Stretches for lower back pain – are they really a waste of time? It depends what outcome you’re seeking. As an Edinburgh osteopath and author of more than one book on low back pain I have a fair bit to say on this.
Low back pain – relief or prevention?
If you’re looking for prevention or long-term relief of low back pain, it’s bad news. There is no evidence at all that stretches for lower back pain help to prevent it. If you’re looking for short-term relief, it does help many people. However probably not for long enough for you to consider it a good return on your investment.
Why do stretches for lower back pain feel good?
This is where I get technical. Bear with me…
The pain signal starts out there in your body. The signal is initially carried in nerves called nociceptors. They connect with nerves in your spinothalamic tract – part of the spinal cord. These nerves then pass messages on to nerves in the brain, where you register pain. Where the nociceptors connect to the spinal cord is a part of the nervous system called the dorsal horn. Here there are a whole bunch of nerves coming into the spinal cord, all of them with a particular role.
One set of nerves are called mechanoreceptors. They bring messages about pressure, stretch and movement. When mechanoreceptors fire, they effectively block the messages passing from the nociceptors into the spinothalamic tract. This is why stretches for lower back pain feel good. Stretching blocks nociceptive (pain fibre) input. This is the same mechanism that TENS works through.
Doesn’t stretching improve the flexibility of my lower back?
When you stretch muscles and other soft tissues, you don’t actually increase the stretchability of them. What you really do is increase your tolerance for the feeling of resistance to stretching. Re-read the last sentence – it’s worth grasping this. This increased tolerance enables you to stretch further. To increase your possible range of motion you’d have to stretch for hours each day. This is what student ballet dancers do. You may increase your range of bending as your pain settles. But this has nothing to do with increasing the stretchability of your muscles, tendons and ligaments.
So, is stretching a waste of time?
I don’t think so. Remember the “Use it or Lose it, But Don’t Abuse it” rule? Any movement that you do that doesn’t increase your pain is a good thing. If nothing else, it helps to calm your nervous system down. Even short-term pain-relief through stretching is better than no pain relief. But remember, that’s all you’re achieving.