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Should I Exercise When I Have Back Pain?

There is no doubt about it, exercise is a necessity for good health. Exercise and strength training can help build up back muscles and prevent future back pain. But should you start exercising when you are experiencing evenminor back pain?

The answer to this question is yes and no.

With any back pain, it is best to be seen by a doctor or Chiropractor first. If the back pain is severe, your doctor may want to take X-rays to get a better look at the problem. Similarly, a Chiropractor can discover the source of your pain through a series of easy questions an alignment. Often times back pain can be remedied through regular adjustments, which will make it easier to resume regular exercise again.

When it comes to working out, rigorous exercise is very popular right now. Extreme programs like P90X and Insanity have taken the fitness world by storm. However, these programs are not right for everyone, especially those with back problems. It is also a good idea to avoid lifting free weights or exercises that require repetitive bending motions, such as squats.

Also, if you have back pain after your time at the gym, you may want to avoid picking weights off the floor as well as doing too many crunches and low back extensions. To avoid further back pain, make sure you bend with your knees and not your back while performing exercises. Also, be sure to set up your exercise machine or equipment up properly. Just exercising on a machine with the improper seat height can bring on pain the next day.

So what kind of exercises can you do when you are worried about back pain? Try to take your workout to the water. Swimming laps or jogging in the water is a great workout. Water aerobics and water zumba are also a lot of fun and easy on your back. Bicycling on a recumbent bike, or walking on a treadmill can also give your back a rest.

Exercise is an important part of every day life, but the calorie burn should not have to come at the price of back pain. If you suffer from back pain, take it easy and build up strength in your back muscles. Remember to not push yourself or do any exercise that is painful. Be sure to consult your Chiropractor or Physician for tips on how to prevent and treat back pain, and the most appropriate exercise program.

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4 Exercises That Can Make Back Pain Worse

An achy back makes it easy to blow off your workouts. But any doctor, physical therapist, or trainer will tell you that exercising is probably the best thing for your back: It can actually speed your recovery and help prevent pain down the road.

The only hitch is that you must avoid moves that will make your problem worse, says Bob Fischer, a personal trainer in Southampton, PA, who specializes in training men and women over age 50. Once you’ve seen a doctor to rule out potentially serious causes of your back pain, it’s time to get moving.

“If your back pain is acute, gentle exercise like walking boosts circulation, which sends a fresh supply of oxygenated blood to the place where you feel pain,” he explains. “This reduces the inflammation that’s causing your discomfort, helping you feel better faster.”

Fischer adds that once the intense pain phase has passed and you’re dealing with more of a chronic, nagging issue, strength training is key.

“It’s important to work the key muscles surrounding the back, such as the glutes, hamstrings, and abdominals, to help support the back and reduce future incidences of pain,” he says.

The catch is making sure those exercises don’t cause further harm.

More From Prevention: Your 10 Biggest Walking Pains, Solved

Here are the 4 riskiest moves when you have chronic back issues, and what to do instead to tone safely.

1. Sit-Ups

Going from laying flat to sitting upright puts a tremendous amount of strain on your spine, says Fischer, particularly if your core is weak–a common issue for people with back pain.

“When you don’t have the muscles in the front of your body to power you as you sit up, your low back ends up doing the brunt of the work, and that will exacerbate pain,” he says.

Exercise to Do Instead: Half Crunches

While most people will tell you to hold a plank, Fischer says half-crunches are actually better–as long as you only come up to a 20-degree angle as opposed to a 90-degree angle with a sit-up. (Your shoulders should come about 5 or 6 inches off the floor.)

“I like this exercise because it gets your upper abs to work without putting strain on the back,” says Fischer. “Holding your body weight in plank while trying to keep your back straight can put a lot of pressure on your back muscles.”

More From Prevention: 11 Highly Effective Solutions For Sciatic Nerve Pain

2. Deadlifts

Squatting over a barbell and raising the weight up using your legs can help strengthen your back as well–provided you use proper form. “Too often, I see people at the gym doing deadlifts with their low backs rounded excessively, which compresses your vertebral discs,” he says.

Exercise to Do Instead: Leg Presses on a Machine

This move strengthens your hamstring and glutes, just like deadlifts. However, it takes your back out of the equation and minimizes the chance of your body shifting into poor form.

More From Prevention: 4 Foam Roller Exercises To Relieve Pain In 10 Minutes

The Best Exercises You Can Do If You Have Back Problems

Back problems are a pain. Both literally and figuratively. Those with back pain know there’s a fine line between exercising the back muscles and pulling them. If you utilize some of the following exercises and workouts — especially the simple stretch on page 9 — you’ll live a more pain-free, pleasant life.

1. Swimming

Swimming is very easy on the joints. | iStock.com

Swimming in a pool can take pressure off your joints, but if you’re not near a body of water, a specific move can mimic swimming and strengthen back muscles, according to Prevention. When performing this exercise you’ll look like a swimmer out of water. Make sure to maintain a long spine and contract the abs to support your back throughout the exercise. Also, focus on the length of arms and legs, not the height.

