Low back pain? Strengthen your core

If you suffer from mysterious low back pain, you're not alone. Between 60 and 70 percent of people in industrialized nations will experience back pain from a non-specific or unknown cause at some point in their lifetime, according to the World Health Organization.

Most people will get their first attack of back pain between the ages of 30 and 50, and it becomes more common as we get older, according to the National Institute of Neurological Disorders and Stroke. Age can bring loss of bone strength, muscle elasticity and muscle tone. Discs can begin to lose fluid and flexibility. Those who are obese or not physically fit are more prone to back pain.

While rest is the most effective way to treat minor pain, doing the right kinds of exercises can often help prevent its recurrence.

By strengthening the key muscle groups responsible for posture and stability, you are, in effect, fashioning an internal girdle to support the spine. These muscles — in the abdomen, pelvis, hip, buttock and lower back regions — comprise what is commonly referred to as the core.

The list of exercises recommended to build the core has undergone a significant overhaul. Traditional sit-ups and even crunches are now regarded as two of the worst exercises for those who suffer from low back pain. They can compress the discs of the lower spine and cause damage if done too often or too forcefully.

So instead of doing endless crunches, it's much better to practice a routine that targets all the muscle groups of the core equally while keeping the spine in a protected, neutral position.

The following exercises are among the safest for the lower back, and they comprise a well-rounded core-strengthening routine. Of course, low back pain can be due to any number of specific causes, such as degenerative disease or acute trauma, so it's important that you see your doctor to rule out these possibilities before you get started.

Lie on a mat on your back with your knees comfortably bent and feet flat on the floor. Place two fingertips at the top of each pelvic bone. This will cue you to pay attention to the movement of your pelvis throughout the exercise. Take a normal breath in and forcefully exhale it out. As you do, contract your pelvic floor (the motion you'd use to stop the flow of urination) and tighten the inner wall of your abdomen as though you are bracing for a punch. Take a moment to feel these muscles contracting — this is your deep core.

Now take a breath and, on the exhale, tilt the front of your pelvis toward your ribcage, flattening your lower back a bit. On the next inhale, tilt your pelvis away from your ribcage, creating some space between the floor and your lower back. Do five to 10 repetitions, paying close attention to the core muscles involved and the natural range of motion in your low back and pelvis.

By working one side of the body at a time in a contralateral or opposite-side fashion, this exercise strengthens the erector spinae (muscles near the spine) without placing a great deal of stress on the lumbar vertebrae.

Lie on your stomach on a mat with your arms stretched out overhead. Keeping a neutral spine, slowly raise your right arm and left leg a few inches off the mat simultaneously. Slowly lower them back down, then repeat the motion with the left arm/right leg.

As you go, think of making your spine long as you reach forward with your arm and backward with your leg. Don't allow your body to rotate at the hips, and keep your toes pointed toward the floor. Do a total of 20 repetitions, 10 on each side, alternating as you go.

Kneel on a mat on all fours, making sure your spine is in its neutral S-curve. Engage the deep core muscles as you did during the pelvic tilts, then slowly reach forward with your right arm as you extend your left leg out behind you. Slowly return them to the mat and repeat on the other side. Note that keeping your balance requires using a great many of the core's stabilizer muscles.

Avoid the tendency to rush, which can make this exercise seem easy and lessen its effectiveness. As you go, don't allow your hips to dip or your upper thigh to rotate outward. Placing a yardstick across your lower back is an effective guide to proper form. Do a total of 20 repetitions, 10 on each side, alternating as you go.

This exercise works the muscles of the buttocks, which are often overly lax and weak from sitting for hours each day. As a bonus, it also simultaneously stretches the hip flexors.

Lie on your back on a mat with knees bent 90 degrees and feet flat on the floor. Engage the muscles of the deep core and move into a bridge position by lifting the buttocks off the floor. Don't force your belly up too high by arching your back; be sure to keep the natural curve in your lower spine. Your buttocks muscles should be actively working to keep your body in a straight line from your shoulders to knees.

Now lift your left foot off the ground and straighten your left leg, extending that line of your body through your left heel. Return it to the floor and repeat with your right leg. Be sure your hips stay square and you don't rotate or dip as you go. Begin with just a few repetitions and work your way up to a total of 20 or 30 alternating repetitions as you get stronger.