with Andreas Klein

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 had a lower back injury and no foam roller many years ago.

Today we get patients to lie face up on a carpeted floor, then place a hard foam roller( about the size of a standard wine bottle) under one side of the small

of their lower back. The roller is placed either just to the left or to the right of the spine, never over the spine itself.

Then while lying on the roller, a patient breathes deeply in and out for about 5-10 mins allowing the back muscles to gently stretch over the bottle. They then swap sides and do the same thing for the other side.

The idea is to stretch the lower back muscles gently but deeply beside the spine( using deep in & out breaths), but without significantly bending the spine itself.

This simple activity can help

ameliorate back pain and avoid increase in pain that may happen between clinic session, due to a patient’ s daily activities. Some patients should not do this activity, so it is important to be assessed first. Let us 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 cannot 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 instar-step distances.

Studies have shown that lowamplitude static( non-cyclical) stretching stop fibrosis and inflammation. To

evaluate 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-tissuestretching. 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 an especially vital component of remedial therapy for people with lower back and other musculoskeletal injuries. That is why patients who incorporate it into their rehab regime often improve more quickly.

If you have a back injury and need help, why not give Andreas a call at the clinic on 0418-166-269.