Low Back Pain And Sciatica – Functional Limitations

The problem with low back pain and sciatica, is that the lower back itself and surrounding area is so important with regards to any movement or activity you become involved in. It is not like when you have injured an arm or a leg, where you can rest the arm in a sling or use some crutches for your leg in order to allow healing to take place, with low back pain you are not afforded that luxury.

With regards to functional activities, the first thing which needs to be addressed is to divide them into two categories:

i) Those which cause or aggravate your low back pain or sciatica.

ii) Those which cause you no pain or do not increase your pain at all.

The chances are that there is a common factor linking the components of each of these two groups.

For example, let’s say sitting down aggravates your low back pain yet keeping upright and a small amount of walking eases your pain. We are going to be thinking along the lines of flexion activities being the aggravating factor for your low back pain and extension type activities being the easing factor.

With this above example, first and foremost we need to modify or temporarily avoid the aggravating factor i.e. sitting down. Now I am not suggesting you do not sit down at all during the day, but rather you try and sit in a more upright chair, with say a rolled up towel for some support for your lower back. In addition to this, I would also recommend that you spend no longer than a maximum of 15-20 minutes sitting down without break i.e. getting up out of the chair.

Moving on to encouraging the easing factors, and once again using the above example, I would suggest you try to have a little walk a few times during the day. This can be anything from a few minutes to say 20 or 30 minutes, depending upon the severity of your pain. The important thing is your low back likes this activity and therefore it is important to provide it with it, as it will be providing you low back with the optimum conditions for it to heal itself.

NB. You can get too much of a good thing, therefore do not just walk for the sake of it. For example, if your low back pain eases after 5 minutes walking, but becomes aggravated after 10 minutes, feel free to walk for 5 minutes, but not too much longer (otherwise you will be simply interfering with the healing process again).

With regards to aggravating and easing factors, it is important to be as specific as possible. Therefore,using the example I have just given, walking for 5 minutes is an easing factor, yet walking for 10 minutes is an aggravating factor.

The main principle is little and often throughout the day. Tying in the above two, the logical thing to do with regards to sitting, is every 15 minutes or so stand yourself up and have a walk up and down the living room. By taking on board the above principle, it will result in less stress being placed across the structures responsible for your low back pain and therefore give your body a chance to heal itself. As healing takes place, the structures responsible for your pain will become stronger, and if they are stronger you will find you can begin to do more and more.

A positive cycle will now result, whereby encouraging the easing factors will promote more healing, which itself will result in your low back becoming stronger and therefore less easily aggravated. If it is less aggravated, it means more healing will take place and therefore you can become more active and your back will become stronger…. and so on.

Sound too simple?

Well there is no doubt I have simplified things a little just to highlight a point. However, it is not too difficult either as the underlying principle is the same. The all important aspect is firstly analysing your day-to-day activities and then dividing them into aggravating and easing ones. When you have established this, begin by temporarily avoiding/modifying the aggravating activities and encouraging the easing ones. As you do this, your low back pain or sciatica will begin to ease and you will be able to become more active.

At this stage, it will be important to consider addressing any muscle imbalances which are present (as it will almost be certain there are some). A simple but effective exercise programme to strengthen any weak muscles and stretch any tight ones will soon have you performing those functional activities you are finding difficult at the moment pain-free…