Next: A better way to rebound

2. Rebounding (trampoline workout)

Did you know you could work out with a trampoline? | viki2win/ iStock/Getty Images Plus

Jumping up and down may seem jarring, especially to your back. However, research shows that trampoline workouts are low-impact — the springs absorb most of the force — and can actually help you recover from a back injury. Jumping on a trampoline increases back flexibility and muscle strength around your spine. NASA even recommends rebounding for returning astronauts.

Next: It seems too simple — but it works.

3. Walking

Count those steps for improved back health. | iStock.com/

You don’t need intense cardio to be healthy; it could even hurt your back more. Instead, go for regular walks. “People with chronic lower back pain who do not regularly engage in aerobic exercise are more likely to be limited in their functionality,” Andrew Moeller of Spine-Health writes. Not only does walking help you stay functional but the movement releases endorphins, which can ease your aches, too.

Next: This workout will give you a strong back and killer body.

4. Pilates

Pilates are a great low-impact exercise. | iStock.com

The benefits of pilates include “improved core strength and stability, improved posture and balance, improved flexibility, and prevention and treatment of back pain,” according to the Mayo Clinic. While the name sounds intimidating, pilates is helpful for those with back pain because it focuses on flexibility, strength, and endurance — and the only equipment you need is a mat. Beginners, start slow and work up to more difficult moves.

Next: This challenging move is worth the effort.

5. Standard planks

Planks can help alleviate back pain. | iStock.com/g-stockstudio

Working the body’s core has tons of benefits. “Planks train the muscles of your abdomen to activate so they support your posture and share in the burden of holding you upright; your back muscles no longer have to do all the work,” LiveStrong says. Not only do planks help in everyday activities, they can alleviate back pain. Put the painkillers aside and perform a plank.

Next: Ease chronic lower back pain with this workout.

6. Cycling

Strengthen your legs to help your back. | iStock/Getty Images

Even people with back pain need cardio. And cycling is one of the best ways to do so. This low-impact workout strengthens your leg muscles, which support your spine and take the pressure of the lower back. Research found that cycling helps control back pain and improve your fitness. The key: Maintaining a good technique and posture.

Next: Don’t “carry” the weight of your back pain.

7. Loaded carries

This simple exercise will strengthen your back and core. | iStock.com/Jacob Ammentorp Lund

This workout seems simple, but loaded carries “create more stability and stiffness while protecting the back,” explains Muscle & Fitness. All you need to do is pick up a set of heavy dumbbells or kettlebells — one in each hand — and walk for a certain distance or time. As long as you keep your shoulders back with a straight spine, you’ll see a stronger, more toned back.

Next: This old form of exercise still works wonders.

8. Yoga

Yoga will give your body a good stretch. | iStock.com/monkeybusinessimages

Practicing yoga — above and beyond the previous stretches we mentioned — can benefit those suffering from backaches and other ailments. “The relaxation techniques incorporated in yoga can lessen chronic pain, such as lower back pain, arthritis, headaches and carpal tunnel syndrome,” Natalie Nevins, DO, an osteopathic family physician and certified Kundalini Yoga instructor, told the American Osteopathic Association. “Yoga can also lower blood pressure and reduce insomnia,” Nevins added.

Next: Raise the “barre” on your workouts.

9. Barre class

Barre class involves low-impact moves while standing at a bar secured to the wall, or with a small exercise ball. | Lily Lawrence/Getty Images for Pure Barre

You’ve likely seen a franchise like Barre3 or Pure Bar pop up in your city. The low-impact, ballet-inspired workout is actually good for the disks that “cushion the vertebrae and the individual spinal bones,” according to research from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Experts say those with back pain can benefit from barre classes as long as they maintain a neutral spine.

Next: A simple stretch that will transform your back woes

10. Child’s pose stretch

Child’s pose is a great place to start if you are new to yoga. | iStock.com

One yoga pose in particular, child’s pose, is extremely useful for those with back pain. The pose, a variation of lying down on one’s stomach, gently stretches the muscles in the lower back, Prevention says. For those who are new to yoga, child’s pose is a good place to start. The move is simple and provides a good stretch.

Next: Fight back pain by learning to fight.

11. Tai Chi

Adults, not just kids, benefit from martial arts. | iStock.com/Garsya

Don’t rule out martial arts just because it’s not a common workout. Research finds that this low-impact exercise eases lower back pain and helps people with fibromyalgia, diabetes, Parkinson’s disease, and heart problems. Tai chi, in particular, can help you improve your posture, breathing, flexibility, and circulation. If you practice regularly, you’ll likely feel stronger, less stiff, and more relaxed overall.

Next: Work your entire body.

12. Forearm plank

The forearm plank is a little more difficult. | iStock.com/gpointstudio

Dubbed the “ultimate core move” by Prevention, the forearm plank works the core, midsection, arms, butt, legs … pretty much the entire body. Form is key to performing a plank and reaping the benefits. Keep the body in a straight line and in no time your body will be shaking, working to maintain its position. To track your progress, write down how long you hold a plank and review your stats weekly.

Next: Reduce stress with this no-equipment technique.

