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BY CATHERINE FISCELLA, MSPT

Help for Low-Back Pain
These Pilates-based exercises can be a safe and effective alternative for clients with lumbarspine disorders.
B Y AT H E R I N E F I S C E L L A ,
Are your clients complaining of back pain, or do they describe themselves as having a “bad back?” If so, their complaints are not uncommon. The Mayo Clinic recently reported that 4 out of 5 adults experience at least one bout of back pain at some point during their lifetime. The Mayo researchers found that back injuries are the leading cause of workrelated disability; in fact, they said, “Even though back pain is rarely life-threatening, the annual cost in terms of lost productivity, medical expenses and workers’ compensation benefits runs into the tens of billions of dollars in the United States” (Mayo Clinic 2005a). The American Association of Neurological Surgeons reports that more than 65 million Americans suffer from lowback pain every year and that back pain is the second most common reason for visits to doctors’ offices. Furthermore, 50% of all patients who suffer from an episode of low-back pain will have another occurrence within 1 year (American Association of Neurological Surgeons 2000). Considering these statistics, the likelihood of your encountering clients with back problems is quite high. This article will take you through three lumbar-spine diagnoses, the common causes, suggested comfortable positions and postures, and recommended Pilates-influenced lumbar stabilization exercises. With any client who is in postrehabilitation or has a history of a spine ailment, it is important to align yourself with the referring healthcare provider to optimize individual recommendations. The information here is generalized to the majority of individuals in each diagnostic population, but keep in mind that there are always outliers.
ANATOMY REVIEW

The spinal cord begins as an extension of the brain and is surrounded by the bony vertebral column, which acts as a protective mechanism. Any sensory or motor information the brain needs to relay to the body travels via the spinal cord. An injury to the spinal cord will interrupt this important communication, resulting in impairments of movement, sensation and/or organ function. The lumbar spine contains five articulating segments that move to flex, extend, side-bend and rotate the torso. Individual nerve roots exit on each side of the vertebrae to become nerves that enable sensation and movement in the lower body (Kibler et al. 1998).
PILATES-BASED EXERCISE AS A TREATMENT OPTION

causes, including normal aging, heredity, tumors, a traumatic event and bone disease, to name a few. Individuals with lumbar stenosis may have pain or discomfort in the legs, as well as weakness or “heaviness” in the lower extremities. Other symptoms may include numbness, tingling or hot and cold feelings in the legs.

Resources
Book

Daniels, D. 2003. Pilates Perfect: The Complete Guide to Pilates Exercise at Home (pp. 130