When your back hurts, the last thing you want to do is exercise. And that is usually a mistake. Traditionally, our grandparents were advised to lie in bed, and not move when experiencing back pain. More and more evidence suggests prolonged bedrest has adverse effects, and unintended consequences of more prolonged pain, and disability.
Exercise and back pain is a common topic to many patients. To review, for the vast majority of the population, back pain results from a soft tissue sprain/strain of the muscles or ligaments of the lower spine. Or, back pain can be the result of irritation of the developing arthritic joints of the spine, called the facet joint. At any rate, as long as the back pain is tolerable or not causing nerve irritation, usually it will resolve, or improve for most people. Exercise has the potential to decrease the duration of back pain, or increase the intervals between episodes of back pain.
I regards to exercise and back pain, my most common advise is to walk. When you are in extreme pain, you may not think that is possible. But I advise patients to just take as many or as few steps for at least 10 minutes twice a day for the first few days of the back pain. The act of walking does wonders for the body. It requires you to get up from a seated or lying position. It requires you to balance and coordinate all your muscles. And, from the mental standpoint, it demonstrates your ability to control some aspect of your pain.
In the act of walking, you must recruit muscles from your abdomen, your back , and your large muscle of the legs. If you place your hand on your back muscles while walking, you can feel the muscles contract and relax with each step. While you may have back pain, the act of recruiting those back muscles help maintain the muscle tone and orientation.
If you are feeling better, and can walk at a faster pace, usually you will find yourself swinging your arms. Again, more muscles are recruited. You can increase your aerobic activities, and help exercise your heart, and burn a few calories. Overtime, the exercise of walking is a low impact, aerobic activity, that burns calories, and for the most part does not cost you anything other than time. And, it helps restore your core muscles, including your abdomen and your back.
In reference to exercise and back pain, I also encourage stretching exercises. under the For Patients tab on the top of this page, I have sections titled Back Exercises, and Neck Exercises. I find these exercises and stretches are helpful for patients recovering from back and neck pain.
And finally, in reference to exercise and back pain, I encourage everyone to be as active as possible. Yoga, Pilates, low impact aerobics, swimming and upright bicycling are excellent other activities.
When experiencing back pain, I usually recommend against vigorous tennis, golf, or heavy weight lifting. Unfortunately, these activities are associated with more injuries to the back.
The bottom-line, is exercise and back pain are good topics of discussion you should have with your doctor. Stay active, stay low impact, and use common sense.
- Magalhães MO, Comachio J, Ferreira PH, Pappas E, Marques AP. Effectiveness of graded activity versus physiotherapy in patients with chronic nonspecific low back pain: midterm follow up results of a randomized controlled trial. Braz J Phys Ther. 2017 Jul 12; PubMed PMID: 28803704