Stretching for back pain relief – good, bad, or indifferent?

You may be one of the many people who are into stretching for back pain relief.  But it’s worth stopping to ask a few questions – like does it work?  Are back stretching exercises worth doing? And if so, what are the best stretching exercises for lower back pain?  Given we specialise in self-help for low back pain and sciatica, this is an important question.  And as an Edinburgh osteopath for 28 years, I’ve got some pretty strong views on stretching the lower back, and they might not be what you expect…

Stretching – what’s the evidence?

You’ll come across loads of people who swear by stretching exercises for back pain.  Youtube is full of videos of exercises for back pain – most of them are stretching exercises.  Why?  Because they feel good.  Why do they feel good?

GEEK ALERT!!!

When you stretch, you stimulate little nerve endings called mechanoreceptors.  These send messages to your spinal cord.  When they reach the spinal cord they block messages coming in from nociceptors.  Nociceptors are part of your pain messaging system (there are no such thing as “pain nerves”).  So if we block the nociceptors you’re likely to lower your pain. This happens at the junction between the nociceptor and the second neuron (in the image below).

Image depicting pain pathway to show how pain can be relieved by stretching

Unfortunately using mechanoreceptors to block nociceptors is a short-lived effect.  So the benefits won’t last long.  But it feels good at the time.  It’s basically like taking short-acting painkillers (but without side-effects).

So is stretching for low back pain a waste of time?

It can be worse than a waste of time for some people.  Here’s an article I wrote about why stretching for low back pain can be a waste of time.

What are the best stretching exercises for lower back pain?

So, if you’re going to do stretches, first be sure they’re not going to do you any harm.  We’d need to test your spine for instability – not something you can do yourself.  Instability in a spinal joint would be a good reason NOT to do stretches.

Assuming you don’t have instability, and that you do feel better temporarily for stretching AND you don’t mind that it’s not doing you any good in the long-run, here are some principles:

  • Don’t do it if it hurts.
  • If you’re worse sitting or bending forwards, avoid stretches that bend your spine forwards.
  • If you’re worse standing or bending backwards, avoid stretches that bend your spine backwards.

That’s it.  So long as you observe those rules, knock yourself out… Do as much stretching as you like.  Although personally I think your time would be better spent reading this article on “What’s the quickest way to fix my back pain / sciatica?

Bear in mind that I run a back pain and sciatica clinic in Edinburgh.  This is what we specialise in.  This is not just my opinion.  It’s based on real evidence.  Consequently it’s unlikely I will ever write an article entitled “Best stretching exercises for lower back pain”.

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