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Ending Lower Back Pain

Anyone who has suffered from back pain will tell you: It’s the f$cking worst. To learn how to treat it effectively—not to mention prevent it in the first place—we talked to structural integration and alignment specialist Lauren Roxburgh—author of Taller, Slimmer, Younger and our go-to on all matters of foam rolling body work (re: fascia, the pelvic floor, getting a slimmer waist).

Here, Roxburgh addresses issues of the lower back and the sciatic nerve, which runs from the lower back into your legs, and is where pain often stems from. Her tips for avoiding a back problems in the first place are a good idea for just about everyone—her restorative routine has benefits beyond soothing your back, e.g., strengthening your core and butt, promoting healthy circulation, and relaxing the body. (Check out another new Roxburgh rolling routine—designed to make you glow—in our GOOP CLEAN BEAUTY book, available here.) At the same time, her techniques for treating back pain once it happens can be life-changing.

The Lower Back/Sciatica Rx

If you’re one of the many who suffer from back pain, you know how debilitating and frustrating it can be. Lower back pain is the biggest cause of disability worldwide and one of the most common reasons that employees miss work. Over 30 percent of women suffer from lower back pain, and experts estimate that 8 out 10 people experience back pain over their lifetime.

The back is a truly complicated, fragile, and miraculous structure made up of ligaments, muscles, fascia, joints, bones, emotions, and energy. Injuries or accidents can cause back problems, but lower back pain can also result from simple movements like bending over to pick something up or twisting too abruptly. Other common causes of back pain include bad posture, obesity, stress, and arthritis. Back problems can also be exacerbated by “situational” circumstances like stress, sitting too much, wearing high heels, or sleeping on a bed that is too soft.

Then there is sciatica. The sciatic nerve is the largest single nerve in the body. It runs from the lower back, through the buttocks, and down the back of both legs where portions of the sciatic nerve branch out to innervate the thigh, calf, foot, and toes. Sciatica symptoms occur when the large sciatic nerve is injured, irritated, compressed, or glued down by scar tissue or damaged fascia at or near its point of origin—which can be caused by poor posture, a pelvis that is out of alignment, or clenched pelvic floor muscles due to stress, trauma, or fear. Sciatica can also result from degenerative disc disease (which breaks down the discs that act as cushions between the vertebrae), lumbar spinal stenosis (narrowing of the spinal canal in the lower back), or spondylolisthesis (where one vertebra slips forward over another one).

Pain resulting from sciatica usually begins in the low back or buttocks and continues along the path of the sciatic nerve—down the back of the thigh and into the lower leg and foot. It can be searing and sharp, or numbing, and often feels better when patients lie down or are walking, but worsens when standing or sitting.

Treating back pain can be tricky since there are so many things that influence the pain and discomfort. Options range from physical therapy to acupuncture, massage, Pilates, structural integration, medication, and as a last resort, surgery. If you’re suffering intense lower back pain or sciatica, seeing a doctor is the best place to start in order to figure out exactly what’s going on so you can decide what the next best step is. I always recommend getting to the root of the problem and figuring out the cause, which could be some sort of emotional stress, poor posture/alignment, sitting too much, over working-out, an injury or accident, etc. Understanding how the problem was caused in the first place is key, because the compensations a patient makes in reaction to the cause can create an additional set of issues or pain.

If you’re lucky enough to not suffer from extreme back problems, the best thing you can do is look after your back. Treat it with the respect that it deserves—it’s the very foundation that holds your body upright—by giving it a little love every day. The investment in prevention will pay huge dividends when it helps you avoid back problems altogether.

10 Easy Ways to Prevent Back Pain and Sciatica

  1. Take a few minutes every morning to stretch from head to toe. I recommend the cat/cow yoga stretch to wake up and decompress your spine, move your spinal fluid, and hydrate connective tissue.

  2. Walk and bounce on a rebounder to build healthy tone in your pelvic floor and deep core muscles, help release feel-good endorphins, flush toxins, move blocked or negative energy, and keep your body and tissues supple and youthful.

  3. Take magnesium, the miracle mineral, to restore your tissues, reduce stress, sleep deeper, and nourish and repair your nerves. (I love Natural Calm.)

