MyAchyBack Potential Pain Solution: Fitness
Fitness Feature Article
Effect of Exercise on Back Pain
- Muscle inflexibility (can restrict the back's ability to move, rotate, and bend).
- Weak stomach muscles (can increase the strain on the back and can cause an abnormal tilt of the pelvis).
- Weak back muscles (may increase the load on the spine and the risk for disc compression).
- Obesity, associated with sedentary lifestyle (puts more weight on the spine and increases pressure on the vertebrae and discs). Studies report only a weak association between obesity and low back pain, however.
Benefits for Chronic Back Pain. People in with sudden and severe back pain should not exercise. Exercise plays a very beneficial role in chronic back pain, however. In one study, for example, patients with back pain lasting for an average of 18 months were assigned eight one-hour exercise sessions over four weeks. They showed greater improvement in nearly every area, including reduced pain and increased capacity, compared to patients who did not exercise. Exercise should be considered as part of a broader program to return to normal home, work, and social activities. In this way, the positive benefits of exercise not only affect strength and flexibility but they also alter and improve the patients' attitudes toward their disability and pain.
- Low-impact Aerobic Exercises. Low-impact aerobic exercises, such as swimming, bicycling, and walking, can strengthen muscles in the abdomen and back without over-straining the back. Programs that use strengthening exercises while swimming may be a particularly beneficial approach for many patients with back pain. In one study, for example, pregnant women who engaged in a water gymnastics program had less back pain and were able to continue working longer.
- Lumbar Extension Strength Training. Exercises called lumbar extension strength training are proving to be effective. Generally, these exercises attempt to strengthen the abdomen, improve lower back mobility, strength, and endurance, and enhance flexibility in the hip and hamstring muscles and tendons at the back of the thigh.
- Yoga, tai chi, chi kung. These exercises combine low-impact physical movements and meditation. They are based on principles of disciplining the mind to achieve a physical and mental balance and can be very helpful in preventing recurrences of low back pain. In one study, pilates, an exercise practice that uses yoga principles, was helpful in a woman with progressive and disabling severe low back pain from early scoliosis. This approach deserves further research.
- Flexibility Exercises. Whether flexibility exercises alone offer any significant benefit is uncertain. One study suggested that any benefits derived from flexibility exercises are lost unless the exercise regimens are sustained.
- Retraining Deep Muscles. Of interest are studies that are finding a link between low back pain and impaired motor control of deep muscles of the back and trunk. According to these studies, contraction exercises specifically designed to retrain these muscles may be effective for patients with both acute and chronic pain.
It is important for any person who has low back pain to have an exercise program guided by professionals who understand the limitations and special needs of back pain and who can address individual health conditions. One study indicated that patients who planned their own exercise did worse than those in physical therapy or physician-directed programs.
Hazardous Effects on the Back. On the other side of the coin, improper or excessive exercise is also an important risk factor for back pain.
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