Lower Back Pain: Help me help you

by Judah Donaldson, APRN, FNP

Lower back pain often is caused by an injury to the lower spine or degeneration of the spine’s structural components. This can be due to age, arthritis, deficiencies, and other factors.

Sometimes, however, lower back pain can result from tightness in the hamstrings (the muscle group that runs along the back of your thigh, from your hip to just below the knee). This is why the Horizon Health orthopedic team recommends physical therapy as the initial treatment for lower back pain.

Your hamstring muscles are skeletal muscles. They are voluntary muscles, meaning you control how they move and work. You have three hamstring muscles at the back of your thigh:

• Biceps femoris (closest to the outside of your body)
• Semimembranosus (closest to the middle of your body)
• Semitendinosus (in between the semimembranosus and biceps femoris)

You use these muscles to walk, climb stairs, squat, bend the knee, extend the hip, or rotate the hip internally or externally.

Tight hamstrings pull on the ischial tuberosities, an area of your pubic bone. This tends to tilt the pelvis backward. Because adjacent joints move in a “coupled” fashion, the vertebrae in the lower back flex forward. This can strain ligaments that surround the vertebrae and make bulging discs in your back worse. Lengthening your hamstrings is key to natural body movement and eliminates stress on the spine.

Relaxed hamstrings allow your pelvis to tilt forward. The lumbar spine will then couple this movement in the direction of the extension, which takes strain off ligaments and discs.

The following stretches can gradually lengthen and reduce tension in the hamstring muscle, decreasing stress felt in the lower back. Be sure to consult a medical practitioner before beginning a new exercise routine. Once you are cleared to begin, try these at-home exercises for lower back pain:

• Supine Hamstring Stretch. Lie on your back on the floor. Wrap a towel around the bottom of one foot, grabbing each end in your hands. Keeping a good grip on the towel or strap, slowly raise your leg into the air. With your leg straight, aim for a 90-degree bend. Hold for a count of 10 and then stretch your other leg. Repeat five times on each side.
• Sitting Stretch. Sit in a straight-backed chair at a comfortable height. Straighten one leg so that it’s parallel to the floor. Stretch both arms toward the toes of that foot. Hold for a count of 10 and repeat with the other leg. Stretch five times with each leg.
• Straight-Leg Bend. While standing, bend from the waist, keeping your legs straight. You don’t have to touch your toes; stretch down until you can feel the stretch in your hamstrings. Hold for a count of 20 and then straighten up slowly.

If your back pain continues or worsens, the Horizon Health orthopedic team can help determine the cause of your discomfort and work with you to solve it.

Judah Donaldson is a family nurse practitioner who sees patients with orthopedic and spine conditions at the Paris Clinic and Terre Haute Specialty Clinic. He supports the practice of Dr. Harish Kempegowda, orthopedic and spine surgeon.