Below is part one of a three part series on exercise to control chronic pain. Part one is on stretching, and the next two parts will be on developing an exercise program and the importance of conditioning.

As part of any good exercise program for pain and general conditioning, stretching is an essential component. The other parts are strengthening and aerobic conditioning. Stretching maintains range of motion and proper muscle and tendon length. Poor range of motion with tight tendons, ligaments and muscles often lead to pain.

Stretching can be done as an independent component of an overall program or integrated into an overall program. There are very few restrictions on stretching, but find a system that works for you. A lot of people with back pain have trouble at night and first thing in the morning. Stretching for several minutes before bed and first thing in the morning is often helpful. If you’d like to integrate a stretching program with strengthening, consider yoga and Pilates routines since these will include good stretching routines.

Stretching and Your Needs

Depending on your needs, stretching can be done for any area of the body. If you are a book person, there is one titled “Stretching” by Robert Anderson that covers any region of the body. Nowadays, everyone seems to have a smart phone and with a simple search of the App Store, multiple apps can be found on proper stretching techniques. You can also search the web for information. The Princeton University physical therapy site has good information for neck and low back regions.

For those who have low back pain, a thorough stretching program can significantly help control pain. Often a large portion of symptoms are related to tight muscles in the core and lower half of the body. Stretching needs to include all areas of the low back and legs. In general, it will include flexor muscles as well as extensor. Most people concentrate on increasing flexion of the body to loosen the low back, but ignoring the extensor muscles may leave one prone to hip and pelvic pain.

Stretching in low back pain patients can often open up the neuroforamina where the nerve roots exit the spine and relieve pinched nerves. Just bending forward and touching the toes or the floor while standing does a good job to stretch the low back and legs. 10-30 seconds of a slow stretch may reduce muscle spasms and pain, allowing one to continue activity for a prolonged period. With a diagnosis of lumbar spinal stenosis, simple forward stretches may reduce pinching of the nerves and allow ongoing activity such as walking with minimal pain symptoms.

Stretching Devices

Stretching can also be done in more formal ways using techniques such as traction, massage and adjustments or manipulation of the body. Traction requires a device to appropriately stretch the neck or low back regions. Neck traction devices that are good include those manufactured by Saunders or Pronex and usually should be prescribed by a healthcare provider  Lumbar traction can be done with fancy traction devices often used by chiropractors or by using an inversion table. The inversion tables are generally safe as long as they are well built and one is securely restrained at the ankles. Deep tissue massage and chiropractic or osteopathic type adjustments can also be part of a stretching routine.

Stretching on long term basis should ideally be part of an individual’s program that is able to be performed on your own at home. Sometimes equipment is beneficial, but for most people just a set of exercises should be sufficient. Physical therapy may help if you have not been able to move well and are afraid of more pain if you try to move. Stretching is not hard if you are self motivated and willing to learn on your own. If you have pain or are afraid of injury, get help, whether it is from a healthcare professional, physical therapist, or other person.