Back ache? 5 tips this physiotherapist says you should try

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Whether your back ache is caused by bad posture or being hunched over a desk, physiotherapist & Healthista Collective Expert Finola Burrell reveals five ways you can alleviate back pain for Back Care Awareness Week 
Pain in the lower part of the back is one of the most common problems that I see as a physiotherapist, and everyone has a slightly different experience.
That said there are also some common exercises and methods which in most cases work really well at alleviating lower back pain
What is lower back pain?
The most common form of low back pain is what we call ‘non-specific low back pain’.
About 80 per cent of the world’s population will experience back pain at some point in their lives and in the majority of cases is not due to anything sinister.
80 per cent of the world’s population will experience back pain at some point in their lives
A diagnosis of non-specific pain is an extremely vague diagnosis, but essentially it means that your pain is due to a variety of factors. The pain is usually localised around the lumbar region of your back and also potentially the sacral area.  
Common causes include: 

Lack of mobility during the day, or staying in one position/posture for long periods 
A sudden increase in activity or exercises without allowing time for the muscles to adapt 
Stress, anxiety and/or depression 
Discogenic pain (pain arising from a disc within your spine) 
Occupations that require a lot of twisting under load
General poor lifestyle habits such as poor sleep  

What about disc bulges? 
Health professionals are now trying to avoid reinforcing the need for scans such as Magnetic Resonance Imaging (MRI) and the use of phrases such as ‘disc bulge’ and ‘degeneration’.
even if you do have a disc bulge, physiotherapy and modified exercises are usually recommended
This is because an MRI is known to show a high prevalence of ‘abnormal’ findings in asymptomatic individuals (such as arthritis, disc bulges and bony spurs). These findings are normal of age-related changes to the body and do not necessarily require ‘fixing’.
In most cases, even if you do have a disc bulge, physiotherapy and modified exercises are usually recommended and are very helpful.
Imaging however should be considered for cases where neurological symptoms (nerve related) are progressing, or if there are signs of more concerning pathology.
Please see a health professional if you experience any of the following symptoms: 

Unexplained weight loss
Constant, progressively worsening pain
Numbness or changes in sensation in both arms or legs  
Numbness or tingling around your genitals or buttocks
Recent trauma (eg: a fall from a height, road traffic accident) 
Previous diagnosis of cancer
Changes in general health – feeling unwell
Difficulty voiding or controlling bowel and/or bladder movements
Saddle anaestheisa (loss of sensation in the genital areas)  
Widespread weakness in the legs or difficulty walking
Chest pain
A high temperature of 38°c or above
A swelling or a deformity in the back
It does not improve after resting or is worse at night

Back ache relief techniques
#1 Heat therapy, muscle rubs and lumber support 
Applying heat to the buttock or area of pain for 10 to 30 minutes can be very helpful in desensitising the nerve pain.
For example a hot water bottle or warm bath/shower, can be great at temporarily relieving pain. 
Although this is usually only for temporary relief it can at least allow your muscles to relax and for you to perform your exercises with less pain.
Muscle rubs can also be very helpful as these too apply heat to the area. Oh and don’t forget to use a cushion or pillow for some lumber support. 

#2 Regular movement at work 
No matter how good your posture is we don’t like being still for too long.
When I tell my patients that they have to move regularly, and I mean every 20-30 minutes, they look at me like I’m crazy! However the benefits of regular movement are huge and can be a life saver when at work.
the benefits of regular movement are huge and can be a life saver when at work
Try setting a reminder on your phone for every 20-30 minutes, then do simple movements for a couple of minutes for example, stand up and down on your toes, perform mini squats, lean side to side, shrug the shoulders, or walk to fill up your water bottle.
This might seem like a lot but it becomes a good habit and won’t interfere with your day. 
#3 Stress management
Stress, anxiety and depression are key factors in pain, and particularly effect back pain.
Finding time each day to do something you know relaxes you, or makes you feel calmer or happier is just as important as the exercises.
If we are stressed or anxious, our fight/flight response is activated and more sensitive. One of the effects of this is that our muscles tighten which can exacerbate pain.
We also know that changes in mood can heighten our pain perception and so taking time to focus on our mental well being is vital for back pain recovery.
If you do have symptoms of anxiety or depression, remember there are health professionals out there who can help. 

