Neck & Back Pain Exercises

Neck & Lower Back Relief Position

Take this position periodically throughout the day if your neck or back are bothering you.

If it is possible, sit on a chair, with your "sit bones" at the edge. Rock your pelvis forward into a tilt. Gently turn your hands outward so that your thumbs are pointing behind you. Hold this position for a few seconds at a time.

This relief position can also be done standing.

With permission: Murphy Dr. Clinical Reasoning in Spine Pain Volume II: Primary Management of Cervical Disorders and Case Studies in Primary Spine Care. Pawtucket, RI: ©CRISP Education and Research 2016.

Neck & Mid Back Relief Breathing Position

Do this periodically throughout the day if your neck or mid back are bothering you..

Sit in a chair facing the wall. Your knees should be approximately 4-6 inches from the wall. Cross your arms and place them on the wall, with your forehead resting on your forearms.

Slowly breathe in, then slowly breathe out and as you do, let your mid back gently sink forward into the breath.

Simple Exercises for Lower Back Pain

Tips:

Avoid positions of flexion (bending, leaning forward) early in the morning
Maintain a neutral spine when bending/lifting (bend at the knees and hips, not at the waist)
Avoid prolonged periods of sitting
Exercise regularly
Choose a diet rich in fruits, vegetables, and proteins; avoid artificial sweeteners, sugars, and processed foods

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Reference Documents

Reference: Common Red Flags Associated with LBP Reference: Guidelines for Pharmacological Options Reference: Radiology Epidemiology Statement

ABI Value	Interpretation	Recommendation
Greater than 1.4	Calcification/vessel hardening	Refer to vascular specialist
1.0 - 1.4	Normal	None
0.9 - 1.0	Acceptable	None
0.8 - 0.9	Some arterial disease	Treat risk factor
0.5 - 0.8	Moderate arterial disease	Refer to vascular specialist
Less than 0.5	Severe arterial disease	Refer to vascular specialist

Red Flag	Concerning Dx	Next Steps
Fever, chills, rigors IV drug use Recent infection	Epidural abscess Osteomyelitis Discitis	Stat MRI or transport to ED
History of cancer, new onset of pain Unexplained weight loss Pain not reproducible	Cancer	X-Ray Sed rate, CRP studies MRI w/o labs
Urinary retention/ incontinence Fecal incontinence Motor deficits at multiple levels Perineal numbness Saddle anesthesia Decreased anal sphincter tone	Cauda equine syndrome	Stat Lumbar MRI or transport to ED
Recent severe trauma or less sever trauma with history of osteoporosis, use of corticosteroids and older age Extreme pain with movement	Vertebral compression fracture	Plain film X-Ray or CT

Among patients in the following age groups who are asymptomatic, a lumbar spine MRI will find about...
	20-30 years old	30-40 years old	40-50 years old	50-60 years old	60-70 years old	70-80 years old	80+ years old
Disc Degeneration	37%	52%	68%	80%	88%	93%	96%
Oisc Signal Loss	17%	33%	54%	73%	86%	94%	97%
Disc Height Loss	24%	34%	45%	56%	67%	76%	76%
Disc Bulge	30%	40%	50%	60%	69%	77%	84%
Disc Protrusion	29%	31%	33%	36%	38%	40%	43%
Annular Fissure	19%	20%	22%	23%	25%	27%	29%
Facet Degeneration	4%	9%	18%	32%	50%	69%	83%
Spondylolisthesis	3%	5%	8%	14%	23%	35%	50%

Patient Exercises