Many people have been told the best course of action when dealing with back pain is to stabilise the back, strengthen the core muscles, and then rely on massage and other forms of manual therapy. Although these things can definitely help with back pain, there is very limited evidence to support that having a weak or unstable core has any bearing on the severity of your back pain. Similarly, research also indicates that core or motor control (stability exercises) are no more effective than any other form of general exercise in relieving back pain.
The most important thing you can do to support your recovery from back pain is, therefore, to simply stay active with activities you can comfortably tolerate. The worst thing you can do for your back pain is to remain sedentary - staying active within your threshold as well as gradual return to previous activity level is key.
There is no one activity that seems significantly better than another when it comes to back pain recovery. Since adhering to exercising can be a struggle for some, most people should probably choose something they enjoy, are happy to do regularly, and that the body can tolerate. If you love doing core-exercises, great! Keep doing them as they can help with pain and increasing strength. But you don’t have to think that the reason they help is because you have a weak and unstable spine and that doing stability exercises makes the “core” stronger and more stable. It’s more likely that it’s because exercise and movement in general is hypo-analgesic (pain-killing) and that doing exercises and staying active increases the physical and mental resilience of your body including your back.
There has been a recent study that has found strengthening exercise to be marginally more effective than other interventions, so incorporating a strength-focused exercise plan into your routine can be recommended.
Research has also shown that walking, which is easy to do and quite accessible for most people, is as effective at improving back pain as other non-pharmacological interventions such as yoga, stress-reduction tools, and physiotherapy rehabilitation.
Walking is a good activity to help your back pain, as it is low-load and low-stress, and can be low-intensity as well. Taking a few steps is not as demanding as many other types of exercises, so it’s often one of the first exercises that people with back pain choose to start building their activity levels with.
When starting a walking program, find a threshold (whether that’s time or distance specific) that you can tolerate comfortably, and then build it up from there.
If you are finding it difficult at first, take it slow. You may find that smaller, but more frequent walks are easier for you to tolerate than one long walk.
As you build your tolerance and your back pain improves, you will then be able to return to more strenuous activities and increase intensity.
Here at Reach, keeping active and building back up to the life you want and see for yourself is what we preach, and what we aim to help you achieve. Read more about us here.
- Searle (2015); Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials.
- Byrnes (2018); Is Pilates an effective rehabilitation tool? A systematic review.
- Sitthipornvorakul (2018); The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials.
- Lawford (2016); Does walking improve disability status, function, or quality of life in adults with chronic low back pain? A systematic review.
- Rehaud (2013); Which physical activities and sports can be recommended to chronic low back pain patients after rehabilitation?
- Shipton (2018); Physical therapy approaches in the treatment of low back pain