With 90 per cent of the population reporting having to lay low at least once due to an aching back, it’s safe to say the majority of us know what back pain feels like. Most of the time the pain is resolved within a few days, but about 20 per cent of low back pain sufferers don’t find relief. And a significant number of those cases never get a specific diagnosis or treatment plan from a health-care professional.
Left to their own devices, most people treat back pain with bed rest and over-the-counter pain relievers. But pampering a sore back isn’t the best way to relieve discomfort. Nor is a massage or a strategically placed ice pack or hot water bottle. Instead, more and more evidence suggests that exercise is one of the most effective ways to reduce chronic low back pain and improve mobility.
The idea that exercise is a key player in relieving chronic back pain isn’t new, but it hasn’t been fully embraced as the treatment of choice. Most people feel more comfortable treating pain with rest, especially if they think vigorous physical activity like shovelling snow or home DIY projects was the root cause.
Sure, some health-care professionals are starting to recommend activities like yoga and Pilates as options for persistent low back pain, but those recommendations are often more intuitive than evidence-based. After all, it seems safer to suggest a gentle version of exercise rather than high-energy pursuits like weight training or interval workouts. But exercise adherence has long been linked to doing what you like, and Pilates or yoga may not be some back pain sufferers’ first choice.
Understanding the importance of physical activity in improving the quality of life for back pain sufferers, a group of Australian researchers took a look at the science behind the effectiveness of various types of exercise in the treatment of chronic back pain. Their review included 89 studies, featuring 9,543 subjects from 20 to 70 years of age, that rated the effectiveness of a specific exercise type on relieving back pain and/or improving physical function, mental health and core strength. The studies covered a large variety of exercise, including strength training, Pilates, yoga, core training, cardiovascular conditioning, water-based training like aqua fitness and stretching. All the studies included a control group made up of either non-exercisers or subjects who received hands-on treatment from a physiotherapist, osteopath, chiropractor, massage therapist or acupuncturist.
After reviewing the data, the researchers concluded that while physical activity is effective in reducing several negative effects of chronic low back pain, there is no single type of exercise that stands out as better than all the rest. Instead, anyone who suffers from persistent low back pain should be encouraged to experiment with a variety of exercise routines until they find one that provides the best results.
“Our study provided evidence that various exercise training approaches are effective and should be incorporated into usual care for adults with non-specific chronic lower back pain due its potential for improving pain, physical function, muscle strength and mental health,” said the researchers.
Specifically, the researchers recommend what they refer to as “active therapies,” like Pilates, weight training, core stabilization exercise and aerobic conditioning, where the individual is “guided (and) actively encouraged to move and exercise in a progressive fashion.”
Physical function seemed to improve most with a training regimen that included weight training, core stabilization training, yoga, Pilates, water-based training and/or cardiovascular conditioning. Cardiovascular conditioning and weight training were deemed the most effective exercise options for improving mental health.
Before you decide to forgo your current back treatment plan in favour of hitting the gym, keep in mind that slow and steady should be your mantra. And let’s not forget trial and error. One of the important takeaways from the data collected by the Australian researchers is that there’s no shortage of exercise options when it comes to making your back feel better. So go ahead and experiment, giving yourself permission to mix and match workouts.
Another piece of advice is to work with a qualified personal trainer or fitness instructor who specializes in therapeutic exercise. Tweaking workouts to make them back-friendly while building muscular strength, endurance and range of motion isn’t the type of routine you can get off the internet. Moving from a mindset that backs are fragile to one that endorses the idea that backs need to move isn’t easy. But if less pain, more mobility and improved mood are the goals, it’s worth giving exercise a try.