FITNESS AND WELLNESS
Is It Safe to Exercise with Back Pain?
Back pain affects four out of every five people here in the United States, with an estimated cost of $240 billion annually. What makes back pain such an intimidating injury is the fear many people have once their back starts to ache, becomes stiff, or acts up. Fear is often exacerbated by healthcare providers who use terms, such as ‘herniated disc’, ‘bulging disc’, and ‘degeneration’. These diagnoses are often accompanied by expensive MRI’s, x-rays, and prescriptions for powerful pain medications, sometimes without consideration for other treatment options.
What is often unstated within the medical community is that as we age, abnormal MRIs are to be expected. Latest research shows that in healthy, pain free individuals, ages 40 and older, nearly 75 percent had some form of spinal disc degeneration. In addition, over 50 percent of these individuals had evidence of a disc bulge/herniation. This same study demonstrates 85 percent of individuals in their 60s and 98 percent of individuals in their 80s have evidence of spinal disc degeneration on MRI. Remember, these are MRI’s of individuals without pain or discomfort! Based on this evidence, we could conclude that terms like ‘spinal disc degeneration’ and ‘disc bulges’ may be part of the expected aging process, almost to be thought of as “wrinkles of the spine.” 1
Hearing that you have some sort of degeneration or that your back is out of place, understandably heightens fear and makes you leerier of additional injury or activities that may increase your pain. You may find yourself thinking, “what if I continue to cause further degeneration and make things worse?”, or “what if I put my back further out of place by moving too much?” It’s not uncommon to feel quickly overwhelmed and out of control of your own situation. You are not alone!
So, how can you get in control of your pain and start your journey to feeling younger and performing better in the activities that you love? First–a quick anatomy lesson. The joints of your body, including the spine, are all surrounded by a fluid that is full of nutrients. This fluid works in conjunction with your muscles and movement to lubricate your joints to keep the joint surfaces healthy and nourished. When your muscles and joints stop moving, this lubrication process greatly slows or stops, and as is to be expected, the nutrients your joint surfaces receive greatly decreases. When these areas of the body don’t get adequate nutrients over time, these areas of the body can become weaker and degenerate. So, what does this mean for you? It means movement is medicine.
By decreasing your activity levels, you increase the likelihood of becoming deconditioned, weaker, and allow your body to get used to the pain – ultimately taking what could be a short-term problem and allowing it to become a chronic issue. By taking control of your situation and staying active, you allow your body to heal itself. Excellent low impact activities to begin with are walking and swimming. The increased blood flow and joint lubrication from these activities will strengthen your muscles, flush out inflammation, and release endorphins (your body’s natural painkiller) to help you feel better and start your journey to achieving your goals.
There is no one-size-fits-all approach to treating low back pain. All people are different and deserve a customized approach to treating their pain. However, there are a few recommendations that can work for everyone. As well as remaining active with a low-impact exercise, try breaking up the amount of time you spend in a prolonged position each day. Do you spend most of your day sitting at a desk? Make it a habit to stand and move around at least once per hour. We also recommend that when you get up to walk, you perform five back bends. Simply place your hands on the small of your back, and lean backwards as far as possible – if you experience pain, you’re bending back too far; if your balance is poor, place one hand on a desk or wall for improved stability. This will help relieve the stress from your joints and muscles, keep you flexible, and make sure that your blood is circulating all day long!
Keep in mind that over 90 percent of all low back pain cases typically resolve within six weeks. Knowing this may help decrease your fear and anxiety and allow you to see that there is a light at the end of the tunnel. By staying active and maintaining a healthy lifestyle, you may be able to avoid pain medication and expensive MRI’s altogether!
As stated above, there is no set solution to low back treatment, which is why if you are still suffering from pain that is stopping you from doing the things you love, the best thing you can do is to contact a healthcare provider that specializes in hands-on, movement-based therapy. These providers can give you a customized approach to address your pain and help you achieve your goals more quickly. Most importantly, realize that you are not alone in your back pain and that by keeping active and moving, you are on your way to beating low back pain!
1 Percentage of ‘abnormal’ findings on lumbar spine MRI & CT images in healthy pain free subjects. Brinjikji et al: American Journal Neuroradiol (2014).
A native of Sheffield, England, Matthew Turner moved to North Carolina in 2016, with his wife Rachael, and has worked in an outpatient orthopedic setting, specializing in manual therapy. Matt is the Facility Director and lead physical therapist for the PHOENIX Rehabilitation and Health Services, Charlotte location. Matt's clinical expertise focuses on outpatient orthopedics, post-operative conditions, concussion, and sports/work-related injuries. Matt underwent post-graduate training with NAIOMT and is a Certified Manual Physical Therapist. He is also certified in Dry Needling and Blood Flow Restriction Training.