Spine Exercises for Pain and Prevention

John D. Koerner, M.D. November 13th, 2020

Exercise for the neck and lower back can be challenging, especially when you are in pain.  Performing the incorrect exercise or using poor technique can make pain worse and slow recovery.  For minor aches and pains in the neck and lower back, it is safe to start exercise without being evaluating by an Orthopedic specialist.  However, pain lasting longer than a few days or requiring regular anti-inflammatories or pain medications should be evaluated by a specialist before starting exercise.  


Understanding the Spine
Understanding the back and spine can help you better understand pain and injuries, how to prevent them, and how these exercises can relieve your pain.

The three main functions of the spine include:

  • Protect the spinal cord, nerve roots and several of the body’s internal organs.
  • Provide structural support and balance to maintain an upright posture.
  • Enable flexible motion.

The regions of the spine consist of the cervical, thoracic, lumbar, and sacral which allow the spine to carry out its functions.

  • Cervical spine: The neck region that consists of seven vertebrae. 
  • Thoracic spine: There are 12 thoracic vertebrae beneath the last cervical vertebrae. They are larger than the cervical vertebrae. Rib attachments add stability to the thoracic vertebrae.
  • Lumbar spine: The five lumbar vertebrae are the largest and carry most of the body’s weight.
  • Sacral spine: Five bones behind the pelvis form a triangular shape to make up the sacral spine.


​The spine is also made up of intervertebral discs, spinal cord and nerve roots, and ligaments, tendons and muscles that work together so it can function properly.

Posture
Focusing on good posture will help you maintain a neutral spine. Stand up and lift your chin slightly. Your ears, shoulders, hips, and knees should all be aligned. Keep your spine straight and avoid twisting. Maintain this alignment throughout the day during all of your activities. When sitting in a chair, place your feet flat on the floor. Sit up straight and avoid slouching.

Spine Exercises
Spine exercises can relax your spine, ease aches, and prevent injury from occurring. The key is to start slow and gradually increase the duration and intensity of the workout.  Some soreness the day after exercise is normal, but the pain should not be so severe that it is difficult to move or get out of bed.  Low intensity cardio workouts are a great start to a healthy spine, and can be as little as a 20 minute daily walk.  Over the counter anti-inflammatories (NSAIDs) are helpful during recovery after exercise if not contraindicated.  

Cardiovascular
Start with a 20 minute daily walk and increase over time.  

Stretching
Neck, shoulder, lower back and leg stretching is key to improving flexibility and reducing pain over time.  The AAOS provides excellent instruction on their website: https://orthoinfo.aaos.org/globalassets/pdfs/2017-rehab_spine.pdf

Strengthening
These exercises are a bit more challenging, but will strengthen the core and ultimately reduce back pain.  Working with a physical therapist is often helpful at this stage to ensure safe and proper technique.  

Dr. John Koerner is an orthopaedic spine surgeon at Rothman Orthopaedic Institute, and currently sees patients in Bergen County. For more information or to make an appointment, please visit www.RothmanNJ.com or call 888-636-7840. 

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