Should you be doing exercises for lower back pain? Are they really helpful or a waste of your time? If helpful, what exercises should you do? How often? What if you have pain when exercising? Is weightlifting harmful? Are there specific stretching exercises you should be doing?
If you are going to be doing exercises for lower back pain, and you should be, these are all important questions that need to be answered.
Speak to 100 different doctors and therapists and you will probably get an array of different answers and recommendations. So much advice and so much confusion.
Who is right?
Well, they all could be right depending on what specific lower back condition they may be talking about. So...
How do you sort out all the recommendations? What exercises for lower back pain should you be doing? What exercises should you not be doing?
One thing should be perfectly made clear and is very important to understand:
Exercises for lower back pain will only help to correct the underlying cause of your pain. Treat the cause with the right exercise and you will invariably be treating the pain indirectly.
The answers to the questions posed in the first paragraph depends on the specific diagnosis and the cause of your lower back pain, your current fitness, your age, whether your problem is acute or chronic.
First you need to answer these questions:
Let's briefly look at each question.
1. What is your diagnosis?
Lower back pain from sciatica or from a facet syndrome requires different exercises than pain from a herniated disc. For example, a facet syndrome may be made worse from lower back extension exercises; whereas, a herniated disc may improve with extension exercises.
Walking may be great for most lower back conditions but if you are overweight, and because walking increases the internal pressure of the disc, your bulging disc may bulge even more and create more nerve compression and thus more pain.
If you have active trigger points strength type exercises may not help... or could even make your pain worse... until you eliminate the trigger points. When that happens strengthening exercises will be very beneficial.
You don't want to stretch the hamstrings if you have sciatica because it will probably stretch the sciatic nerve as well. Stretching an inflamed sciatic nerve will only further irritate it. But...
With myofascial pain stretching is great.
Knowing your diagnosis is important because your pain may or may not be coming from your current diagnosis. Yes, specific exercises need to be prescribed for your diagnoses but your pain needs to be treated at the same time.
Don't think you are doing exercises for lower back pain, when in reality you are doing exercises to improve your lower back muscular strength, balance, endurance and flexibility. The improvement in pain is the result of the improvement of your diagnoses or condition... not the direct result of improved fitness.
2. What is causing your pain?
The answer to the question should come from your physician. However, many doctors will conclude that the pain is related to the diagnosis. Always consider all of your diagnosed conditions; but...
Always look beyond the diagnoses as well.
The biggest and most important diagnosis for lower back pain and exercise recommendations is usually not even examined for.
It doesn't show up on any blood test, x-ray or MRI.
It can only be discovered and diagnosed with a proper physical exam.
It is the great imposter.
This great imposter is myofascial pain syndrome (trigger points). A thorough knowledge of trigger points is a requisite for an accurate diagnosis and effective treatment. To recommend exercises or other therapies without a proper trigger point exam will probably result in poor results at best and unnecessary care and expense.
3. When is the pain present?
If you awaken in the morning with more pain then you have during the day and you have a job that requires you to move about then it is probably a good idea to exercise. However if your job is a physical one and your pain gets worse with activity and exercise then avoiding exercise may be your best approach initially.
Or perhaps you have a brief increase in pain or a greater awareness of pain in the first 5-10 minutes of exercise and then the pain seems so subside or go away as you get further into your exercise period then it is probably better to exercise.
4. What effect does exercise have on your pain?
If stretching seems to aggravate your pain yet your doctor or some well intending friend or relative told you to stretch then by all means ease off the stretching or temporarily stop them until you are able to perform them without aggravating your condition.
Keep in mind that some discomfort may be necessary while exercising. But pain is not.
Listen to your body. Pain is a warning... discomfort is not. With stretching there should always be some mild discomfort. With strengthening there should be difficulty in effort--not pain with effort.
5. What is your overall fitness level?
If you have not been exercising for sometime, you are over-weight, have a sedentary job or lifestyle, and exercise doesn't seem to cause an increase in your pain then most likely you should begin an exercise program with specific exercises for your lower back.
If you are overweight then it is imperative that you get your weight down to a normal level. Any excess weight is an added burden to your lower back and will most likely interfere or hinder your recovery.
Exercise should not be easy... that's why it is called a workout.
Early in your program (first week) you will probably experience muscle soreness. This is normal. As you progress there should be no or minimal soreness. If you do not experience occasional mild soreness you are not challenging yourself enough and not progressing.
Remember, post-exercise soreness is good... post-exercise pain is not.
Exercises for lower back pain, although not a direct treatment for your back pain, is essential for full rehabilitation and prevention. Without including exercises in your overall care you will never achieve a maximum level of improvement.
By incorporating exercises for lower back pain treatment you help to ensure a return to normal function along with prevention and maintenance of your lower back pain and related symptoms and a more pain-free life.