To Your Health: “Back to Life” After Low Back Pain

Before this past weekend, I had never given low back pain much thought. I knew plenty of friends and family who had occasional short-term muscle soreness in their back or even symptoms from a bulging disc, but I had never suffered back pain that interfered with my normal daily routine. That changed after deciding to run on a Friday, spin on Saturday and work in the yard for several hours on Sunday. Three consecutive days of “overdoing it” landed me on a heating pad, popping ibuprofen every four hours. I had joined the 61% of Americans who say that they have experienced low back pain and, of those, 69 percent reported that it had affected their daily lives. That was me. The American Physical Therapy Association (APTA) published these findings in 2012 and currently provides evidenced-based information at on proven treatments such as physical therapy for the elivation of low back pain. The APTA also reports that “physical therapy is a cost-effective first choice in an era when all too often back pain is over-treated with narcotics or unhelpful imaging scans that lead to higher costs.”

Activities that are commonly affected by low back pain include exercise, sleep, work, intimacy, travel, “other” and family time, in order of prevalence. For me, spending way too many hours gardening resulted in lack of sleep, back pain that prevented my daily exercise routine and increased time needed for daily activities like showering, walking, standing and dressing. My main symptom was pain with movement during sit to stand and after prolonged sitting. The typical symptoms of low back pain vary a great deal, but can be described as pain that is dull, burning or sharp. Pain might be felt at a single point or throughout a broad area in the back. It might be accompanied by muscle spasms or stiffness. Sometimes, it might spread into one or both legs.

According to the APTA, there are three different types of low back pain:

  • Acute – pain lasting fewer than three months
  • Recurrent – acute symptoms come back
  • Chronic – pain lasting longer than three months

The APTA goes on to report that “most people who have an episode of acute pain will have at least one recurrence. While the actual cause of low back pain isn’t often known, symptoms usually resolve on their own. Psychosocial factors, such as self-confidence and a perceived ability to cope with disability, have been shown to be predictors of who might not recover from low back pain as expected. We used to believe the cause of low back pain was related directly to the tissues of our body but are now understanding the condition to be more complex.”

While most low back pain resolves after a few days on its own, there are several conditions that  may be related to your low back pain that can be more serious, such as:

  • Degenerative disk disease
  • Lumbar spinal stenosis
  • Fractures
  • Herniated disk
  • Osteoarthritis
  • Osteoporosis
  • Tumors of the spine

If your low back pain is accompanied by loss of bowel or bladder control or numbness in the groin or inner thigh, you should visit your local emergency department immediately as the spinal cord may be involved.

I could almost bet that my low back pain was a result of overuse of back and leg muscles over three days that culminated with a long gardening session on the last day. I should have reviewed the following tips from the APTA before spending three hours trimming and gardening!

  • Warm up before you garden. A 10-minute brisk walk and stretches for the spine and limbs are good ways to warm up.
  • Change positions frequently to avoid stiffness or cramping.
  • Be aware of how your body feels as you work in your garden. If a part of your body starts to ache, take a break, stretch that body part in the opposite direction it was in or switch to a different gardening activity. For example, if you’ve been leaning forward for more than a few minutes, and your back starts to ache, slowly stand up and gently lean backwards a few times.
  • Make use of a garden cart or wheelbarrow to move heavy planting materials or tools. Be sure to keep your back straight while using a wheelbarrow.
  • If kneeling on both knees causes discomfort in your back, try kneeling on one and keep the other foot on the ground. Use knee pads or a gardening pad when kneeling.
  • If kneeling or leaning down to the ground causes significant pain in your back or knees, consider using elevated planters to do your gardening.
  • Use good body mechanics when you pick something up or pull on something, such as a weed. Bend your knees, tighten your abdominals and keep your back straight as you lift or pull things. Avoid twisting your spine or knees when moving things to the side; instead, move your feet or pivot on your toes to turn your full body as one unit.
  • Avoid bending your wrist upwards when pulling things or using gardening tools. Instead, keep your wrist straight and use your shoulder muscles to pull and lift.
  • End your gardening session with some gentle backward bending of your low back, a short walk and light stretching, similar to stretches done before starting.

(Tips Authored by: Andrea Avruskin PT, DPT on