Back Pain and Exercise: Should I or should I not?

     More than 80% of Americans have suffered with back pain at one point in their life. Once you have experienced back pain, it will more than likely reoccur. Around 90% of those who experience back pain, are classified as non-specific, meaning there is little evidence as to the actual cause of the pain. Each back pain professional will explain the cause based on their area of expertise. And then they will treat it according to their training. Back pain cannot be ignored. It has even been classified as one of the leading causes of disability in America.

    So what can cause non-specific back pain? Knowing this will help to answer some of the questions about if, or how, exercise can help. The causes can be placed in two main categories: bio-mechanical or psycho-social. The bio-mechanical causes include: joint alignment, muscle imbalance, poor posture, damaged structures, poor strength or stability, poor flexibility, poor posture, or obesity. Psycho-social causes include: unmanaged stress, sedentary lifestyle, poor nutrition, smoking, emotional stress, or muscle pain memory. The body remembers a painful experience or painful movement and sends pain messages to your brain to guard or brace, even when the tissue has already been healed. In determining if exercise is a good choice for someone with reoccurring back pain, it is important to look at the many factors that can contribute to the cause. From my experience as a physical therapist, and practicing Yoga therapist, I believe it is vital to address "both" the bio-mechanical and the psycho-social aspects to get the best results.

    People respond differently to exercise and what may work for some, may not work for others. It is important to learn what types of exercises work for you to help reduce low back pain, and help to prevent it from coming back. There are many evidenced based research studies that indicate that exercise can help reduce and even prevent back pain. But knowing the right exercises can be vital to prevent any further damage.

     From my experience, gently dynamic, bio-mechanically safe movements, within a pain free range, is best for relaxing the muscles and re-educating the muscles and joints to be able to move without pain. Incorporating proper breathing with the exercises is also key. Individuals with chronic back pain tend to be shallow chest breathers. This limits the amount of healing oxygen that gets to the muscles. A good, deep breath, during a stretch, can effectively improve the stretch and help to lengthen the muscles.

     If you can find a joint friendly way to perform aerobic activity such as chair aerobics, water aerobics, or a recumbent bike; then the increase in heart rate, over time, can release pain relieving hormones. Strength training for the core and postural in postural muscles, in prolonged holds; or stability type exercises are also important methods to support the spine and improve posture. The extremities need to be able to move and accept loads from a stable base of support in the core.

    And lastly, a good stretching program for all the muscles that affect posture is most important to prevent abnormal pulling on the spine. The simplest logic is-if the exercise causes increased pain, then don't do it. Finding a good physical therapist or doctor that can help to determine the best method or mode of exercise can help in the healing process and prevention of the pain reoccurring. Remember, taking medicine is helpful with reducing pain, but sometimes it only masks the problem. Then, the pain will eventually return and further progress is the causes are not addressed.

    Treating the psycho-social causes of back pain are as important, if not more important in some cases, to reducing back pain. Poor posture and body mechanics over time have a profound effect on the spine.

    The body has three natural curves when, in good alignment, will absorb the shock on the spine. But when the curves are not in their proper position in sitting, sleeping or standing; then undue muscle strain occurs. Being overweight, smoking and poor nutrition, also affect the muscle function and the ability of the joints and muscles to heal after an injury. Unmanaged stress causes the body to become tense and guarded, and also impairs breathing. Muscles that have been injured, tend to hold stress and toxins in them. Yoga, relaxation exercises, or even stress relieving, pleasurable activities, incorporated into a daily routine, can greatly help to reduce pain and prevent further re-occurrence of pain. My experience has indicated that my patients who perform 5-10 minutes of deep, diaphragmatic breathing (breathing from the belly, instead of the chest) a day improve their sleep, reduce their stress, and help relieve pain.

    Back pan can become a major hindrance to anyone's life. Taking the "full court press" philosophy to addressing the pain is most effective. By addressing both the "bio-mechanical and psycho-social" causes of back pain; one can influence the healing process and help to create a lifestyle change to better your future back health. ~ Beth Patterson PT, CYT.

     Beth Patterson PT, CYT

     Patterson Physical Therapy

     731-300-4950