Fix Low Back Pain with Lumbar Extensions

Dr. Jeffrey Jones, DC

Hey everybody, it’s Dr. Jones here from SpineCare Chiropractic in Madison, Alabama. I want to talk to you a little bit about what to do when you’ve got back pain. 

So I want to provide a little clarity in figuring out what those first steps are and what are the things you should be doing, and sometimes more importantly, what are the things you should not be doing.

When you’ve got mechanical pain of the low back, the majority of the time it’s going to have a specific direction that it likes to move versus all other movements. Or all the, all other directions of movement.

This is not to say that every low back pain patient that we see is going to get better moving in these one, this one specific direction I’m going to show you, but it is a really, really good starting point that’s going to resolve a lot of the low back pain that we see and it’s also going to be a good starting point even if it’s not the thing that resolves it. It’s going to be a good starting point to start that process of getting you moving in the right direction or expose another movement that you might need to do to get the full resolution of that, that low back pain.

Now, the movement that I’m talking about is called lumbar extension and there’s a couple different ways that we can get there.

Now, the most common way, the most common version that we’ll give to patients is simply lying down and doing a prone press-up. So, what we’re doing is starting on the belly, low back’s relaxed, glutes are relaxed, legs are relaxed, everything except the arms should be totally relaxed as we work to press up into this position. Let the air out, let that low back sag into full extension.

Now, if your low back pain is really acute, you may find that you can only go up to there before it gets really intense and that’s fine. I tell my patients all the time what we’re doing is just bumping up into where you feel that pain, teasing into it a little bit and then letting that pressure off. And you may find that over the course of 8, 10, 15 repetitions, you can go a little bit further and a little bit further and that back pain starts to decrease or that leg pain starts to recede up towards the back, which is a really, really good clinical sign.

For patients who have, I always call it older, stiffer spines, they tend to do a little bit better with having some type of stiff fulcrum to lean back against. So, sometimes it’s a kitchen countertop, a workbench, something sturdy that hits you, somewhere around belt line or so, a couple inches above or below is close enough and what we’re doing is leaning the body weight against that fulcrum and we’re bending back as far as we can go. Same rule applies. If you start with this and right there, it starts to get really intense, that’s it.

That’s all the movement requires is for you to bump up into where that barrier is and typically, you’ll find with mechanical low back pain that we are able to get a little bit further with each repetition.

Now, the most common recommendation, if one of these movements is beneficial, we’re starting to get increased range of motion, decreased pain, decreased leg symptoms. I’ll tell my patients to go home doing 10 repetitions every two or three hours and that’s not a forever kind of a thing. Usually, it’s a handful of days and then we can start decreasing that dose back a little bit but if you’re finding that direction to be really helpful in reducing your pain, it’s something that you’ll need to do a handful of times throughout the day.

Now, the flip side of that too is typically, if you’ve got that one direction of movement that’s really beneficial, movement in the opposite direction tends to have the opposite effect. So, a lot of times, that’s forward bending, it’s slouch sitting, putting on the socks and shoes, picking up the kids, feeding the dog. You can see how often we start going that direction. So, it’s really, really important to be aware of how often we’re going there or trying to limit the amount that we’re going in that opposite direction to make sure that you’re getting the full benefit out of actually doing those lumbar extensions if they’re helpful.

So, I hope this helped clear up a little bit of confusion around, you know, those first couple days of having low back pain can be really frustrating because it can feel like it’s getting better and feel like it’s getting worse and you don’t know why. Usually, it’s because you have that directional preference, we call it, of low back pain and we’re not maximizing that or limiting the things in the opposite direction or we’re treating the wrong type of pain. We can throw all the anti-inflammatories in the world and mechanical low back pain and it’s not really ever going to get better because it’s not the right treatment type.

If you’ve got questions on this or if you’re trying these exercises and you’re finding that you’re not getting the benefit that you were hoping for, that you thought you were going to get, please come see us, we’d be happy to help you navigate that.