Something that I ask many of my ‘lower-back-pain’ patients to do as homework to ease their pain between sessions is to get on the bottle! Nothing like a stiff drink to ease back pain, right? Just kidding of course. I did use a wine bottle for this purpose when I myself had a lower back injury and no foam roller many years ago.

Patients lie down on a carpeted floor, and place a foam roller (about the size of a standard wine bottle) under one side of the small of their back. The roller is placed either just to the left or to the right of the spine, never over the spine itself. While lying on the roller this way, they breathe deeply in and out for about 5-10 mins. The same is then done for the other side. The idea is to gently but deeply stretch the lower back muscles beside the spine (using in & out breaths) without bending the actual spine itself.

This simple activity helps ameliorate back pain generally and avoids increase in pain that may happen due to daily activities, between clinic sessions. Some patients shouldn’t do this activity so it’s important to be assessed first. Let’s see why such stretching often helps reduce back pain?

Scientists can induce lower back pain in animals simply by injecting carrageenan into the lower back area. Carrageen damages lower back tissues, causing local inflammation, and subsequent infiltration of immune cells such as monocytes, macrophages and neutrophils from the blood stream. These immune cells then release further signals that can exacerbate things, leading to ongoing pain & eventually to tissue fibrosis. Fibrosis is the formation of excess fibrous connective (scar) tissue in an organ or area during any repair process that occurs in reaction to tissue injury.

After carrageenan injections, these animals can’t walk properly and their lower back is much more sensitivity to mechanical stimulus. In short, their back is painful, it hurts the animals to move and so they had shortened stride length and lower instra-step distances.

Studies have shown that low-amplitude static (non-cyclical) stretching stop fibrosis and inflammation. To test the effect of stretching on pain and inflammation in the context of lower back inflammation, half of the above carrageen-injected animals underwent a program of daily ‘sustained stretching. For 10 minutes twice a day, for 12 days, animals did simple sustained back-tissue-stretching. What did researchers find?

Stretching significantly mitigated inflammation-induced changes and lead to:

1. lowered tissue infiltration of inflammatory immune cells
2. decreased scar tissue formation
3. decreased mechanical sensitivity of the back
4. restored stride length and
5. restored intra-step distance,

Scientists are beginning to appreciate the important therapeutic effects that stretching can have on the pain associated with many musculoskeletal conditions and injuries. When appropriately done, stretching is a very important component of remedial therapy for people with lower back and other musculoskeletal injuries. That’s why patients who incorporate it into their rehab regime often get better with less suffering overall and much more quickly.