  4. Take evening baths with magnesium chloride salt flakes to chill out, calm the nervous system, and help your fascia loosen up.

  5. Check in with, or get to know, your pelvic floor. This area has a huge impact on the alignment of the pelvis and pain in the lower back. We tend to process stress and hold tension in this area.

  6. Stay hydrated, and take a collagen supplement powder or supplement your diet with bone broth to keep your tissue, fascia, and inner webbing supple and resilient.

  7. When bending down to pick something up, bend your knees and squat down using your booty muscles, hamstrings, and core, and press though your heels. Avoid bending at the hips since this loads the discs of your spine.

  8. Roll your feet out with a tennis ball to maintain healthy plantar fascia—this has a huge impact on the health and mobility of your spine.

  9. Build and maintain a strong and flexible core and hip rotators—especially your glute medius. (The foam rolling sequence below will help you do this!)

  10. Go upside down every day: Inversions can be amazing for decompressing the discs of your spine and helping nourish and redistribute your spinal fluids.

How to Treat Your Back With Foam Rolling

When clients do come to me with low back or sciatica issues, I take them through this series of specific moves on my signature foam roller, which is designed to be a little softer than other rollers, so that using it is less painful, and more like bodywork—flushing toxins, hydrating, and ringing out your tissues. (For non-clients, there’s a restorative online video course, which can help alleviate back pain, among other aches.) Keep in mind that the body is an interconnected matrix, so be present, go slow, breathe deep, and focus on your entire body while doing the moves below.

1: ROLLING SPINAL DECOMPRESSION

Benefit: Creates space between your vertebra, decompresses the spine, opens up the lungs, and massages the shoulder blades—helping to take the weight of the world off your spine, body, and mind.

  1. Lay on the roller the long way, so your entire spine is supported from head to tailbone.

  2. Reach your arms up over your head and inhale as you lean your upper body to the right and your knees and hips to the left.

  3. Exhale as you feel the deep stretch in your spine.

Repeat this movement eight times on each side.

2: ROLLING FIGURE FOUR

Benefit: Helps smooth away congestion and scar tissue in and around the sciatic nerve.

  1. Sit on the roller and reach your right arm behind you, placing your right palm on the mat for stability. Cross your right ankle over your left knee in a figure four position.

  2. Shift your weight slightly over to the right hip/glute area and roll back and forth a few inches in each direction.

  3. Roll in circles to help increase circulation and blood flow, and to reduce congestion.

Repeat this movement on each side for about 30-45 seconds.

3: QL ROLL

Benefit: Helps create space between the hip and ribs. Promotes circulation and blood flow in the lower back, and reduces an anterior tilt, or an over-arched lower back, which compresses the lower spine. Also helps increase the flexibility and mobility of the spine, decompress the lower vertebra, and align the pelvis.

  1. Place the roller behind you. Come to a figure-four position with your left knee bent, right ankle crossed over your left thigh, right above the knee. Place your right forearm on the mat and press your right palms into the roller, thumb facing up. Place your left hand on your right knee to deepen the pressure and create more space.

  2. Lean your body to the right while feeling a subtle pressure on the right quadratus lumborum (QL), a lower back muscle between the bottom of your ribs and the top of your hips.

  3. Keeping the roller stable, press down into your left foot while you inhale and round your tailbone up, raising your right hip off the ground.

  4. Exhale—come back down and feel the lower back release and your core connect.

Repeat this movement eight times on each side.

4: PSOAS ROLL

Benefit: Helps release the hips and deep core, massages the organs, and releases lower back tension.

  1. Come down to your forearms with the roller placed perpendicular under your left hip and right inner thigh, by turning your right knee out to the side, which helps expose the deeper muscles of the hip and core.

  2. Twist your body slightly to the right and inhale as you roll up towards your pelvis and to the attachment of your hip and psoas (the deepest core and hip flexor muscle in the body).

  3. Exhale as you roll back down the left thigh.

Repeat 8 times on each side.

5: GODDESS ROLL

Benefit: Helps restore soft tissue suppleness to your thighs and hips, which decompresses the hips and lower back.

  1. Come down to your forearms with your belly facing the mat. Place the roller under your hips, with your feet together and knees wide. Keep your belly engaged to prevent overarching your lower back.

