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Health & Exercise Forum

Prevention of Lower Back Pain: Part 3 of 3

Nov 11, 2019

Part 3 of 3

Dr. Paul Mackarey, DPT


Lower back pain (LBP) is one of the most common problems in our society as well over 85-90% of all Americans will suffer from it at least once in their lives. It affects productivity in the workplace and lifestyles at home. The medical costs of treatment including; medication, physical therapy, alternative medicine, and surgery are staggering. It is generally agreed that prevention is the best treatment for LBP.


  • Maintain Fitness Level:As little as 10 extra pounds puts great stress on your lower back. It also makes it more difficult to maintain good posture. Eat well and exercise regularly.
  • Aerobic Exercise:Aerobic exercise will help prevent weight gain and stiffness for a healthier lower back. Perform mild aerobic exercise such as walking 3-5 times per week for 30-45 minutes. Keep joint compression and pounding to a minimum. For example, run 2-3 days a week, not 6-7 and cross-train on off days; elliptical, bike, swim, kayak.
  • Core Exercises:Core stabilization exercises designed to strengthen the abdominal and lower back muscles will help prevent injury. Some examples of core exercises are:
    • Pelvic Tilt - lying on your back and performing a pelvic tilt as you flatten you lower back into the floor.
    • Pelvic Tilt and Heel Slide- lying on your back, hold a pelvic tilt as you slide your one heel up and down and repeat with the other heel.
    • Core on Ball (Photo 1) perform arm exercises such as biceps and triceps with light weight while sitting on a therapeutic ball while simultaneously trying to hold an isometric contraction of your abdominal and lower back muscles.
    • Avoid sit-ups! Limit repeated flexion and torque on the lower back by using core stabilization techniques to strengthen abdominal muscles instead of a sit up unless you are at a higher fitness level.
  • Do Not Smoke: Smoking affects natural healing because it constricts the small blood vessels. Smokers have a much higher incidence of LBP and failure from lower back surgery.
  • Practice Good Posture & Body Mechanics:Good posture is critical for a healthy back. When sitting, standing or walking maintain a slight arch in your lower back, keep shoulders back, and head over your shoulders. In sitting, use a towel roll or small pillow in the small of the back.
  • Perform postural exercises throughout the day. Most of us spend much of the day sitting, standing and reaching forwards and flexing your spine. Postural exercises are designed to stretch your back in the opposite direction of flexion by extending or arching. Please perform slowly, hold for 3-5 seconds and repeat 6 times each 6 times per day.
    • Chin Tucks - tuck your chin back to bring head over shoulders.
    • Shoulder Blade Pinch – (Photo 2) pinch your shoulder blades together.
    • Standing Arch – (Photo 3) while standing, put your hands behind back, extend lower back 10-20 degrees.
  • Ergonomics
    • Sitting - When sitting, use an ergonomic chair and work station with a lumbar support and adjustable heights. Get close to your keyboard and monitor. Stand up and perform above postural exercises every 45-60 minutes.
    • Driving - If you drive long distances, use a lumbar support to keep an arch, sit close to your steering wheel to prevent bending forward and stop to stretch using the above postural exercises every 45-60 minutes.
    • Lifting - Think twice. Be mindful of the weight, size and shape of the object. Also, consider the height of the object, handles or grips, location to place object and foot traction prior to the lift. First bend your knees and arch your back. Then, brace your abdominal muscles. Bend your spine forward as little as possible to pick up the load. Use legs, turn with feet, and do not twist spine with load in hands. When possible, get help to lift very heavy loads and push rather than pull. Immediately following the lift, stand up straight and stretch lower back into extension.
  • Clothing - If you walk or stand most of the day, wear good shoes. Avoid high heels and shoes without adequate support like sandals. Tight pants, belt and oversized wallet in the back pocket can all contribute to LBP.

GUEST COLUMNIST: Paul Mackarey, Jr. DPT is clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC where he specializes in the prevention and treatment of neck and LBP.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton and is an associate professor of clinical medicine at GCSOM.

Visit your doctor regularly and listen to your body.