Most people suffer with some degree of low back pain during their life. Back pain can affect all age groups, and it is increasing. Disability due to back pain has risen by more than 50% since 1990 (1). For nearly all people with low back pain, it is not possible to identify a specific cause. However, there are some common movement patterns which we identify in the clinic.
Discogenic low back pain
A common symptom reported by low back pain sufferers is discomfort across the lower back when bending forwards or after sitting for long periods of time at a desk. This type of back pain is what health professionals refer to as “discogenic low back pain”.
Discogenic pain means that one or more intervertebral discs are the pain source. Your discs are the cushion-like structures in-between each vertebra of your spine. Discogenic low back pain can cause mild lower back pain or in more serious cases, a lumbar disc herniation can result in symptoms such as sharp back pain, muscle spasm, leg weakness and sciatica. This happens when the gel inside the disc is squeezed out the back of the disc space and onto the spinal cord.
Discogenic pain is associated with activities that increase the pressure within the intervertebral disc. If you have an injury to your disc, bending forwards can cause the disc bulge out backwards and result in pain across the lower back. Moreover, when you’re in a sitting position, you place more load through the discs in your back. This is especially true if you are prone to slouching when sitting.
What can I do?
To oppose the pressure in your back after prolonged sitting or bending forwards, an exercise called a McKenzie Extension is great to help relocate the disc forwards. The McKenzie extension is a treatment established by New Zealand Physiotherapist Robin McKenzie, which has been used since the 1950’s (2). To do this exercise, simply lay on your stomach with your hands beside your head with your elbows bent, like you’re making a “W” shape with your arms. Use your arms to assist and push up, lifting your chest off the floor and extending your lower back. Make sure your hips stay on the floor and only come up to the point where you feel no more than a slight discomfort in the lower back. Hold this position for three seconds and slowly lower back down to the floor. Repeat this movement ten times. If your pain is new and severe, do this exercise every hour, gradually decreasing the amount of times you do it as your symptoms resolve. Eventually you may only need to do it after you have been sitting for a while. Click here to watch a video demonstration of this exercise.
If your back feels worse after this exercise then it may indicate a different pathology is present, and it’s worth booking in for a free consult to determine cause of your pain. Click here for a free assessment.
References:
1. Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., ... & Smeets, R. J. (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356-2367.
2. McKenzie, R., & May, S. (2003). The lumbar spine: mechanical diagnosis & therapy. Vol. 2. Spinal Publications New Zealand.