The exercises on the following pages can help improve your symptoms but please also take note of the following information:

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1 Back pain Back pain is common; it can be considered normal as 80% of the population experience at least one significant episode in their lifetime. It is partly caused by the stresses we place on it during daily life. The exercises on the following pages can help improve your symptoms but please also take note of the following information: It is quite normal to experience some additional discomfort. You may need adequate medication on a regular basis to control the discomfort and enable you to exercise. You can discuss medication with your local pharmacist at any chemist or with your General Practitioner. Avoid excessive rest; it s better to keep moving. Aim to stay at work or maintain regular activities as much as possible. If you have had this problem a long time, expect to recover your function more slowly. However, if you develop new Bowel or Bladder symptoms, or if you feel generally unwell contact a health professional. E.g. GP or NHS helpline If you have not improved to your satisfaction or your pain is not settling after 2-4 weeks you should contact your GP.

2 Light stretching exercises for low back pain This is the early cycle of pain that everyone encounters Now you need to change the cycle to improve recovery. Try the exercises in the order on the sheet numbered 1-6. They should help you recover from your current episode of pain and help reduce recurrence of your pain. Spend time working from one exercise to the other; your muscles will guide you as to how far you can progress with each exercise. The most helpful exercises may be the most difficult and painful to do. This means you may experience an increase in pain in the back or leg during the exercises, this is normal. However, if your back pain is not improving after 2-4 weeks please get back in touch with your GP. 2

3 How to START Try two or three exercises today. Repeat them as they will get easier to perform. If you are at the stage where you have already started to improve you may be able to try all the exercises. Use your medication or heat during this time to allow you to exercise more easily. If you have pain in your leg and you get a temporary increase in back or buttock pain, don t panic. This is a good sign of the effects on the back and may be necessary for you to improve. This is nothing to worry about and the exercise will get easier to complete. MORE CENTRAL BACK PAIN = effective EXERCISES Section One: 1. Stretch upwards Lie flat on your stomach; push up on your hands straightening your elbows as much as possible, keeping hips relaxed on the surface. On the last 3 or 4 push ups of each set of repetitions keep your elbows straight, breath out and slowly let your back sag. 2. Stretch backwards Standing upright with feet shoulder width apart, arch backwards as far as you can, use your hands for support below your belt line. 3

4 3. Turning your back lying down Lying on your back with knees bent and feet supported. Move your knees side to side. 4. Knees to chest Lying on your back knees bent and feet supported, pull your knees to the chest and repeat. 5. Keep one leg straight, and gently stretch the other towards you. Hold briefly and relax. Now repeat on the other side. If one side is more painful repeat several times and hold the stretch longer (up to 30 seconds). 6. Gradual return to bending is essential for a functioning back; this may take several days to several weeks to restore this essential movement. Doing day to day activities like tying your shoe laces, collecting items off the floor and reaching into cupboards will help with this. 4

5 Posture Any benefit of exercise will be taken away by poor sitting posture. If the back rest on your chair doesn t give you adequate support you may need to use a lumbar roll. If your occupation involves sitting for long periods of time it is important to take a short break every minutes. Exercise 2 is useful to do to stretch your back at work. Sometimes in the early stage of back/leg pain symptoms may worsen when sitting upright. It may be necessary to sit a little slouched to relieve the pain but this should only be a short term measure. As soon as able you must return to sitting upright and well supported. Preventing re-occurrence or managing mild low back pain Generally the fitter you are the less likely you are to have severe episodes of back pain in the future. Activities like walking, swimming and gym work are suitable. To prevent further episodes of back pain try exercises 1 or 2 twice a day. If you are stiff after sitting or undertaking physical activity use the exercises 3 to 5 to loosen things off especially after bending or lifting. When your symptoms have improved you should be able to manage all the exercises fairly comfortably. When bending and lifting keep the natural hollow in your back by bending your knees and sticking your bottom out. Try to sit correctly as shown above when sitting for prolonged periods. Remember Keep this exercise sheet for future reference. You can use one or two of the exercises again when needed or use them all to maintain back fitness. If you have a mobile device you can download the following free app: NHS 24 MSK Help for further information and exercises. If you have access to the internet you may find the link to the following youtube video helpful too - 5