  2. Exhale as you roll all the way down to your inner knees.

  3. Inhale as you roll back up to your pubic bone attachment.

Repeat this movement eight times.

6: THIGH DE-BUNCH

Benefit: Decompresses and helps balance the hips, pelvis, and lower back while also creating more length in the hips and thighs.

  1. Lay on the mat and place the roller under your sacrum (the triangular bone at the base of your spine). Bend one knee and draw it into your chest. Keep the other leg extended down on the mat in front of you, flexing and reaching through the heel.

  2. As you inhale, lift the extended leg two inches off of the mat. Hold here for three slow, full breaths, allowing your hips to fully extend and elongate. (This will free up toxins for the lymphatic system to flush.)

  3. After your third round of breaths, exhale as you release your extended leg down to the mat, reaching through the flexed heel.

  4. Repeat eight to ten times on each leg.

7: INVERTED LATERAL SPLIT

Benefit: Creates space in the inner thighs and pelvic floor, which helps release the lower back and hamstrings. This is also a great inversion to help decompress the spine.

  1. Lie down on the mat with the roller placed just above your sacrum, so that your hips are on the roller. Place your hands on either end of the roller, with legs extended to a 90-degree angle toward the ceiling.

  2. Inhale as you open your legs out to the side, stretching your inner thighs and hamstrings, and decompressing your lower back.

  3. Exhale as you squeeze the legs back together.

Repeat this movement eight to ten times.

8: INVERTED DOUBLE LEG LOWER LIFT

Benefit: Helps connect you to your deeper core muscles to balance your pelvis and protect your lower back.

  1. Lie down on the mat with the roller placed just above your sacrum so that your hips are on the roller.

  2. Place your hands on each end of the roller, bring your knees over your hips, and slowly extend your legs up to a 90-degree angle while engaging your deep abdominal and inner thigh muscles.

  3. Inhale as you lower your legs down to a 45-degree angle, keeping your core and inner thighs connected to avoid arching your lower back. (This helps to build a stronger deep core.)

  4. Exhale as you lift your legs back up to your start position.

Repeat this movement eight to ten times.

9: ROLLING MERMAID WITH TWIST

Benefit: Creates space on the sides of the vertebra and discs. The twisting helps nourish the vertebral disc with spinal fluid.

  1. Sit with the roller close to your left side and bend your left shin in front of you, your right shin to the right side of you. Twist your upper body to the left and place both sets of fingertips on the roller.

  2. With your chest open, sit up as tall as you can, open your chest, look up, and roll your shoulders down and back.

  3. Take a big breath in as you look up and twist your spine to the left.

  4. Exhale as you start to roll the roller up your forearms to just below your elbows, reaching your body parallel to the floor, twisting even more to decompress your spine and ring out your organs.

  5. Inhale, then exhale as you come back up.

Repeat this motion eight times on each side.

10: CORE STABILITY FOOTWORK

Benefit: Helps build a connection to your deep core muscles, which build the foundation for a healthy spine.

  1. Lie on the roller from head to tailbone with a slight curve in the lower back—otherwise known as neutral spine. Place your forearms on either side of the roller to stabilize.

  2. Inhale as you lift your left arm and right leg, and reach long.

  3. Exhale as you engage your deep abdominals to curl your head and upper spine up off the roller. Reach your left hand toward your right leg, maintaining stability.

  4. Exhale as you return to your start position.

Repeat this movement eight to ten times.

11: ROLLER SIDE KICKS

Benefit: Strengthens and tones your hip rotators and gluteus-medius muscles to help stabilize and protect your lower back. This moves also gives your waistline a massage to help create space between the ribs and the hips.

  1. Bring your right hip down to the mat and place the roller under your right side at your waistline, making space between your hips and ribs. Place your right elbow directly under your right shoulder joint. Bend your bottom knee and extend your top leg long.

  2. Maintain stable, square hips and shoulders; engage your core, and inhale as you reach your left leg forward with a slight external rotation.

  3. Exhale as you reach back, opening the front of the hip. The roller will massage your waist while you work your core and thighs.

Repeat this motion eight times on each side.

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