Greater than 80% of adults experience nonspecific (in the absence of a specific underlying condition) low-back pain (LBP) at some point in their lives and most episodes are self-limited. Most patients with acute LBP improve regardless of specific management (use a few days of over the counter pain medications with superficial heat). Patients who continue to have back pain beyond the acute period (four weeks) may go on to develop chronic LBP (persists for ≥12 weeks). The majority of patients with chronic LBP have no anatomic spine issues and the pain is due to weak core muscles.
Best ways to relieve chronic LBP
For all patients with chronic LBP, exercise therapy is highly recommended to improve pain and function. Examples of exercise programs that are beneficial for patients with chronic LBP include: walking, stretching, Pilates and Yoga. There are likely several mechanisms (neurologic, musculoskeletal, and psychological) contributing to the derived benefit from exercise-based therapy.
Despite proven benefits, most people with chronic LBP are reluctant to do daily back exercises due to unawareness and a lack of discipline.
Chronic LBP practical issues while traveling
- Pain is precipitated during long-distance travel with poor lumbar support. I recommend taking a small travel pillow that is easy to carry in your hand luggage to place in the lower back while flying and driving in rental cars for longer distances.
- Hotel mattresses vary from hotel to hotel and even the best places may not have the correct mattress that fits every traveler with chronic LBP.
- the typical hotel pillows are low quality and collapse your head down to the mattress, precipitating neck and back pain. Even 5-star hotels do not provide memory foam pillows and it is worth asking the room service to try and locate some.
Elbow Plank is the single best exercise for the lower back
In my experience, elbow plank is the single best exercise to prevent or maintain LBP. I recommend doing the plank for just 10 seconds before going to bed and repeating the same in the morning after waking up.
Elbow plank is easy to do in any hotel room without the need for a yoga mat or carpeted floor (you can even do it on the mattress).
- Start on your forearms and knees.
- Extend your legs behind you, placing your toes on the ground.
- Keep your back as flat as you can, maintaining a strong abdominal contraction.
- Hold for 10-20 seconds and repeat 2 times if possible.
- Gradually increase the duration to 30 seconds at a time.
Other useful lower back exercises
There are several other core muscle strengthening exercises and I will write about two additional ones that I do every day to help my chronic LBP.
Glute Bridges
- Lie on your back with your knees bent and your feet flat on the floor.
- Press your heels into the ground in order to lift your hips off of the ground.
- Hold this position for 30 seconds.
Seated Spinal Twist
- Start in a seated position.
- Cross your right leg over your left, placing your right foot flat on the ground on the outside of your left thigh.
- Twist to your right, placing your left elbow on the outside of your right thigh.
- Place your right hand on the ground behind you, using it and your left elbow to push you further into the stretch.
- Hold for 10-20 seconds and repeat on each side.
- Seated spinal twists help to strengthen your loin muscles, making you less prone to developing twist injuries (e.g., placing weights back into the rack at an angle).
Child’s Pose
Locust Pose
How I improved my chronic LBP
I have been suffering from chronic LBP since I was a teenager and went through multiple exacerbations. My MRI scan showed degenerative disk disease and disk protrusions as usual with many people with chronic LBP. I used to go to chiropractor sessions which were expensive with a short-lived effect.
Finally, my LBP is almost gone from continuously doing the back stretches and taking chelated magnesium (4 capsules) and high dose vitamin D3 (50,000 units weekly) supplementations (not affiliate links). Magnesium and vitamin D deficiency are prevalent worldwide (>90% adults are low) and there are several important health benefits from taking the supplements. Chronic LBP will never completely go away and I will still bring a small lumbar support travel pillow during my overseas trips.
Conclusion
Traveling with chronic LBP is difficult and the best way to prevent exacerbation is by incorporating a daily exercise program for the lower back. If you can spare a few minutes of your time, I recommend doing all the exercises listed above. If you can only do one single exercise per day, I recommend just doing the elbow plank.