Mir H. Ali, MD, PhD
Orthopedic Spine Surgery
Patient Educational Series
Managing Chronic Low Back Pain
Whether it's a lumbar strain or lumbar degenerative disc disease, many patients suffer from chronic low back pain.
Sometimes physicians refer to this is as chronic axial low back pain. Usually surgery is not recommended for this
condition. A few simple tips may help you manage this condition and minimize the limitation that occurs from your
low back pain.
If you can remember and apply the tips mentioned above, I am certain that your back will be less of a limitation
in your daily life. If you ever have any questions or concerns, please free feel to discuss with an orthopedic
- Weight management - Keeping your weight at the appropriate level minimizes the stresses and loads on the discs
of the lower spine. It also minimizes the amount of work the back muscles need to do on a daily basis in order to
keep your posture straight. Good weight management can also help reduce arthritic pain in other joints such as the
hips and knees. A good diet as well as a well-rounded exercise program can help you maintain or lose weight as
appropriate. This is one of the biggest keys to managing chronic low back pain.
- Lumbar exercises - A regular set of exercises focused on strengthening the low back muscles and the abdominal
muscles can help lessen the amount of stress placed on your spine. These exercises are usually taught to patients
during their physical therapy sessions. At the end of your course of physical therapy, you should be able to
perform most, if not all, of the exercises yourself. These exercises should be performed on a daily basis to
help you recover from your current flare-up of back pain and also to help prevent future episodes of back pain.
These exercises not only help the back muscles heal, but also keep the back in good shape to help you avoid
re-aggravating it in the future.
- Aerobic Exercise - Regular aerobic exercise (defined as 15 to 30 minutes of activity that increases your heart
rate to 80% of the maximum recommended heart rate for your age group) can lessen the chronic daily pain in one's
back. A healthy exercise that increases your heart rate and makes you sweat releases the body's natural painkillers,
such as opiates (morphine, etc.) and endorphins. Studies have shown that regular aerobic exercise lessens the
patientsí need for regular pain medications and lessens the number of days missed from work. It's not going to take
all of the pain away, but patients who find benefit from regular aerobic exercise notice their back discomfort more
on the days that they have not had a chance to exercise. It becomes a regular and important part of their daily
lives. Plus, it's good for your heart, lungs, muscles, and weight. Check with your primary care physician prior
to starting an aerobic exercise program.
It's okay if you have not done regular aerobic exercise in a long-time or never have done it at all. Start with
something simple and achievable. The most important thing is consistency. Start with a stationary bike and work
your way up to an elliptical, or even a treadmill. If a stationary bike is too difficult, then start with a hand
bike. The most important thing is to work up a sweat and increase your heart rate.
- Avoid Re-Aggravation - Hopefully, physical therapy and medicines are successful in helping you overcome your
current episode of low back pain. Once this episode resolves, weight control, lumbar exercises, and aerobic
exercise should all help you to avoid another episode. Most importantly, it is your awareness of your environment
and avoiding activities/movements that can potentially aggravate your back. There are many instances in our daily
lives where our backs are placed in compromising positions, both at home and at work. During your physical therapy
sessions, your therapist has taught you how to lift properly and to properly accomplish most of the tasks of your
daily life. Continue to be mindful of your body posture and bending techniques at home and at work. Sometimes
taking an extra few seconds can help you avoid a few weeks worth of low back aggravation.
Mir H. Ali, MD,PhD
Director - Deerpath Spine Institute
Orthopedic Spine Surgeon - Rezin Orthopedics & Sports Medicine
Dr. Ali is a board certified orthopedic spine surgeon trained in the diagnosis as well as the treatment of
non-operative and operative spinal disorders. Dr. Ali practices in the far western and southwestern
suburbs of Chicago and utilizes surgery as a last resort when all other non-operative treatments have
failed to relieve pain and/or reduce risk of nerve damage/injury. All recommendations on this site are for
general situations and a particular situation requires evaluation before specific treatment recommendations
can be made.