#4 Key stretches for back ache
In most cases there is nothing to worry about and most back pain does resolve with specific exercises and pain relief techniques.
These exercises may be a bit uncomfortable but please don’t push through pain.
Aim to do these every day, and if possible a few times per day! 
Child’s pose – Hold for five breaths 
Cat/cow – x3 each way 
Reverse pigeon – Hold for 30 seconds each side. 
Read More: 5 back stretches to help relieve desk hunch
For a flow of additional stretches you can follow, try the below:

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BACK PAIN STRETCHES . This week @hannahbarrettyoga and I have definitely needed to utilise each other’s skills to help us with our own problems. Han has been having back pain and sciatica type symptoms, whilst I have been very stressed these last couple of weeks (plus have damaged myself falling off of my bike so full pity party going on here). I’m showing the back stretches that I’ve recommended to Han, whilst she’s showing a stress and anxiety relieving restorative #yoga flow on her page. Try this flow a couple of times per day even if you haven’t got back pain, as it can be a good preventative. . #Backpain is affected by so many things and during this pandemic I’ve had a lot more patients complaining of back pain. Some reasons for this could include: 🤔Stress & anxiety resulting in a fight/flight response which increases muscle tension and pain, 🤔Lack of movement due to working from home and so the morning commute or walking to the toilet/coffee shop/or getting out for lunch, 🤔Sustained postures at the desk, even if it’s a good posture or a standing desk. We’re not made to stay still for long periods of time (check my stories to see a 2 minute desk stretch you can do yourself at home). . In our @strengththroughyoga eguides we include both mind and body exercises which can help common issues such as back pain. We also have our new short guide “Mindfulness & Connection Toolkit” recently released, providing audio and video meditations to help with stress and anxiety further. If you have back pain and had a recent trauma, any other unusual symptoms, it’s not improving or it’s worsening then please see/speak with a health professional. . #strengththroughyoga #physio #fitspo #physiotips #restorative #sciatica #stretches #deskstretch #sciaticarelief
A post shared by Finola Burrell (@finolaphysio) on Jul 23, 2020 at 8:46am PDT

#5 Key exercises to strengthen core 
Try these exercises three times per week with a day break in between.
On these ‘rest’ days, try other gentle forms of exercise such as a 30 minute walk or a swim. 
Strengthening of our muscles around our lower back and pelvis is equally as important as stretching, not only to help with the recovery from back pain but also as a preventative. 
In particular, strengthening the gluteals and the deep abdominal and pelvic floor muscles is great at giving you a strong base. 
Shoulder bridge – repeat ten times

Squeeze your glutes/buttocks as you gently lift your hips up towards the ceiling.
If this too painful, start by keeping your hips on the floor and squeeze your glutes in this position for ten repetitions instead until it starts to feel easier to bridge.
Bring your heels in towards your sit bones if you find you have cramp in your hamstrings/the back of your thighs. 
Side lying hip raises x10 each side
Keep your hips facing forwards and try to avoid letting your top hip roll backwards as you slowly lift your top leg up towards the ceiling and back down again.
Try to keep a gap between your lower waist and the mat to keep your spine in a neutral alignment.
Bird dog modified x5 alternating each leg
Come into tabletop. Breathe in, then as you breathe out to engage your core by pulling in your lower stomach muscles, and pulling up your pelvic floor (imagine trying to stop yourself passing urine and flatulence).
Once you feel this is engaged, gently extend your right leg back aiming to keep your pelvis still.
If you have to keep your leg low to begin with this is fine, you want to concentrate on keeping your core engaged and your pelvis stable. 
 Finola Burrell is a physiotherapist based in London who is passionate about giving people the knowledge and tools to help them lead the life they want, without pain or injury stopping them.
Since graduating from King’s College London, Finola has gained additional qualifications as a Pilates teacher, in women’s health physiotherapy, acupuncture and in psychological therapies for pain.
Together with yoga specialist Hannah Barrett, she has co written a postnatal yoga based fitness guide, Strength Through Yoga, to inspire and help women regain strength in both body and mind after having a baby.
Follow Finola on Instagram @finolaphysio
You can find Strength Through Yoga guides here, including their most recent Mindfulness and Anxiety Toolkit guide. 
More from Finola:
5 easy steps to help sciatica – the physio’s guide
5 back stretches to help relieve desk hunch
Relevant Healthista content:
8 sciatica treatments that don’t involve drugs
Got back pain? This hand reflexology can help quickly
Got back pain? This 10-minute yoga sequence will help

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