Managing Chronic Lower Back Pain: Rehabilitation Tips and Exercises

Lower back pain?

I would like to consult a physician regarding my lower back pain, which has persisted for about a month.
It is particularly noticeable when I wake up, and occasionally occurs after prolonged sitting or sneezing, but not every time.
Currently, I do not experience discomfort while running or walking in my daily activities.
A few days ago, I visited an orthopedic doctor, and after an X-ray, the doctor indicated that my bones appear normal and there is no herniated disc.
It seems more like lumbar fasciitis.
The treatment involves medication, and the doctor advised that continuing to run could be beneficial for my fascia recovery.
However, I forgot to ask a few questions during the appointment, so I am reaching out here.

1.
Is it advisable for me to continue exercising normally, such as running and core workouts (like planks)?
2.
I forgot to ask the doctor whether I can do or if there are recommended electrical stimulation therapies and cat-cow stretches as part of my rehabilitation.
3.
Does this sound like fascia inflammation, and what rehabilitation methods and precautions would you recommend? Currently, I am elevating my knees and placing a towel under my lower back while sleeping.

I apologize for the many questions, and I appreciate your help!

jerry, 30~39 year old female. Ask Date: 2023/06/27

Dr. Wang Zhaomin reply Rehabilitation

This is a consultation platform and cannot provide diagnoses or treatment methods.
Each individual's condition is different and cannot be generalized.
Generally, patients with myofascial pain syndrome can engage in basic stretching and gentle exercises.
Jogging and core muscle training can be performed based on individual circumstances.
For further rehabilitation, please visit a rehabilitation specialist; appropriate rehabilitation treatment can only be arranged after an in-person evaluation.
When sleeping, it is advisable to slightly elevate the knees, but it is not suitable to place objects under the lower back, and an appropriate mattress should be chosen.

Reply Date: 2023/06/27

More Info

Managing chronic lower back pain can be a challenging journey, but with the right rehabilitation strategies and exercises, you can significantly improve your condition. Based on your description, it seems that your lower back pain is likely related to myofascial pain syndrome, which is characterized by muscle tightness and discomfort in the fascia surrounding the muscles. Here are some tips and recommendations to help you manage your pain effectively.

1. Continuing Physical Activity
It’s great to hear that you can still run and walk without discomfort. Regular physical activity is crucial for maintaining mobility and strength, especially when dealing with lower back pain. Running can actually help improve blood flow to the muscles and promote healing. However, it’s essential to listen to your body. If you experience pain during or after running, consider reducing the intensity or duration of your runs.

In addition to running, incorporating core-strengthening exercises, such as planks and bridges, can help stabilize your spine and support your lower back. These exercises engage the abdominal and back muscles, providing better support for your spine during daily activities.

2. Recommended Rehabilitation Techniques
Regarding your inquiry about electrical stimulation (electrotherapy) and cat-cow stretches, both can be beneficial for managing lower back pain.
- Electrical Stimulation: This therapy can help reduce pain and promote muscle relaxation. It works by sending electrical impulses to the affected area, which can help alleviate discomfort and improve muscle function. If your healthcare provider recommends it, it can be a valuable addition to your rehabilitation plan.

- Cat-Cow Stretch: This gentle yoga stretch can help improve flexibility and relieve tension in your back. To perform this stretch, start on your hands and knees in a tabletop position. Inhale as you arch your back (cat position), and exhale as you round your back (cow position). Repeat this sequence for several breaths, focusing on the movement of your spine.

3. Understanding Myofascial Pain and Rehabilitation
Myofascial pain syndrome can indeed cause inflammation in the fascia and surrounding muscles. Here are some rehabilitation strategies and precautions to consider:
- Stretching and Flexibility Exercises: Incorporate gentle stretching into your daily routine. Focus on stretches that target the lower back, hips, and hamstrings. Hold each stretch for 20-30 seconds and repeat 2-3 times. Be cautious not to push into pain; stretching should feel relieving rather than painful.

- Strengthening Exercises: In addition to core exercises, consider incorporating lower body strengthening exercises, such as squats and lunges, to support your back. Strengthening the muscles around your pelvis and hips can help alleviate strain on your lower back.

- Posture Awareness: Pay attention to your posture during daily activities, especially when sitting for extended periods. Use ergonomic chairs and maintain a neutral spine position. Elevating your knees while sleeping, as you mentioned, can also help maintain spinal alignment.

- Heat and Cold Therapy: Applying heat to your lower back can help relax tight muscles, while cold therapy can reduce inflammation. Consider alternating between heat and cold packs based on your symptoms.

Conclusion
In summary, it’s essential to maintain an active lifestyle while being mindful of your body’s signals. Continue with your running and core exercises, and consider integrating electrical stimulation and gentle stretches like the cat-cow into your routine. Always consult with your healthcare provider or physical therapist before starting new exercises or therapies to ensure they are appropriate for your specific condition. With consistent effort and the right approach, you can effectively manage your chronic lower back pain and improve your overall quality of life.

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