Novel coronavirus has affected many areas of our daily life, but perhaps none more so than work, with estimates ranging from 75 - 90% of Americans now staying at home versus working in the office (1). These workers are now confined to a home office, dealing with changes to their work station and ergonomics, and spending more time being sedentary - all things that put them at increased risk for low back pain. Low back pain is already a significant contributor to disability and pain in America, with the World Health Organization stating that it is the most common cause of musculoskeletal pain and the leading cause of disability worldwide (2). Estimates from the National Institutes of Health suggest that up to 80% of Americans will experience low back pain at some point in their life, and of these, a significant number will experience missed work days and a loss of income due to their pain (3).
What can stay-at-home workers do?
A 2016 study looked specifically at 70 stay-at-home workers with low back pain, with the goal of finding the most effective method of treating their pain and keeping it away for the longest period of time possible. This study randomly assigned the workers to either a group that performed standard strength training, like push ups or sit ups, or to a group that performed exercises aimed at stabilizing the lumbar spine. These lumbar stabilization exercises were based on many of the principles of Pilates, and included both dynamic movements and static positions, held for 6 - 20 seconds at a time.
Participants did their exercises only twice a week, for 45 minutes each session. Participants were asked to do their assigned exercises for 20 weeks.
At the end of the 20 weeks, it was clear - both sets of participants experienced significant reductions in their low back pain. Researchers followed up with participants for a few weeks after the program ended, though, and found that the participants who had done typical strengthening exercises began experiencing more discomfort after about a month. Participants who had done the lumbar stabilization exercises, however, went three months without any discomfort.
Dr. Kliziene, the author of the study, noted that other studies have shown the benefits of a lumbar stabilization program lasting even longer:
“There are studies proving that after a year, lower back pain returned only to 30% of people who have completed a stabilization program, and to 84% of people who hadn’t taken these exercises. After three years these proportions are 35% and 75%.”
Why does lumbar stabilization work?
Traditional strength exercises tend to work on the muscles that we can see, like the trapezius muscles of the upper back and shoulders, or the rectus abdominis muscles (the “6 pack” muscle) of the abdominals. But these muscles are relatively superficial - meaning they’re closer to the skin than they are to the bones and joints.
Stabilization exercises aim to target the deep muscles of the low back and core. These muscles are very close to the spine - often right up on it - and therefore not typically visible to us. But their proximity to the spine gives them an advantage when it comes to supporting the low back.
Dr. Kliziene’s study on lumbar stabilization exercises took ultrasound-based measurements of some of these deep muscles, in particular one called the multifidus. After just one month of lumbar stabilization exercises, the multifidus was shown to already be larger and stronger than it had been at the start of the study. By the end of the study, the multifidus muscle was significantly bigger in people who had completed stabilization exercises than in people who had done the traditional strengthening exercises.
How do I get started?
Dr. Kliziene’s lumbar stabilization routine is based on Pilates-type movements. Pilates-type workouts would be a great place for the at-home worker to start. But to ensure a comprehensive evaluation and a lumbar stabilization program tailored to your individual needs, consider an evaluation with a physical therapist at Pearl Physical Therapy. Many insurances now cover electronic video conferencing physical therapy services, or telehealth, and Pearl Physical Therapy is proud to announce that we are offering telehealth services to our Plattsburgh and North Country community. Getting a telehealth evaluation ensures that you can start working on your goals for your lumbar spine as soon as possible from the safety of your home. Call us at (518) 563 - 7777 or drop us a line in our contact us box to discuss your goals and set up an evaluation.
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