The American College of Sports Medicine has been a proponent of the idea that exercise is medicine since the launch of its campaign in 2007. (Technogym has partnered them in this campaign since 2010). Whilst it is easy to see how exercise can be beneficial for conditions like reducing blood pressure, heart disease and weight loss, it is perhaps more difficult and even counter intuitive to think of it as a treatment for lower back pain. After all if the muscles supporting your trunk are in pain, moving them is probably the last thing you’d want to do.
Indeed the medical community would have agreed with this view. However, more research into the cause and symptoms of lower back pain have resulted in exercise being promoted as a treatment with increasing regularity.
There are three types of lower back pain - acute lower back pain, subacute lower back pain and chronic lower back pain. Acute lower back pain is short term, lasting a few days or a few weeks and tends to resolve on its own with self-care and there is no lasting lost of function. The causes of acute lower back pain is mainly mechanical, i.e. either the spine, muscles, intervertebral discs or nerves have been disrupted in some way and this has effected the way they fit together. Subacute lower back pain, on the other hand, is defined as pain that lasts between 4 and 12 weeks.
Chronic lower back pain is pain that lasts for longer than 3 months. Some common causes of chronic lower back pain include physical strain and stress on your muscles, joints and ligaments, e.g. incorrect lifting technics, being overweight, unconditioned muscles resulting from a sedentary lifestyle, and over use; being emotionally or mentally stressed and muscular imbalances are also causes.
There is wide agreement on recommending exercise for the treatment of chronic lower back pain. This is because almost all of the common causes of lower back pain would benefit from the sufferer becoming more active, and by both strengthening and stretching their back muscles.
For example, lower back pain caused by stress would benefit from exercise because not only is exercise an excellent form of stress relief, but movements designed to lengthen and stretch tight muscles would help to alleviate the muscle tension that could be causing the pain in the first place.
However, studies have shown that almost all types of lower back pain would benefit from exercise as a treatment. Many people who suffer from acute lower back pain are reluctant to exercise for fear of causing either more pain or increasing damage to their back. However, the reality may be different.
"Current medical literature suggests that exercise has either a neutral effect or may slightly reduce risk of future back injuries." A reference is needed for this statement. If the statement is realted to the below article (Hedges et al. it is too week. A study with 39 patients can not support a statement lake this)
Hedges et al studied 39 patients with acute back pain and found that their back pain significantly decreased in both the short and long term following a program of specific spine stabilising exercises. [Reported in “Exercise as a treatment for chronic low back pain”, The Spine Journal 4 (2004) 106–115.]
The medical literature in support of exercise as a treatment for back pain identifies three symptoms of chronic back pain that can be address by an exercise regime. Namely:
- Improving reduced flexibility, strength and cardiovascular endurance, and other function impairments usually associated with lower back pain
- Reducing back pain intensity
- Reducing back pain-related disability by lessening excessive fear and concerns about back pain and alter stifling pain attitudes and beliefs
- Improving reduced flexibility, strengths and cardiovascular endurance and other function impairments usually associated with lower back pain
Overall fitness is adversely affected by lower back pain. A vicious circle is created whereby individuals fearful of doing more damage tend to restrict their movements. This leads to short, tight muscles, reduced flexibility, and reduced cardiovascular endurance, which in turn intensifies the back pain.
Stretching exercises can be used to restore flexibility on average by 20%. Back strength in lower back pain sufferers has been shown to improve by as much as 80% following exercise. Cardiovascular endurance can be increased by a variety of exercises including treadmills (MyRun) and exercise bikes (Group Cycle), walking, dancing etc..
- Reducing back pain intensity.
"Results from several randomised, controlled studies using a variety of types of exercise have demonstrated a positive effect on pain." [Frost et al.] However, the process by which exercise reduces back pain is not fully understood.
Studies suggest that the most beneficial type of exercise for reducing the intensity of back pain is high intensity cardiovascular exercises. The exquisite Technogym Cross Personal elliptical crosstrainer, designed by Antonio Citterio, is an ideal way of performing such exercise. Combining all the new ideas in the biomechanical and technological fields, Cross Personal provides a movement that resembles Nordic Walking, with non of the impact, and allows for performing intense cardiovascular training with minimal perception of fatigue.
- Reducing back pain-related disability by lessening excessive fear and concerns about back pain and alter stifling pain attitudes and beliefs.
The mechanisms through which exercise can accomplish this goal have been the subject of substantial research. It is known that our beliefs are powerful factors in how we experience the world. An individual who believes exercise will exacerbate their back pain and thus never attempts any exercise will never know otherwise. Also, they are likely to have their fears reinforced by their lack of movement, which is likely to worsen the discomfort they are feeling. Another vicious circle!
Of course, there are many treatment options available to low back pain sufferers, ranging from medication to surgery. Exercise, however, has long been understood to be one of the most sustainable and effective solutions for eliminating chronic low back pain. There is a growing body of research that demonstrates that it is also an effective treatment for acute back pain and individuals are unlikely to worsen their lower back conditions if they engage in exercise, even at a higher intensity.
If you suffer from lower back pain, before commencing an exercise program it is advisable to check with your medical practitioner so that they can:
- Assess the condition of your back condition to make sure your issue is muscular and not something more serious in nature
- Assess that you are physically healthy enough to exercise