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Did you know up to 85% of people will suffer lower back pain throughout their lifetime. There are many different structures whereby pain can exist or originate from, including tendons and joints, vertebral discs, muscles, nerves and bones. This article aims to give you some tips to self manage long term lower back pain. Long term back pain > 3-6 months - usually this is signified by constant aching especially when initiating movement, eg getting up from a chair after prolonged sitting. Pain may tend to be hard to locate as it will move around each time you notice it. You may feel that you live with a heat pack on, as it is the only thing that seems to help.

The Brain - which is where pain signals are felt, the pain receptors in the back are hyped up and over active which signals the brain with increased pain inputs. The brain then responds by telling all the muscles around the lower back tense up in an attempt to protect the area. Tightness of all muscles in the lower back which start to compress the vertebral joints causing inflammation and pain. This will then lead to posture changes such as anterior tilt of the pelvis (rolling the bum out) so the muscles don't feel as tight. This may feel better initially although, the problem here is that now there is a lot of force going through the front of the hip and thigh which often leads to knee pain. Usually this pain is coming from two major sources:

THE FIX - It is very well studied and absolutely conclusive that the best thing to do here is to be active and move. Walking (as physically tolerable) is great for this as it increases blood to the lower back muscles which helps them relax. Also it enables the vertebrae bones to move which reduces stiffness and pain. Furthermore by walking and increasing blood circulation, this helps to remove inflammation from the affected area.. So when in doubt, go for a short walk. Another great whole body exercise is hydrotherapy - a fancy word for saying go for a walk in water. This is great to take pressure off the muscles and joints, due to buoyancy of the water it reduces stress on the joints by up to 30%. Therefore it will enable the body to move with less protective pain signals by the brain.

STRETCHES - although it may hurt at first as you should settle as the muscle relaxes if you can hold each position for 1 minute is ideal, and repeat stretches 3-5 times daily. Common stretches I give clients for long term back pain are: Hamstring, quads, hip flexor (psoas), lower back (child's pose).

EXERCISES - This is the most important part, as strengthening will enable long term change. The initial exercises I give my clients in the early phases of long term lower back pain are bridge rolls, knee rocks, dead bugs, roll downs, band pull apart. Remember the brain will not like you initially as it is in protective mode and will most likely signal that these movements are painful. With long term lower back pain be assured that structurally there is no injury anymore to the lower back itself. If there was a previous injury usually they have actually healed at the site of the lower back.

FINAL NOTE - This article is not meant to replace the need for medical advice and there can be many instances whereby getting checked out by a physio is important such as, if you're having fevers, general fatigue constantly, pins & needles down the legs, pain coughing/sneezing, localised catching pain walking, numbness, or if pain continues to worsen with these exercises it is important to see your physio for a professional assessment. - MATTHEW HEARN - PRINCIPAL PHYSIOTHERAPIST

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