Pain in the Lower Back

If you've ever experienced either a sharp pain or dull ache in your back, your not alone. An amazing 8 out of 10 Americans experience low-back pain at some time in their lives, often on a recurring basis.

The causes range from stress, inactivity, and poor posture to physical injuries and diseases such as osteoarthritis. Recovery from most cases of acute back pain may take from three days to three weeks.

However, regular exercise is not only effective in the prevention of low-back pain but it's also a simple self-help measure for providing relief from the pain you may currently be experiencing.

Many people suffering from low-back pain lack adequate levels of flexibility, or strength in the muscles surrounding the lower back. Exercise will help to correct or improve these deficiencies.

Starting an Exercise Program
At the onset of low back pain, most patients are usually advised to rest. This relaxes the muscles and to allows any inflammation to subside. You should avoid bed rest that exceeds four days, however, because it can weaken muscles.

When the acute pain has improved, you can begin some low-impact exercises like biking, walking and swimming. After a couple of weeks, you should start some conditioning exercises that strengthen your trunk and abdominal muscles.

• Perform low-impact cardiovascular exercises, which place minimal stress on the joints. Aerobic activities such as walking, swimming and bicycling are ideal.
• Exercise three to five times per week for 20 to 30 minutes per session.
• Start slowly and gradually build endurance to a comfortable level. The first three to five minutes should serve as a warm-up to give your body the necessary time it needs to get used to the activity. Tight back muscles subjected to sudden or jerking motion are easily strained.
• Continue at a comfortable pace that allows you to talk without difficulty and not perspire profusely.
• Always slow down for the last three to five minutes of exercise to allow the blood to return from the working muscles to the heart and for the body to return to its resting state. Never skip this cool-down.

Muscular/Skeletal Fitness
A weight-training program, which strengthens muscles and bones as well as improves shape, should be monitored and should consist of low-intensity, high-repetition sets. Strengthening exercises should be targeted at the shoulders, back and abdominal muscles.

When performing weight-training exercises, make sure that your lower back is fully supported.

Two or three days of weight training are recommended. The exercises should be performed on non-consecutive days, such as Monday, Wednesday and Friday.

• Avoid jerky movements when performing the exercises. Instead, do slow and controlled movements.
• Use a comfortable weight that allows between eight and 15 repetitions per set. Besides being harder to control, heavy weights can damage a weak or injured back.
• As you make progress, increase the number of repetitions and then start increasing the weight of the resistance. Be sure you increase the volume and intensity no more than 10 percent a week.
• Perform one or two sets of eight to 10 different exercises (eight to 15 repetitions per set), targeting the major muscles groups, especially those of the back, abdomen, upper legs and shoulders.
• All your exercises should require the muscles to go through their full range of motion for maximum benefit.

Strengthen your abdominal muscles
Modified sit-ups are recommended for strengthening the abdominal muscles, which support the lower back.

1. Lie on your back with your knees bent and your feet on floor. With your hands behind your head for support, lift your shoulder blades off the floor and slowly return to the starting position. Start with one set of 12 to 15 repetitions, then add one or two repetitions each session, working up to 40 total.

To help improve your flexibility try these basic lower back stretches:

1. Lie flat on your back with your knees bent. Flatten your lower back against the floor by contracting your stomach muscles (abs). Gently pull both your knees into your chest as shown. Hold this stretch. Exhale slowly, and gently release.
2. Lie flat on your back. Keep your knees bent if your lower back bothers you). Gently lift one knee to your chest and hold it there with your arms. Hold for 30 seconds. Release and stretch the other leg.

**Be sure to consult with your physician, a physical therapist or a qualified fitness professional to design an exercise program that suits your specific needs.

Stephanie Oakes is a fitness correspondent for Discovery Health Channel, a contributing editor for USA Weekend Magazine and the LA Times, and appears on NBC's 'Today in New York'. She can be reached at soakes@beststuff.com.