BBack pain is the most common form of chronic pain, with approximately 4 million people living with her in Australia. The most effective way to manage chronic back pain is with a multidisciplinary approach, of which exercise is a key component.
“A single treatment for low back pain is never enough on its own,” says Associate Professor Michael Vagg, a pain medicine physician and dean of the College of Anesthetists of Australia and New Zealand College of Pain Medicine. “But exercise is a critical part of recovering from low back pain and managing it if it becomes persistent.”
But people who have suffered from back pain for a long time may be afraid to move.
Curtin University Pain Scientist and Physiotherapist Dr. Matthew Bagg says the first big challenge for people with chronic back pain is understanding that pain is not an accurate indication of how robust your body is. “Regardless of how they feel, they are not broken, damaged or falling apart.”
“If it hurts to do something, people are likely to do less,” says Vagg. But those who stay active tend to have better long-term results. “Even when we experience back pain, it doesn’t mean we shouldn’t move.”
“Pain itself is not a problem,” agrees Dr. Rob Laird, a musculoskeletal physical therapist. But increased pain during and after exercise is a red flag, he says. “Exercise should reduce, not increase, pain.”
There is limited evidence to suggest that one type of exercise is better than another when it comes to chronic back pain. “The best exercise is the one that you will continue to do and enjoy,” says Vagg.
Laird says that physical activity for chronic back pain should include three domains: strength, mobility, and cardiovascular fitness.
It is strongly recommended to consult a GP or physical therapist before starting an exercise routine for chronic back pain. But here are some practical tips that can help you stay active.
The class: Pilates
in a study Published in October in the Journal of Physiotherapy, Bagg and his colleagues conducted a statistical analysis that combined the results of multiple clinical trials of exercise therapies for people with long-term back pain.
They found some evidence to suggest that Pilates exercise might have the most significant effects on pain intensity.
Pilates classes include a series of exercises that focus on the stability and mobility of the body, particularly the spine, core, and pelvic area.
It emphasizes the “neutral position of the spine” – the natural curves of our spine that provide stability and mobility to take the weight and pressure of our bodies. Pilates exercises also help strengthen the legs and the muscles of the buttocks, shoulders, and arms.
The move: single knee squat
Laird advises strengthening the muscles of the lower extremities and glutes because these are the muscles we use when we bend or go from sitting to standing. “If they are not well done, the back muscles have to work more.”
Because working out the legs and glutes doesn’t over-recruit the back muscles, he says, most people feel confident doing it. Laird suggests starting with the classic pilates roll down and progress to single knee squats.
To start rolling down, imagine yourself standing against a wall, then think about peeling your spine off the wall one vertebra at a time, starting by tucking your chin in, rotating your neck, and slowly working your way down to your pelvis. Your knees are slightly bent and you may feel some pressure on your hamstrings. To get back up, turn your pelvis first, then your spine, one vertebra at a time. The neck and head are the last.
The second part of the exercise focuses on the gluteus maximus. Go back down one vertebra at a time, place one hand on a chair for balance, and lift one foot off the ground. Bend the knee of the supporting leg, then push through the heel and back up. Aim for five to ten reps and switch sides.
Reduced spinal mobility has a poor impact on back function, Laird says. A simple exercise that can help improve back mobility is the cat-cow stretch.
Begin in a four-point kneeling position with your hands under your shoulders and your knees under your hips. Inhaling, allow your stomach to drop slowly and tilt your pelvis forward. As you exhale, arch your back up by tucking in your tailbone and pulling your navel toward your spine.
The activity: walking, biking, swimming.
Laird says brisk walking, cycling, or swimming are great ways to include cardiovascular fitness in your workout. These are all activities that most people with chronic back pain can do, he says. “Cardiovascular fitness is essential. If you are not fit enough to walk around the block easily, you will have a hard time with life in general and pain will continue to be a real problem. “
The hard pass: running
Laird doesn’t encourage you to start running. “Running is not recommended at the beginning of a recovery plan, but it can be used in younger patients towards the middle or end of their recovery plan,” he says.
“It is less useful in older patients (over 60 years or so, although there are always some exceptions) due to the shock load when there is already a significant degenerative change.”
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George is Digismak’s reported cum editor with 13 years of experience in Journalism