Lower Back Pain Relief Exercises e book (Doc H - Paul and Steve )ver 4.0

Exercises to Relieve Lower Back Pain:
A guide to the use of physical exercise to alleviate lower back pain
About the Authors
Ryon M. Hennessy, M.D.
Dr. Hennessy graduated from Rush Medical School in 1991. He completed
his residency in orthopedic surgery at Rush-Presbyterian St. Luke's
Medical Center in 1996. He subsequently completed a one year
fellowship in spinal surgery at Rush-Presbyterian St. Luke's Medical
Center and Chicago Shriners Hospital. In addition to the practice of
general orthopedics, Dr. Hennessy has a special interest in spinal surgery
and joint replacement as well as sports medicine.
Steve Sapoznik, DPT
Steven received his bachelor's degree in Kinesiology with a focus in
Athletic Training from Northern Illinois University in 2006. He became a
Certified Athletic Trainer in September 2006 and his athletic training
experience includes both collegiate and high school athletics. His sports
medicine background and desire to further his knowledge of
rehabilitation brought him to West Virginia University, where he
graduated with a Doctorate in Physical Therapy in 2011.
Paul Hagen
Paul received his bachelor’s degree from George Mason University, and
his Master’s in Business Administrations from Boston University. He is a
Service Disabled Veteran of the United State Marine Corps and founder
and CEO of VacuPractor. Paul won the Zino Life Science Award for Best
New Invention.
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Lower Back Pain: More Common than the
Common Cold?
Nearly everyone at some point will
experience back pain that interferes with
work, routine activities, or recreation. In
fact, back pain is the second most common
neurological ailment in the United States –
second only to the headache – and it is the
number one cause of job-related
disabilities. And lower back pain is costing
us more than just lost productivity.
American consumers spend about $50
billion each year on lower back pain
treatments.
Symptoms of Back Pain
Symptoms of back pain range from muscle
aches to shooting or stabbing pain, limited
flexibility and/or range of motion, or an
inability to stand up straight. “Acute” back
pain generally lasts from a few days to a few
weeks and is commonly the result of
trauma. Back pain is “chronic” when it
persists for more than three months.
Anatomy of the Back 101
The back is an intricate structure of bones,
muscles, and other tissues that form the
posterior of the body’s trunk from the neck
to the pelvis. The lower back, or “lumbar
region,” is where the most pain is typically
felt. The centerpiece of the back is the
spinal column, which not only supports the
body's weight but also houses and protects
the spinal cord.
The spinal column is comprised of multiple
vertebrae that are stacked on top of each
other, protecting the spinal cord inside.
Bands of tissue, known as ligaments and
tendons, hold the vertebrae in place and
attach the muscles to the spinal column.
Between the vertebrae are spaces through
which nerves enter and emerge from the
spinal cord. These spaces are filled with
round, spongy pads of cartilage known as
intervertebral discs. These discs allow for
flexibility in the lower back and act like
shock absorbers throughout the spinal
column to cushion bones as the body
moves.
If the spine becomes overly strained or
compressed, a disc may rupture or bulge
outward. This rupture may put pressure on
one of the more than 50 nerves rooted to
the spinal cord that control body
movements and transmit signals from the
body to the brain. When these nerve roots
become compressed or irritated, back pain
results.
2 | P a g e

The Role of Aging
Age, combined with the rigors of daily life,
increases our risk of experiencing back pain.
As people age, bone strength and muscle
elasticity tend to decrease. Discs also begin
to lose fluid and flexibility, decreasing their
ability to cushion the vertebrae. In this
deteriorated state, pain can occur even
when performing routine activities. Lifting a
slightly heavy object or stretching a little too
far suddenly results in a sprain, strain, or
spasm.
Muscle Strain
While back pain tends to increase with age,
it often begins to affect us during the prime
of our lives between the ages of 30 and 50.
This is due in part to the general aging
process, but also is rooted in what is
typically a more sedentary lifestyle during
our prime working years. For many
Americans in this age group, the week is
spent sitting at a desk followed by more
strenuous physical activity on the
weekends. Our bodies are simply not
stretched and toned to handle this change
in physical activity.
Young are not Immune
While the risk of experiencing lower back
pain generally increases with age, children
also are affected. In the year 2000,
approximately 13,000 mostly young patients
were medically treated for injuries related
to carrying backpacks (source: U.S.
Consumer Product Safety Commission).
Other Causes of Back Pain
Back pain can also result from degenerative
conditions such as arthritis or disc disease.
Less commonly, lower back pain may be the
result of nerve or muscle irritation or bone
lesions.
Bone Lesion
3 | P a g e

