Back to Fitness Exercise and Education Class

How can this class help me?

The aim of this class is to improve your quality of life by giving you the tools to manage your lower back pain.

To achieve this, the class will help you understand your lower back pain, teach you self-management strategies and importantly improve your ability to physically do the things you want to do.

How long will the class last?

Each class will last 1 and a half hours, and the classes will run once a week for 6 weeks.

The class will take place in a gym and you will be asked to wear clothes suitable for exercise. For example, training shoes, tracksuit bottoms, not overly loose fitting clothing.

We recommend you bring your own bottle of water to keep hydrated.

What does the Back to Fitness class involve?

The class is a combination of exercise and education. All exercises are adapted to your needs and you will be expected to take part in physical exercise.

Some of the exercises may include:

• Use of gym machines (i.e treadmill, rowing machine, exercise bike).
• Using weights.
• Floor based exercises.

There will be an education part to the class. This will give you advice on how best to manage lower back pain.

Topics included are:

• Understanding lower back pain.
• Sleep and back pain.
• The importance of physical activity.
• Lower back pain Myths vs Facts.
• Managing flare ups.
• Why body relaxation is important.

While waiting to attend the Back to Fitness class please continue to follow the Golden Rules of back pain as listed below.

The Golden Rules of back pain.

1. Keep moving as much as possible, even if slowly at first.
2. Keep living and working as normally as you are able.
3. Avoid bed rest during the day.
4. Exercise within your ability.
5. Stand up and move around for 1 minute every waking hour.
6. Don’t be afraid to take ‘over the counter’ pain relief, unless advised against by a healthcare professional
7. Stay active and remember to reintroduce activities like heavy lifting gradually.
8. Improve your sleep pattern as this is proven to help back pain.

Benefits of physical activity:

• Benefits health
• Improves sleep
• Maintains healthy weight
• Manages stress
• Improves quality of life

Physical activity² reduces your chance of:

• Type 2 diabetes by up to 40%
• Cardiovascular disease by up to 35%
• Falls and depression by up to 30%
• Joint and back pain by up to 25%
• Cancers (colon and breast) by up to 20%

How much physical activity?

Some is good, more is better. Make a start today: it’s never too late. Every minute counts.

Be active at least 150 minutes of moderate intensity per week (increased breathing and able to talk) or at least 75 minutes of vigorous intensity per week (breathing fast and difficulty talking), or a combination of both.

Examples of moderate intensity activity are: Swimming, brisk walking, cycling

Examples of vigorous intensity activity are: Running, climbing stairs, sport

Minimise sedentary time by breaking up periods of inactivity.

Build strength to keep muscles, bones and joints strong, build strength on at least 2 days a week.

Examples of bone and muscle strengthening activities are: Carrying heavy bags, Gym, Yoga

Balance activities for older adults: For older adults, to reduce the chance of frailty and falls, improve balance 2 days a week.

Examples of balance activities are: Dancing, Bowls, Tai Chi

Sleep and back pain.

Research shows that improved sleep helps lower back pain.

There are some tips to help improve your sleep;

1. Reduce your caffeine intake (Tea, Coffee, Cola etc.)
   • Caffeine reduces the production of the hormone melatonin. Melatonin helps you get to sleep.
   • Reduce daily caffeine intake. No caffeine after midday.
2. Reduce your alcohol intake.
   • While it may help you to get to sleep, it reduces the quality of your sleep.
3. Have a sleep routine – Use an alarm clock if needed.
   • Going to sleep and waking at a set time allows your internal body clock to set a routine. You will find getting to sleep a lot easier.
4. Reduce light exposure 1 hour out of bed.
   • Light tricks your brain into thinking it is morning. This reduces the hormone melatonin, which is key to get off to sleep.
   • Dim lights leading up to going to bed.
   • Do not look at TV, computers and smart phones.
5. Optimal bedroom conditions
   • Cool room helps sleep as it simulates night-time conditions.
   • Block out any light with blackout blinds or a facemask.
6. Cannot switch off, overthinking, watching the clock?
   • A busy mind creates a restless body – Try a notebook to write thoughts down before bed.
   • Turn the clock around, or put it somewhere you cannot see it.
   • Try earplugs or drown out the noise.
7. Food can affect your sleep.
   • Don’t eat big meals 2 hours before bed.
   • Don’t go to bed hungry.

What if I can get to sleep but wake and cannot settle?

You should try getting out of bed and sitting downstairs with a dim light on and read. Try relaxation and once you begin to feel tired go back to bed.

Suggested exercises to try

Diaphragmatic (Belly) breathing relaxation – This can reduce lower back pain.

Find a comfortable position sitting or lying down. Put your hands on your belly. As you breathe in your belly should inflate, and as you breathe out your belly should deflate.

Slow your breathing down, breathing in for 4 seconds, and slowly out for 6 seconds. As you breathe out, relax all the muscles in your face (if your face is tense your body will also be tense).

Now repeat the breathing, relaxing muscles in different parts of your body each time, including your neck and shoulders, arms, back and then your legs.

Try this for 5 to 10 minutes.

Knee rolls or lumbar rotations

Lay on your back with your knees bent and your feet flat on the floor. Slowly drop your knees sideways while keeping them together until you feel a stretch. Remember to breathe and relax as you do this.

Repeat this 5 to 15 times moving left to right. Hold at each position for 5 to 10 seconds.

Seated bend forwards

Sit in a comfortable, relaxed position. Slowly bend forwards letting your arms relax towards your feet. Make sure you do not hold your breath. This is easiest to do by breathing out as you bend forwards. When you have reached as far as is comfortable try some belly breathes which may help you get a little further. Then return to the start position.

Repeat this 5 to 15 times moving left to right. Hold at each position for 10 to 30 seconds.

Knee Hugs

You can try one leg at a time, or both legs at once. See which one is best for you. The images show doing this one leg at a time.

Lie on your back with your knees bent. Lift one or both legs to your chest. Remember to breathe and relax as you do this. Hold at the top and breathe and relax. Now slowly lower your leg(s) to the start position.

Contact Numbers

North Tees & Hartlepool Hospitals

If you are unable to attend the class or have any queries prior to attending please contact the physiotherapy team.

Telephone: 01429 522 471, Monday to Friday, 8:30 to 4:30.

Further information is available below:

Sleep:

https://thesleepcharity.org.uk/information-support/adults/sleep-hub/

Physical activity:

https://www.nhs.uk/live-well/exercise

Relaxation:

https://www.youtube.com/c/calm

Understanding pain:

https://livewellwithpain.co.uk/ten-footsteps-programme/

https://www.flippinpain.co.uk/event/pain-do-you-get-it-tees-valley/

Back facts:

https://www.southtees.nhs.uk/resources/10-back-facts/

References

1. National Institute for Health and Clinical Excellence (NICE) (2016) Low back pain and sciatica in over 16s: assessment and management. (NICE guideline NG59). Available at: https://www.nice.org.uk/guidance/ng59
2. Physical Activity Guidelines: UK Chief Medical Officers’ Report (2019), A Report from the Chief Medical Officer in the UK on the Amount of Type of Physical Activity people should be doing to Improve their Health, Available at:  https://www.gov.uk/government/publications/physical-activity-guidelines-uk-chief-medical-officers-report
3. NHS Darlington CCG, ‘North of England Back Pain Pathway’, (2018) Available at: https://www.health.org.uk/improvement-projects/north-of-england-back-pain-pathway
4. The Sleep Charity website (2024). Available at: https://thesleepcharity.org.uk/information-support/adults/

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]