It’s easy to think that when your back hurts, you should get some rest. Indeed, for many years that was the prescription: bed rest. But now we know better. Exercise is the number one prescription for non-specific lower back pain.
The source of back pain can be well-defined such as from a herniated disc, arthritis, scoliosis, tumours or infections, but it can also be non-specific, simple, low back pain. This is very common among adults and is usually caused by overuse and muscle strain or injury. This pain is localized in the lower back, maybe radiating slightly into the buttocks or thighs. Avoiding treatment can lead to a chronic (persistent) condition especially if you avoid any movement that brings pain, which then weakens muscles more, which makes movement more painful… it can be a vicious circle. Fortunately, most low back pain can get better if you stay active and avoid making it worse.
Exercise is a good choice for general lower back pain. It can strengthen and stretch muscles that will not only decrease the pain but it should also help you recover faster and prevent recurrence. As to when to start exercises, the answer is simple: as soon as you start noticing the pain and gradually increase the level of activity.
Having claimed that exercise is beneficial for lower back pain, we should be clear that not all exercises are created equal. For example, toe touches are not a good idea. Partial crunches are good, but stay away from sit-ups.
We can group exercises for back pain into three types. There is first general exercise to improve strength, flexibility and endurance. Brisk walking and swimming are both excellent ways to accomplish this. Second are core stability exercises. These target the trunk muscles — back, abdominal and pelvic — which keep the spine stable. Pilates is one form of core exercise that can help. Other methods offering gentle exercise include the Alexander technique and the Feldenkrais Method which can improve balance, posture and movement. Tai Chi and yoga can also contribute to back health. If you are taking a class or working with a trainer, mention your back pain so they can account for the limitations you may have.
Whatever form of exercise you choose, it is always a good idea to check with your doctor or a physical therapist or trainer first. This will make sure you are not taking on too much or the wrong exercise. A trainer or physical therapist can also design the right program for your individual situation and train you in the right techniques.
Any new exercise program should start slowly and ideally, with the right guidance. But doing exercises for your back does not mean you must have a trainer. Increase the amount and intensity of your workout gradually as you feel better and stronger. At any time, if your symptoms get worse, stop right away and see your physician or therapist.
Once the back pain is gone, don’t stop exercising; staying active will help keep your back healthy and prevent re-injury.
Dr. Paul Martiquet is the Medical Health Officer for Rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to-Sky, Bella Bella and Bella Coola.