Conditions Requiring Medical Care
Bulging or Protruding discs occur when the
disc extends outside the space it should
normally occupy. Invision a hamburger
that's too big for its bun. When the bulge
extends into the space containing the spinal
cord or a nerve root, pain results. Bulging is
part of the normal aging process of the disc
and is common to see on MRIs of people in
almost every age group.
Bulging Disc
Herniated, Ruptured, or Slipped Discs are
conditions that result when a crack in the
tough outer layer of cartilage allows some
of the softer inner cartilage to protrude out
of the disc. The protrusion usually happens
in one distinct area of the disc, whereas a
bulging disc usually occurs along a large
component of the disc. Studies have shown
that most herniated discs occur in the lower
(lumbar) portion of the spinal column. A
more serious complication of a herniated
disc occurs when disc material is pushed
into the spinal canal and compresses the
bundle of lumbar and sacral nerve roots.
Permanent neurological damage may result
if the condition is left untreated.
Herniated Disc
Sciatica is a condition in which a herniated
or ruptured disc presses on the sciatic
nerve, which is the large nerve that extends
down the spinal column to its exit point in
the pelvis and carries nerve fibers to the leg.
This pressure causes shock-like or burning
low back pain combined with pain through
the buttocks and down one leg to below the
knee, occasionally reaching the foot. In
extreme cases, when the nerve is pinched
between the disc and an adjacent bone, the
symptoms involve not pain, but numbness
and some loss of motor control over the leg
due to interruption of nerve signaling. This
condition could also be caused by a tumor,
cyst, metastatic disease, or degeneration of
the sciatic nerve root.
4 | P a g e

Sciatica
Spinal degeneration is present when disc
wear and tear leads to a narrowing of the
spinal canal. A person with spinal
degeneration may experience stiffness in
the back upon wakening or may feel pain
after walking or standing for a long time.
Spinal Degeneration
5 | P a g e

Treatments for Lower Back Pain
Surgery involves serious risks and is usually
the last resort for treating lower back pain.
Fortunately, most lower back pain can be
treated successfully without surgery.
Surgery
Simple rest can have positive results,
particularly when back pain is associated
with muscle strain or inflammation.
However, for most of us, rest is not enough
to alleviate our back pain.
Medications, both prescription and over-
the-counter, are commonly used to treat
back pain. Medications can be helpful, but
in many cases provide only temporary relief
without addressing the underlying cause of
the back pain. Moreover, some pain
medications have harmful side effects, are
unsafe to use during pregnancy, or may
interact negatively with other medications.
Traction involves the use of weights to
gradually pull the skeletal structure into
better alignment. Traction should only be
used in cases of chronic back pain.
Traction
Acupuncture/Dry Needling: involves the
insertion of needles along precise points
and/or trigger points throughout the body.
Research has demonstrated this causes the
release of naturally occurring painkilling
molecules called peptides and normalizes
the body's natural chemical environment.
Clinical studies have demonstrated the
effectiveness of needling techniques in
treatment of back pain.
Acupuncture
6 | P a g e

Spinal manipulation, as performed by a
chiropractor uses leverage and a series of
exercises to adjust spinal structures and
restore back mobility. Some clients have
reported good success in managing back
pain through chiropractic care.
Spinal Manipulation
Therapeutic massage, particularly when
performed by a specially trained massage
therapist, can be beneficial in treating both
chronic and acute lower back pain by
relaxing the muscles and increasing blood
flow to the area.
.
Massage
Exercise is proving effective in managing
lower back pain, both in speeding recovery
and in preventing recurrences.
Recommended exercises include those
designed to strengthen the back and “core”
abdominal muscles. Back-healthy exercises,
such as those found in yoga, help to
improve posture and maintain proper
muscle balance.
Exercise
The VacuPractor –Lumbar Traction is a
revolutionary patented device for the self-
treatment of lower back pain. The user lies
on the device, creating a natural vacuum
effect to gently pull the spine and stretch
the muscles in the lower back area. Pain is
relieved in as little as five to ten minutes of
use. VacuPractor can be used at home, and
it can be combined with other pain
treatments as part of a patient's total care.
7 | P a g e

EXERCISES TO MANAGE AND
PREVENT LOWER BACK PAIN
1. The Warm Up:
Lie down with your back on the floor.
Raise the knees in a bent position
and place feet flat on floor. While
lying in this position, stiffen your
stomach muscles as if preparing to
be hit in the belly. Hold for five
seconds then release.
2. The Partial Curl-Up
Using the same position as in the
warm-up, with arms down at the
sides, tighten the lower stomach
muscles and slowly raise your chin
toward the knees. Extend the chin
forward only to the point that your
shoulders are raised off the floor.
Imagine you are “curling-up” with
the apex of the curl being a point in
the back centered in the area of the
shoulder blades. Hold for the count
of five.
8 | P a g e

