Exercise and Fitness to Help Your Back
Importance of exercise and fitness
A common (and harmful) misconception is that exercise should be avoided when a patient is experiencing back pain. Understandably, many patients are reluctant to exercise out of the fear that any exercises or stretching will aggravate their existing back pain. This may make them rely too heavily on medical treatments and underemphasize the importance of exercise for healing and long term back pain relief.
For most back problems, exercise and movement are the natural stimuli for the healing process. Controlled, gradual and progressive exercise, rather than inactivity and bed rest, most often provides the best long-term solution for reducing back pain and preventing (or lessening) future episodes of pain.
Most experts recommend no more than one or two days rest at the onset of most episodes of back pain. Prolonged inactivity can actually increase back pain as the back becomes stiff, weak, and deconditioned. As the pain increases, many patients reduce their activity and exercise levels, resulting in even more back pain and aggravating the cycle of inactivity and back pain recurrence.
Exercise plays the dual role of both treating back pain and helping prevent future episodes of pain.
- By nourishing and repairing spinal structures, exercise helps alleviate existing back problems.
- Movement and exercise keep the anatomy of the back healthy, flexible and strong in order to reduce the chances of further injury and back pain.
It is always advisable for patients to first consult with a health professional before beginning any exercise or fitness program. Working with a physician or experienced spine specialist will ensure that patients’ activities are safe for their back and for their overall health. With back pain, it’s particularly important to get an accurate diagnosis for the cause of the patient’s pain from a physician or chiropractor in order to rule out possible types of back pain that may be aggravated by exercise (such as spinal instability).
How exercise helps the back
Engaging in exercise and fitness activities helps keep the back healthy by allowing discs to exchange fluids which is how the disc receives its nutrition. A healthy disc will swell with water and squeeze it out, similar to the action of a sponge. This sponge action distributes nutrients to the disc. In addition, fluid exchange helps to reduce the swelling in the other soft tissues that naturally occurs surrounding injured discs. When there is a lack of exercise, swelling increases and discs become malnourished and degenerated.
Exercising the back reduces stiffness by keeping the connective fibers of ligaments and tendons flexible. Improved mobility through back exercise helps to prevent the connective fibers from tearing under stress, which in turn prevents injury and back pain.
Another important effect of exercise is that it stretches, strengthens and repairs muscles that help to support the back. The back and abdominal muscles act as an internal corset supporting the vertebrae discs, facet joints, and ligaments. When back and abdominal muscles are weak they cannot support the back properly. Strengthening exercises help to strengthen these supporting muscles in order to prevent straining soft tissues (e.g. muscles, ligaments and tendons) and provide sufficient support for the structures in the spine.
Additionally, stretching is good for the back. For example, stretching hamstring muscles helps to relieve stress on the low back. Another benefit of back exercise is that the motion helps lubricate the facet joints, which are synovial joints that require appropriate motion.
Integrating exercise with medical treatment
Exercise and fitness are necessary for healing existing back problems, recovering from back surgery, and especially for keeping the back healthy to help prevent (or at least lessen) future episodes of back pain. Ideally, an exercise and fitness program should be integrated during most phases of treatment for pain relief and to improve the overall health of patients. If the pain is severe, however, patients may first need to be treated for the pain prior to starting a back exercise program.
