Ask Our PT – Low Back Pain

Question:  My lower back has been bothering me for the past several weeks.  I am extremely stiff first thing in the morning and have a really hard time standing up straight or bending forward to put on my shoes.  It seems to loosen up during the day but gets very achy and painful in the evenings after work.  Currently I am working as a contractor and have been doing lots of flooring jobs which seems to be making things worse.  Thanks for your time.  


Ask Our PT Answer: 

Non specific low back pain such as yours is very common, especially in people that have a job requiring them to bend forward repetitively throughout the day.  The pain you have is likely coming from your intervertebral disc.  This disc is situated inbetween the vertebrae throughout your spine.  When you bend forward this disc bulges slightly backward.  This is normal for the spine, however if you tend to bend forward many times more than you bend backward throughout the day these discs will begin to deform.

There are many levels of severity for pain arising from the intervertebral discs of your spine.  Initially you may experience dull achy pain across your lower back (the left and right side may be equal in severity or there may be a significant assymetry in pain intensity).  As the disc bulge increases you may experience pain in your buttock or thigh region.  Ultimately if the bulge is severe enough to bother the neighboring nerve structures you may experience “Sciatic” pain shooting down below the knee.  It sounds to me that you are in the first stage of this progression.  Treatment in this stage consists of finding a balance in your daily life between forward and backward bending of your spine.  If your job entails that you are in a forward bent position for most of the day you may have to schedule specific breaks in your day and gently bend backwards several times to help restore balance.  This backward bending exercise/protocol is commonly called “McKenzie” therapy (named after the Physical Therapist who made this approach famous).  Additionally hip stretching is often invaluable in the treatment of back symptoms like yours as it takes force and pressure off the spine ultimately helping to prevent reaggravation during movement.

It is important to note that if you begin to have pain down your leg, especially below your knee it is imperative that you contact a Physical Therapist or medical doctor to ensure that your nerves have not been damaged and more aggressive treatment is not necessary.  Hope this helps and thanks for writing!

Jeff Moore, DPT, MTC

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