3. The Pelvic Tilt
Using the same position as above,
flatten your back against the floor by
tightening the stomach muscles and
bending the pelvis up slightly. Hold
for the count of ten.
4. Quadruped Pelvic Tilting
Assume the cat position, with hands
and knees on floor. Hands should be
shoulder length apart and knees
should be hip-width apart. As you
inhale, gently stretch the spine
downward toward the floor while
tipping the head up slightly toward
the ceiling. Now exhale and gently
bend the spine up into an arch while
moving the chin down and in
toward the chest. Try not to move
your arms or legs during this exercise.
Instead, invision pushing/pulling the
bellybutton down and up.
9 | P a g e

5. The Plank
Get down on your knees and hands.
Place forearms flat on mat/floor. The
arms and forearms should form a 90
degree angle. Now extend both
legs straight behind you and lift your
body by shifting all the weight onto
the tips of the toes and the forearms.
Keep the face/head down in order
to form a straight line, like a plank,
extending from the neck to the
lower back. Do not lift the buttocks.
Hold for 5 seconds and release.
6. The Side Plank
Using a mat for comfort, lie on your
side with legs straight, one on top of
the other. The upper arm should rest
on top of the upper leg. The lower
arm will be used for lift and balance
by placing the forearm on the mat
at a 45-90 degree angle from the
shoulder. Using the forearm, lift the
upper part of the body while
keeping both legs together and
straight. Only the edge of the lower
foot should still be touching the
mat/floor. The body should be rigid
like a plank. Hold position for five
seconds, then repeat with the
opposite side.
10 | P a g e

7. Hamstring Stretch
Lie on your back with knees bent
and feet flat on the floor. Lift one leg
straight up, with the foot facing the
ceiling. Do not point the toe. Gently
lift the leg in toward the chest. As
you do this, you should feel the
hamstring stretching behind the
upper thigh. Place both hands
behind the thigh and walk the hands
up toward the ankle to further
stretch the hamstring. Hold for 15
seconds. Repeat the exercise with
the other leg. Tips: Keep buttocks
on the floor. Do not allow the back
to curl. Do not force the leg to be
pulled. Flexing the foot during the
exercise will also stretch out the calf.
8. Gluteus Stretch
Lying flat on your back, use your
hands to pull one bent knee up to
the shoulder on the opposite side.
Hold this stretch for the count of ten
and release. Repeat with other
leg/knee. (Note:
SportsInjuryClinic.net reports that
stretching this region can relieve
pain and pressure on the sciatic
nerve.)
11 | P a g e

9. Quadruped Alternating Extremities
Get down on all fours (the knees and
hands) with the head facing down
so that .a continuous straight line is
formed along the spine and neck.
While holding the spine in this straight
line, extend one arm straight out in
front of the body while also
extending the opposite leg straight
out from behind. Hold for the count
of five and repeat with opposite arm
and leg.
We hope you can use some of these tips to efficiently and effectively decrease your lower back
pain and that we make a contribution to you goals of getting out of pain. If you
have any comments or feedback on these tips, we would love to hear from you at
customerservice@vacupractor.com
The exercises provided in this book are for educational purposes only, and are not to be interpreted as a recommendation for a specific
treatment plan, product, or course of action. Exercise is not without its risks, and this or any other exercise program may result in injury.
They include but are not limited to: risk of injury, aggravation of a pre-existing condition, or adverse effect of over-exertion such as muscle
strain, abnormal blood pressure, fainting, disorders of heartbeat, and very rare instances of heart attack. To reduce the risk of injury, before
beginning this or any exercise program, please consult a healthcare provider for appropriate exercise prescription and safety precautions.
The exercise instruction and advice presented are in no way intended as a substitute for medical consultation. We disclaim any liability from
and in connection with this program. As with any exercise program, if at any point during your workout you begin to feel faint, dizzy, or
physical discomfort, stop immediately and consult a physician.
12 | P a g e

