Patient Handout: Preventing Low Back Pain

The American Academy of Orthopaedic Surgeons (http://orthoinfo.aaos.org) has developed tips to help you reduce your risk of back pain and injury. In this handout, you will find guidelines on how to lift heavy objects and exercises designed to strengthen and stretch your back, stomach, hip, and thigh muscles.

Are you at risk of low back pain/injury?

You are most at risk for back pain if:

  • Your job requires frequent bending and lifting.
  • You must twist your body when lifting and carrying an object.
  • You must lift and carry in a hurry.
  • You are overweight.
  • You do not exercise regularly or do not engage in recreational activities.
  • You smoke.

If you are a caregiver for an ill or injured family member, you are at greatest risk for back pain when:

  • Pulling the person who is reclining in bed into a sitting position.
  • Transferring the person from the bed to a chair.
  • Leaning over the person for long periods of time.

Learning how to lift heavy objects

Whether you are lifting and moving a person or a heavy object, the guidelines are the same.

  • Plan ahead what you want to do and don’t be in a hurry.
  • Spread your feet shoulder-width apart to give yourself a solid base of support.
  • Bend your knees.
  • Tighten your stomach muscles.
  • Position the person or object close to your body before lifting.
  • Lift with your leg muscles. Never lift an object by keeping your legs stiff, while bending over it.
  • Avoid twisting your body; instead, point your toes in the direction you want to move and pivot in that direction.
  • When placing an object on a high shelf, move close to the shelf. Do not stand far away and extend your arms with the object in your hands.
  • Maintain the natural curve of your spine; don’t bend at your waist.
  • When appropriate, use an assistive device such as a transfer belt, sliding board, or draw sheet to move a person.
  • Do not try to lift by yourself something that is too heavy or an awkward shape. Get help.

How to prevent back pain

  • Use the correct lifting and moving techniques.
  • Exercise regularly to keep the muscles that support your back strong and flexible.
  • Don’t slouch; poor posture puts a strain on your lower back.
  • Maintain your proper body weight to avoid straining your back muscles.
  • Keep a positive attitude about your life; studies show that persons who are unhappy at work or home tend to have more back problems and take longer to recover than persons who have a positive attitude.

Exercises to minimize problems with back pain

You can minimize problems with back pain with exercises that make the muscles in your back, stomach, hips, and thighs strong and flexible. Some people maintain good physical condition by being active in recreational activities like running, walking, bike riding, and swimming. In addition to these activities, there are specific exercises that are directed toward strengthening and stretching your back, stomach, hip and thigh muscles. Inhale deeply before each repetition of an exercise and exhale when performing each repetition.

[Before beginning any exercise program, you should discuss the program with your doctor and follow the doctor’s advice and directions. It is important to exercise regularly and warm up with slow, rhythmic exercises; if you haven’t exercised in some time, you can warm up by walking.]

Wall slides to strengthen back, hip, and leg muscles

Stand with your back against a wall and feet shoulder-width apart. Slide down into a crouch with knees bent to about 90°. Count to five and slide back up the wall. Repeat five times.

Abdominal contractions

Lie on your back with knees bent and hands resting below ribs. Tighten abdominal muscles to squeeze ribs down toward back. Be sure not to hold breath. Hold five seconds. Relax. Repeat 10 times.

Heel raises

Stand with weight even on both feet. Slowly raise heels up and down. Repeat 10 times.

Leg raises to strengthen back and hip muscles

Lie on your stomach. Tighten the muscles in one leg and raise it from the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg.

Leg raises to strengthen stomach and hip muscles

Lie on your back with your arms at your sides. Lift one leg off the floor. Hold your leg up for a count of 10 and return it to the floor. Do the same with the other leg. Repeat five times with each leg. If that is too difficult, keep one knee bent and the foot flat on the ground while raising the leg.

You can also sit upright in a chair with legs straight and extended at an angle to the floor. Lift one leg waist high. Slowly return your leg to the floor. Repeat five times with each leg.

Partial sit-up to strengthen stomach muscles

Lie on your back with knees bent and feet flat on floor. Slowly raise your head and shoulders off the floor and reach with both hands toward your knees. Count to 10. Repeat five times.

Single knee to chest stretch

Lie on your back with both knees bent. Hold thigh behind knee and bring one knee up to chest. Hold 20 seconds. Relax. Repeat five times on each side.

Hamstring stretch

Lie on your back with legs bent. Hold one thigh behind knee. Slowly straighten knee until a stretch is felt in back of thigh. Hold 20 seconds. Relax. Repeat five times on each side.

Back leg swing to strengthen hip and back muscles

Stand behind a chair with your hands on the back of the chair. Lift one leg back and up while keeping the knee straight. Return slowly. Raise other leg and return. Repeat five times with each leg.

Exercises to decrease the strain on your back

Exercise 1. Lie on your back with your knees bent and feet flat on your bed or floor. Raise your knees toward your chest. Place both hands under your knees and gently pull your knees as close to your chest as possible. Do not raise your head. Do not straighten your legs as you lower them. Start with five repetitions, several times a day.

Exercise 2. Stand with your feet slightly apart. Place your hands in the small of your back. Keep your knees straight. Bend backwards at the waist as far as possible and hold the position for one or two seconds.

Reprinted with permission from: The American Academy of Orthopaedic Surgeons. For more information, please see: http://orthoinfo.aaos.org.