, using the legs as a counter weight and sit up. Reverse to move from sitting to lying down.
Body Mechanics for lifting and bending tasks The following are examples of different lifting situations that you may find yourself facing in everyday life. These illustrations may help to demonstrate the concepts of proper body mechanics. The Basic Squat Lift This lift is useful for something of moderate size and weight such as a laundry basket, a box of clothes, or a bag of groceries. Begin standing close to the object to be lifted. Squat down, keeping the back straight and firmly grasp the container. Use your leg muscles to lift keeping the container close to you. The Half-Kneel Lift This lift may be helpful with things that have an irregular shape or tend to move as you lift. This might include a small fan, a small pet, or a small child. This lift can also be useful when lifting objects from a low shelf or table. Stand close to the object to be lifted. Squat down onto one knee. Keep the back straight pick up the object keeping it close to your body. Use your leg muscles to help you to stand. The Partial Golf Pickup Keep one foot planted firmly on the ground, keep back straight and pivot at the hips while extending the opposite leg backwards, as you reach towards the object.
Be Mindful of Your Back! Mindfulness is a nonjudgmental, moment-to-moment awareness where you acknowledge and accept every thought, feeling, or sensation that arises within you. By being mindful you can help reduce your pain as well as prevent further irritation. Many studies have looked at mindfulness meditation for back pain and found that it could improve: pain intensity, emotional distress, coping, anxiety, and pain tolerance. It also has been shown to change the parts of your brain that perceives pain-and reduces its activity! People report that with mindfulness they are able to develop a better self-awareness which can result in behavioral changes that help reduce their pain. By bringing attention to day to day activities, you may be able to cope with the pain in a more active and involved way and also hopefully reduce it! Below are a few quick ways to practice on your own. Ways to Practice Mindfulness Breathe Easy: An easy way to start mindfulness is by focusing on your breath. Sit or lie in a comfortable position and focus on breathing in and breathing out. There will be thoughts that come into your mind. Acknowledge them and then return your attention to your breathing. Spending 20 minutes focusing on just your breathing has been shown to greatly reduce pain intensity and stress levels. Body Scan: Another option is the body scan, where you draw your attention on the body starting at the feet and working through the entire body. Be aware of all the sensations that you experience in that body part. Note any areas of discomfort and then move on to the next body part. When a thought comes to mind, acknowledge it, and then return your focus to what is going on at that moment. Yoga: Another way to practice mindfulness is with yoga. Yoga is praised for its great physical benefits such as balance, strength and flexibility, but it has an equally important mind element. With the guidance of an experienced instructor, you can practice becoming more aware of how your body moves, feels and reacts to different positions and strains. This can then help you reduce your pain throughout your day. Once you become more comfortable with these basic elements of mindfulness, you can include it into your everyday activities such as mindfully brushing your teeth or eating dinner. As you do this you will more than likely see improvements with your quality of life and reductions in your pain. If you would like more information or would like to learn more about mindfulness, contact the Concord Hospital Center for Health Promotion at 230-7300.
Resource List Research shows that aerobic fitness, strength and flexibility, stress, and mindfulness all can impact back pain. Below is a list of resources that may be helpful for you in managing back pain, preventing recurrence and keeping you well. Facilities Offering Multiple Activities The Center for Health Promotion: 230-7300 Offerings: Yoga, Tai-Chi, Mindfulness Meditation and Mindfulness Stress Reduction, aerobics classes The YMCA: 228-9622 Offerings: Yoga, tai-chi, aerobics and pool exercises for all abilities. Senior Centers offer a variety of different activities listed above. Contact the centers directly for a listing of programs. Concord Senior Center: 228-6630 Slusser Senior Center(Contoocook):746-3800 Bradford Senior Center: 938-2104 Pittsfield Area Senior Center: 435-8482 Pools at local hotels offer affordable memberships. Contact the facilities directly for cost and time information. Red Roof Inn (Loudon): 225-8399 Comfort Inn (Concord): 226-4100 Holiday Inn (Concord): 224-9534 Best Western (Concord): 228-4300 Days Inn (Concord): 224-2511 Taylor Community Woodside Therapy Pool: 366-1226 Books and References Treat Your Own Back by Robin McKenzie Healing Back Pain: The Mind-Body Connection by John Sarno Mindfulness Meditation for Pain Relief: Guided Practices for Reclaiming Your Body and Your Life by Jon Kabat Zinn