GLOSSARY OF TERMS
Acute - having a sudden onset, sharp rise,
and short course
Chronic - marked by long duration or
frequent recurrence
Cupping - an operation of drawing blood to
the surface of the body by use of a glass
vessel evacuated by heat
Intervertebral disc - any of the tough elastic
disks that are interposed between the
centra of adjoining vertebrae and that
consist of an outer fibrous ring enclosing an
inner pulpy nucleus
Ligament - a tough fibrous band of tissue
connecting the articular extremities of
bones or supporting an organ in place
Lumbar - of, relating to, or constituting the
loins or the vertebrae between the thoracic
vertebrae and sacrum
Mechanical - caused by, resulting from, or
relating to a process that involves a purely
physical as opposed to a chemical or
biological change or process
MRI - a procedure in which magnetic
resonance imaging is used
Muscle - a body tissue consisting of long
cells that contract when stimulated and
produce motion
Nerve - any of the filamentous bands of
tissue that connect parts of the nervous
system with the other organs, conduct
nerve impulses, and are made up of axons
and dendrites together with protective and
supportive structures
Nervous system - the bodily system that in
vertebrates is made up of the brain and
spinal cord, nerves, ganglia, and parts of the
receptor organs and that receives and
interprets stimuli and transmits impulses to
the effector organs
Neurology - the scientific study of the
nervous system especially in respect to its
structure, functions, and abnormalities
Pelvis - a basin-shaped structure in the
skeleton of many vertebrates that is formed
by the pelvic girdle and adjoining bones of
the spine
Sacral - of, relating to, or lying near
the sacrum
Sciatica - pain along the course of
a sciatic nerve especially in the back of the
thigh
Spinal column - the axial skeleton of a
vertebrate that consists of an articulated
series of vertebrae which extend from the
neck to the tail and protect the spinal cord
Spinal cord - the cord of nervous tissue that
extends from the brain lengthwise along the
back in the vertebral canal, gives off the
pairs of spinal nerves, carries impulses to
and from the brain, and serves as a center
for initiating and coordinating many reflex
acts
Tendon - a tough cord or band of dense
white fibrous connective tissue that unites a
muscle with some other part (as a bone)
and transmits the force which the muscle
exerts
Trauma - an injury (as a wound) to living
tissue caused by an extrinsic agent
Vacuum - a degree of rarefaction below
atmospheric pressure
Vertebrae - one of the bony or cartilaginous
segments composing the spinal column
13 | P a g e

Copyright Information
Copyright © 2015 by VacuPractor
All rights reserved.
Photos Provided by: Paul Hagen
No part of this book may be
reproduced in any form or by any
electronic or mechanical means
including information storage and
retrieval systems, without permission in
writing from the author.
Printed in the United States of America
First Printing: March 2015
The exercises provided in this book are for educational
purposes only, and are not to be interpreted as a
recommendation for a specific treatment plan, product, or
course of action. Exercise is not without its risks, and this or
any other exercise program may result in injury. They include
but are not limited to: risk of injury, aggravation of a pre-
existing condition, or adverse effect of over-exertion such as
muscle strain, abnormal blood pressure, fainting, disorders of
heartbeat, and very rare instances of heart attack. To reduce
the risk of injury, before beginning this or any exercise
program, please consult a healthcare provider for appropriate
exercise prescription and safety precautions. The exercise
instruction and advice presented are in no way intended as a
substitute for medical consultation. We disclaim any liability
from and in connection with this program. As with any exercise
program, if at any point during your workout you begin to feel
faint, dizzy, or physical discomfort, stop immediately and
consult a physician.
References:
1. Deyo RA; Tsui-Wu YJ. Descriptive epidemiology of low-
back pain and its related medical care in the United States.
Spine 1987 Apr;12 (3): 264-8.
2. Hayden JA; van Tulder MW; Malmivaara AV; Koes BW.
Meta-analysis: exercise therapy for nonspecific low back
pain. Ann Intern Med 2005 May 3;142 (9):765-75.
3. Banwell, B, Hoehing, P. Physical Interventions, Exercise,
and Rehabilitation. In: Soft Tissue Rheumatic Pain:
Recognition, Management, Prevention, 3rd ed, Sheon, RP,
Moskowitz, RW, Goldberg, VM (Eds), Williams & Wilkins,
Baltimore 1996.
4 Journal of Strength and Conditioning Research, 2007, 21
(3): 979-985
5 Journal of Strength and Conditioning Research, 2007, 21
(3): 979-985
6Panjabi MM. Low back pain and spinal instability. In:
Weinstein JN, Gordon SL, eds. Low Back Pain: A Scientific
and Clinical Overview. Rosemont, Ill: American Academy of
Orthopaedic Surgeons; 1996: 367-384.
7 Panjabi MM. Low back pain and spinal instability. In:
Weinstein JN, Gordon SL, eds. Low Back Pain: A Scientific
and Clinical Overview. Rosemont, Ill: American Academy of
Orthopaedic Surgeons; 1996: 367-384.
8 Stuart McGill. Low Back Disorders. 2007.
9 Arch Phys Med Rehabil 2009 (90): 118-126
10 Phys Ther 2005; 85: 209-225
11 J Strength Cond Res. 2009 Oct 24
12 Arch Phys Med Rehabil 2009 (90): 118-126
13 Furlan AD, van Tulder MW, Tsukayama H, Lao L, Koes
BW, Berman BM. Acupuncture and dry-needling for low
back pain. The Cochrane Database of Systematic Reviews.
2005, Issue 1.
14 Langevin HM, Churchill DL, Fox JR, Badger GJ, Garra BS,
Krag MH. Biomechanical response to
acupuncture needling in humans. J Appl Physiol. 91:2471-
2478, 2001.
14 | P a g e

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