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Low Back Pain

Joe Sweeney
Lower back anatomy
Sign/symptoms and risk factors for low
back pain
Common lower back injuries
Training individuals with lower back pain
Lower back Anatomy
Lumbar Vertebrae, L1-L5
Intervertebral Discs
Spinal Nerves
Lower Back Pain Facts
Avoid prolonged bed rest and return to
normal ADL (Exercise, 2004)
Increase with age
Low back pain in childhood typically
proceeds into adulthood
In most cases, want to avoid surgery
Effects men and women the same (Low
Back, 2015)
Lower Back Pain Facts
Low back pain is most common
workplace injury
80% of adults will have an episode of low
back pain (Back Pain, 2015)
31 million Americans experience low back
pain in a year
Low back pain results in $50 Million
dollars a year in medical expenses
Signs and Symptoms
Pain can range in Decreased
intensity, duration, flexibility
and frequency Difficulty sleeping
Radiating pain Difficulty with
Numbness weight-bearing
Lower extremity activities or certain
weakness movements and
Risk Factors
Obesity Sedentary lifestyle
Smoking Heavy lifting and
Genetics poor posture
Age (Metcalf, 2015)
Acute vs Chronic Low Back Pain
Acute Chronic
Pain lasts 4-12 Pain lasts more
weeks than 12 weeks
Heals on its own (Low Back, 2015)
No lasting pain or Pain is persistent
Acute vs Chronic
Common Low Back Injuries
Muscle soreness
Spinal stenosis Sciatica
Ankylosing Degenerative Disc
spondylitis (Ehrman, Disease
2013) Herniated disc
radiculopathy (Low
Back, 2015)
Sciatic Nerve
What Sciatica does
Can be caused by
a herniated disc or
spinal stenosis
Piriformis syndrome
(Piriformis, 2015)
Herniated Disc

(Herniated Disc, 2014)

Degenerative Disc Disease

(Nordqvist, 2014) (Bohinski, 2015)

Diagnosis and Exercise Testing
Medical History Evaluation
Physical Exam (Ehrman, 2013)
ACSM recommends low back pain can be
tested in the same way as healthy
ACSM recommends if other
comorbidities are present then testing
should follow guidelines for that
Exercise Prescription:
Cardiovascular Training
No direct positive effect on low back pain
ACSM guidelines should be followed
Safe Cardiovascular Exercises: Walking,
Swimming, Elliptical machines
Avoid jogging, biking.
Exercise Prescription: Resistance
Weak core muscles NCHPAD
-Strengthening core
Avoid loading spine
-Stabilizing trunk
Good Exercises:
-Age under 50
crunches, side 10-15 reps /day
-Age above 50
planks, BW good 8-12 Reps/ day for 2
mornings, lunges, or more days/week

Lat pulldowns.
Exercise Prescription: Flexibility
Balance of back flexion and extension
Include hip, hamstring, and quadriceps
stretches as well
Case Study
My client is a 48 year old male who lives a
sedentary lifestyle and is a regular smoker.
He has had occurrences of acute low
back pain in the past. He has recently
been experiencing constant and sharp
pain in his lower back. The pain radiates
down to his upper leg, and was brought
on by doing continuous heavy lifting at his
Risk Stratification
My client is at a moderate risk level
because he is a male over 45 with 2 risk
factors. The risk factors are a sedentary
lifestyle and smoking.
Past history of back pain
Lack of flexibility, sharp pain, and muscle
Herniated disc, which led to sciatica
Prescribed ketoprofen (Low Back, 2015)
Exercise Testing: Cardiovascular
Exercise Testing: Muscular
Endurance and Flexibility
My Exercise Prescription:
Cardiovascular Training

Day Exercise Time

Monday Walking on treadmill 45 mins

Wednesday Swimming exercises 30 mins

Friday Elliptical machine 30 mins

Saturday Walking on treadmill 60 mins

My Exercise Prescription: Resistance
Day Exercise Reps Sets

Tuesday Lunges holding dumbells 10 3

Body weight box step-ups 12 3

Leg extension machine 15 3

Calf raises 15 3

Crunches 10 3

Thursday Bench Press 10 3

Lat Pulldowns 10 3

Hammer curls 15 3

Tricep close-grip bench press 12 3

Side planks hold for 20 secs 3

My Exercise Prescription: Flexibility
Training Hamstring

Back Extension Back Flexion

Take care of yourself!
Spread awareness
Proper lifting techniques and posture
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