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Exercise and Low Back Pain

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What is Low Back Pain?

Low back pain is defined as pain and discomfort, localized below the costal margin and above the inferior gluteal folds. This is a fancy way of saying between the bottom middle of the back to the bottom of your butt cheek.  For the sake of my terrible typing skills, I will refer to low back pain as LBP. It is reasonable to estimate that every American will experience some form of LBP at least once in a lifetime. The reality is much harsher. Upwards of 70% of persons in most industrialized countries will experience LBP that may or may not radiate down the leg. 

LBP can be caused by an injury or biomechanical breakdown. LBP due to infection, tumor, osteoporosis, ankylosing spondylitis, fracture, etc. must be cleared by your physician or therapist before beginning an exercise program.  Non-specific LBP is the most common form. This is because there is no obvious cause for the chronic or acute symptoms. This type of LBP can usually be addressed through the intelligent application of a progressive corrective exercise program.

Chronic LBP is a leading cause of medical facility visits each year costing billions of dollars annually in lost days of work, reduced quality of life, and increased health care expenses.

Non-specific LBP and Exercise

It is suggested that regular exercise is an effective measure to combat chronic LBP. Millions of people sidelined by nonspecific LBP because it hurts to move. I realize pain tolerance is very unique to each of us, but we should resist the urge to sit still. Some people can “fight” through the pain while others fully succumb to it. Either way, the issue can be addressed through intelligent program design. Most cases of nonspecific LBP do not require hospitalization or even physician care. Modification of exercises can help manage the symptoms. If you do decide the pain is too much take the time off but set a realistic and quick return time. This time should be with or without discomfort still present.  The reason is that we need to practice strengthening core musculature through deliberate application of specific exercises.

Non-specific LBP program design

We should always realize that all pain management is specific to the individual. What exercises help person “A” may increase pain in person “B”. For this reason, I believe you should seek out a certified corrective exercise or functional movement professional to assess which exercises will be right for you. Again, if you are under the care of a medical professional then stick to their exercise prescription.

Research supports incorporating multiple forms of exercise. Try different positions and variations to find what works best for you.  Chronic or reoccurring LBP that is not indicative of a greater injury can be used as a guide to assess program effectiveness. Remember, be patient with your program. The dysfunction did not happen overnight, and the correctives may take 3 months or longer to take hold.

The focus of the program should be geared toward muscular endurance rather than strength. Core stability is a systemic harmony of muscle contraction and relaxation to maintain static and dynamic posture. The majority of low back injuries happen during fatigue.

Well, that is all for today. Look for me to write more on low back pain in the future.

Live healthy everyone,

-Reuben


photo credit  © Dirima | Dreamstime.com

References

ACSM. (2009). ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities. Champaign, Illinois: Human Kinetics.

American College of Sport Medicine. (2014). ACSM's Guidelines for Exercise Testing and Prescription (Ninth ed.). Baltimore, Maryland, United States of America: Wolter Kluwer Lippincott Williams & Wilkins.

McGill, S. M. (2003, March). Enhancing low back health through stabilization exercises. Retrieved September 1, 2015, from American Council on Exercise: http://www.acefitness.org/pdfs/lowbackstabilization.pdf

Powers, S. K., & Howley, E. T. (2012). Exercise Physiology: Theory and Application to Fitness and Performance (Ninth ed.). New York, New York, United States of America: McGraw Hill.

Web MD. (2010). Living with Low Back Pain. (B. Nazario, Ed.) Retrieved September 1, 2015, from Web MD: http://www.webmd.com/back-pain/living-with-low-back-pain-11/causes?page=3




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