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. |
