exercise and low back pain

 Exercise and low back pain

You’ve probably heard that exercise is good for low back pain!  But what if I told you not all exercise is good for all types of lower back pain?  What if I told you some exercise can be downright harmful for some low back problems?

Types of Low Back Pain

First of all understanding your problem so you can apply the right exercise to help yourself is vital.  For the purposes of this article we will focus on whether a problem is “acute” or “chronic”.

Acute pain:

Many definitions include short term/recent injury, severe/sharp pain.  Very often it has significant swelling and inflammation.  It acts as a signal to the body to stop activity to reduce risk of further injury.

With this type of pain there is “tissue damage” that needs to heel.  Further exercise in this case can therefore be unhelpful at best and harmful at worst.

Chronic pain:

Chronic pain has long duration, often greater than 3 months.  This is considered to be greater than the time required for the heeling of the original injury.  It is often described as deep, dull, aching and widespread.  There is frequently a loss of mobility associated.

There are combinations as well.  As a Chiropractor, I commonly see what we call “acute on chronic”.  In these cases, you may have chronic pain which can become acute state after what often seems like a small injury/trivial incident.  In these cases, it is best to use exercise like it is an acute problem.

What the research says:

Acute pain is not generally helped by exercise.  This makes sense as too much activity will reduce healing.

But the research also shows that bed rest gets a worse result.

The general advice is to keep performing usual duties within your pain limits.  I would add walk as much as tolerable.  In some severe cases, this will mean up and down the hallway a few times with occasional lie downs through the day.  Other cases this means getting off the office chair as often as possible.  This will vary with each case and the actual part of the body damaged.

With gentle movement and walking, swelling/inflammation will start going down and you can start healing quicker.  Ice packs help at this stage also.  I’ll do another article on ice vs heat in greater detail soon.

When the injury has passed the acute phase and transitions to a chronic type of injury, exercise is more helpful.

1. Whole body movement
   That’s where your whole body: arms, legs and spine are working together. Like walking, running and swimming.  We are talking about longer, slower sessions here to improve blood flow, overall fitness and co-ordination (i.e. promote brain to body connection and awareness).
2. Regional spinal movement.
   This is more focused on moving the entire spine through its’ FULL ranges.  (Walk, run, swim only gets the middle part).  Spinal rehab type exercise, Yoga and Pilates are the best-known types of regional spinal movement.

The regional spinal movement is what most people think of when they picture “back exercise”.

What not to do?

What a loaded question!  Different problems can benefit from some exercise that can be harmful to other problems.

It’s always wise to have a trained professional assess your ability to tolerate the movements you do.  Many of the exercises commonly recommended for back pain can in fact aggravate weak spots EVEN THOUGH THEY FEEL BETTER WHILE DOING THEM.

A prime example here is the “child pose” common in many yoga classes.  Lots of patients I see feel better after doing these but then complain about their back getting aggravated by bending forward.  It’s a classic case of the deep parts of the spine that are weak being irritated while the muscles on top get stretched.  Once we eliminate those aggravating movements and develop better movement patterns and strength, then the back can truly heal longer term.

What else can you do?

There’s another piece of the puzzle missing: Spinal segmental movement.  Probably the most neglected.  The goal here is to make sure each segment of the spine is moving properly.

Daily stresses like too much bending/sitting, poor posture or emotional overload can stiffen segments of the spine.

Because of the way the brain controls the spine, it’s impossible for us to move an individual segment of the spine by ourselves.  This is where specific Chiropractic adjustments come in to restore movement and balance and reduce friction and stress.

You will know you need extra help like a Chiropractic adjustment if:

1. you can’t do the exercise
2. the exercise aggravates your condition
3. you’ve done them 3 weeks and nothing is improving.

Sometimes you just cant exercise your way out of a bad back!

If you’ve tried all the usual “back exercise” or even Yoga and Pilates, and you are struggling with a bad back still, maybe something else is going on and it may mean you need an adjustment.  There’s no need to struggle with low back pain.  Over the last 20 years we’ve helped 1000’s of people with low back pain.  So my recommendation is to call Cathy and Shannon on 6652 4025 to get to the root of the problem ASAP.