Everyday Tips for Low Back Pain...
What you wear matters:
Wear comfortable, low-heeled shoes.
▪ Do not carry a wallet in
your back pocket. This simple fix can
save you a whole lot of trouble in your low back.
Move, and move often:
regularly. A sedentary lifestyle contributes to low
back pain. Seek out low impact exercise such as swimming, walking, water
aerobics, yoga, and pilates.
▪ Try to maintain a healthy
lifestyle and weight. Excess weight
aggravates low back problems.
▪ This old
adage holds true: if you have to lift things, lift from
your legs, not your back. A trick to help you do this is to tuck your
under (meaning do not let your butt stick out) - you will feel your
muscles kick in and this will give you added support while you lift. Try
hold the object close to your body and avoid twisting.
▪ If you
to stand for long periods of time (at work or while
doing the dishes for example), rest 1 foot on a low stool to relieve
in the low back. Change feet whenever you start to feel tension in the
back, or every 5 to 10 minutes or so. Try to maintain good posture when
standing - keeping the belly gently
pulled in and the shoulders slightly back will help.
Sleep and Back Pain:
Invest in a mattress with good support. A sagging mattress
stresses muscles in the low back and can set you up for trigger points
If you sleep on your side, place a pillow between the knees.
This relieves pressure on the low back and the buttocks.
sleeping on your stomach if you have low back pain. If you
absolutely must, try placing a thin pillow under the hips to relieve low
▪ If you sleep on your back, try placing a pillow
knees. This restores the spine's natural curve and relieves tension.
Sit in a chair with good lumbar support. Get up to stretch and
walk around as much as possible for as long as possible (this could mean
simple changes like going to the bathroom furthest from your desk,
further away, and taking a brisk ten minute walk during your lunch
small pillow or rolled up towel under the low back may provide extra
while seated (while driving for example). Resting the feet on a low
▪ Avoid crossing legs while seated. If you must,
▪ Self treatment is tricky for the low back, but it can be
helpful. Try a tennis ball under one side of the low back or buttocks at
while lying on the floor or another firm surface. For the buttocks
(gluteal muscles), a tennis ball
against a wall while standing also works very well. Gently move over the
to apply pressure to your active trigger points. Special tools are also
sold to aid in
self massage - ask your myofascial pain therapist which tools they
be very therapeutic. If you don't like to use a heating
pad, try a hot wattle bottle or a rice sock (fill an old sock with rice
heat it in the microwave for a minute, it can be reused many times). Try
heat for at least 10 minutes at a time.
any considerable leg length discrepancy if one exists by
wearing a lift in one shoe. Your Myofascial Trigger Point Therapist can
help you determine if you have a leg length discrepancy.
down to put on pants and shoes. Extreme
bending (and worse, trying to catch a fall) can seriously irritate the
of the low back and buttocks.
Muscles Involved in
Low Back Pain and Stretches That Can Help:
Stretching is an integral part of
successful therapy. However, not
every muscle listed is necessarily involved in your low back pain, and
other than those listed may be contributing to your pain. The most
thing to remember that these tips and stretches are just meant as a
certain stretches may be contraindicated in your case. Please talk to
your Myofascial Trigger Point Therapist about which stretches would be
the most helpful, and which, if any,
you should avoid. Listening to
your body is paramount - if something does not feel right to you, just
The muscles covered will be
1. Quadratus lumborum
3. Gluteal muscles
Lumborum Muscle and Trigger Point Referral Pattern The
Lumborum is a common source of pain in both the low back and the
buttocks. The "QL" is primarily used for maintaining upright posture and
sideways. The QL is aggravated by prolonged periods of sitting and by a
pelvis - sitting with legs crossed to one side for example.
movements that involve twisting the torso, such as sweeping floor,
and shoveling snow aggravate MTrPs (myofascial trigger points)in the QL.
lumborum trigger points are often found
together with trigger points in the gluteal muscles.
Pain is likely
to be felt along the crest of the ilium (along the top of the
pelvis), in the low back and sacro-iliac joints, in the buttocks and in
is generally deep, dull, and aching, but may be sharp during movement.
sneezing can be extremely painful.
for quadratus lumborum (c)
Muscles Trigger Point Referral Pattern
group: Erector Spinae (Longissimus and Iliocostalis)
Semispinalis, Multifidus, Rotatores
muscles all fall under the group 'Paraspinal muscles'. They consist of a
superficial group of muscles that run longitudinally (parallel) along
length of the spine, and a group of deeper muscles that are much shorter
run diagonally to connect the vertebrae. These muscles primarily extend
spine and contribute to rotation of the spine to some extent
points may occur in these muscles at any point along the spine. The pain
produced by these trigger points is often felt locally, however, some
points in these muscles send pain to the SI region or down into the
(see picture). Pain from these muscles groups may also be felt in the
The pain is often unilateral (one-sided), and is felt as a deep ache in
spine. The pain can be quite intense, and often feels as if it is coming
from the bones rather than the muscles. Trigger points in the deep,
short, spinal muscles can even pull
vertebrae out of place. The pain from MTrPs in these muscles often
spinal motion and a person's activity, making it especially difficult to
from a chair or climb stairs facing front.
twisted to one side can aggravate the deep spinal muscles. As can quick,
awkward movements, particularly those that involve bending and
twisting. These muscles are also very sensitive
to repetitive strain.
Tip for Problems with the Paraspinals:
walking or jogging on slanted ground or slanted beach.
for Low Back
and lift head
back and tuck chin toward chest
Gluteus Maximus, gluteus medius, gluteus, minimus
gluteals are very important muscles - essentially they allow you to walk and
move your legs in, out, and back. Surprisingly, the gluteal muscles are also a
very common source of low back pain - the main offender among them is the
gluteus medius. Pain is usually felt as low back pain, but is also felt over
the sacrum as well as over the buttock. The gluteus maximus can also refer pain
to the low back.
with MTrPs in the gluteals will usually complain of pain while walking, lying on
the back of the affected side, and when sitting in a chair.
Sleeping on the side without support between the
legs is particularly aggravating to the gluteals, as is sitting too long in one
position. The stop and start pace of tennis can also set up MTrPs in the
piriformis refers pain to the sacroiliac joint region, the buttock, and over
the posterior hip joint.
car for long periods with the foot on the accelerator can aggravate the
piriformis. In this position the foot is usually rotated outward,
contracting the piriformis.
and Piriformis Stretch:
Ilio-psoas consists of two muscles: The psoas (pronounced so-az), and the
iliacus. The Ilio-psoas flexes the thigh at the hip and helps maintain upright
posture. The iliacus primarily refers pain to the lower abdomen, front of the
hip and upper thigh. The psoas refers pain to the lower back and is an often
overlooked, major contributor to low back pain.
Pain is distinctive with psoas trigger
points - they create a vertical pattern of pain from the bottom rib down to the
SI joint. Pain is usually more intense when standing and less when seated.
Difficulty may be noticed when trying to
get up from a seated position, especially one that is deep seated like a very
with knees above the chest and sleeping in the fetal position shorten the
iliopsoas and may activate MTrPs.
tip for Iliopsoas problems:
your chair into a slightly higher than normal position, so that the knees are
lower than hips. This can help relieve tension in the psoas. Iliopsoas Stretches (easy to hard):