13. Practicing breathing

Taking slow, deep breaths can help calm your nerves. | iStock.com

Stress can contribute to back pain. But breathing exercises can help reduce stress, which can ease muscle tension. Spend a few minutes taking slow, deep breaths to calm your nerves. Practice meditation or download an app that guides you through breathing exercises.

Next: Mimic animals’ movements with this stretch.

14. Cat/cow pose

This move is great for your back. | iStock.com

Another yoga pose for back pain sufferers is the cat/cow pose. On all fours, the back is convex and concave to mimic a cat and a cow. While the move may feel silly, back muscles are being stretched to release tension. The pose moves the back muscles in two different directions, according to Prevention. That way, back muscles are targeted from all angles.

Next: Start small with this move.

15. Side plank

A side plank can help relieve your back pain in no time. | iStock.com/undrey

Planks are God’s gift to people with low back pain, Dr. Jordan Metzl writes. In his NBC News article, Metzl recommends performing three minutes of plank exercises a day. He suggests doing one minute in a traditional plank and one minute on each side. If a side plank with both feet stacked on top of one another is too difficult, lower one leg to support yourself.

Next: This exercise looks funny but it’s worth it.

16. Pelvic tilt to pelvic curl

The pelvic tilt will help strengthen your core. | iStock.com

A pelvic tilt to a pelvic curl is similar to a bridge. As with all exercises, form is crucial. Lying on your back with knees bent and feet flat to the floor, lift your pelvis then bring it back down to the floor, Very Well says. This sequence “teaches us to use our abdominal muscles in a way that supports and lengthens the lower back.”

Next: Channel your inner canine with this helpful move.

17. Bird dog

The “bird dog” pose |Source: iStock

It looks easy, but the “bird dog” gets more challenging the longer you maintain it. You don’t need to be highly coordinated to practice this core-strengthening exercise. It will gently strengthen your back and abdominal muscles, which support your posterior.

Next: Channel your inner swan.

18. Swan prep

This move is simple yet effective. | iStock.com

This move “strengthens the back extensors, the muscles the hold us upright,” according to Very Well. “These muscles are often weak and over-stretched in people who have back pain.” With arms tucked close to the body, lying face down on the mat, life your chest up, lengthening your spine. While the move may not involve big movement, swan prep is effective.

Next: Want a strong, flexible spine? Do this move regularly.

19. Twists

The yoga twist is perfect for your spine. | iStock.com/Wavebreakmedia

Yoga Journal says twists can be transformative for those with back pain and those who spend their days sitting down. “Twisting has the potential to help decompress the discs and elongate the spine, opening the spaces between the vertebrae, activating the muscles around the discs, and increasing blood flow to the spinal area to deliver pain-fighting, healing, anti-inflammatory oxygen.” Do the move regularly and you’ll have a strong, flexible spine.

Next: The general impact of exercise on your back

20. Overall? Move more

Get moving! | iStock.com

Bed rest for back pain isn’t the best plan, according to Harvard Medical School. “Limit the time you are lying down to a few hours at a stretch, and for no longer than a day or two.” Doctors don’t often suggest strict bed rest for back pain. Instead, they suggest the opposite.

“We know now that staying in strict bed rest can actually exacerbate pain, so we essentially tell patients to take it easy and move as much as tolerated,” Jeffrey Goldstein, MD, Director of the Spine Service at the New York University Hospital for Joint Diseases, told Health.

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5 Ways to Avoid Dangerous Ab Rollout Mistakes

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The Ab Rollout may be the best core exercise ever, but when it is performed incorrectly, the move can cause serious injury to your lower back.

What a good Ab Rollout does is strengthen your abs and teaches them to support your spine. It’s similar to a Plank, but more advanced.

As you roll out, your lumbar spine naturally wants to arch, or move into extension. This is what your abs are trying to prevent from happening, which makes it such an effective exercise.

But if you have poor form, you can easily end up moving into a dangerous position that can damage or even herniate the cartilage discs that sit between the vertebrae of your spine.

To prevent this from happening, below are a few simple form tips that will teach you to lock your core musculature in place while still getting the most bang for your buck from the exercise.

1. Take a deep breath in

Before each rep, take a deep breath into your stomach as if you were trying to fill your entire abdomen with air. Then brace your core as if you were about to take a punch.

2. Use your lats

At the beginning of each rep, tighten your lats by pulling your shoulders down and back. This helps to stabilize your spine in a manner similar to when you do a Deadlift. At the bottom position, roll yourself back to the starting position by pulling with your lats, which is a similar movement to a Straight-Arm Pulldown.

3. Start with the wheel directly under your shoulders.

To keep your core engaged, the ab wheel or barbell should start directly under your shoulders at the start and finish of each rep.

4. Keep your shoulders and hips aligned

To perform the Rollout effectively, ensure that your hips and shoulders are aligned with the same form as a proper Plank. If your hips dip, that means you’re placing unnecessary stress on your spine.

5. Avoid shooting forward with your hips

One of the worst mistakes is driving downward with your hips as you lower in the rollout. This all but guarantees you will cause your lower back to arch and take the tension out of your abs, which puts your spine at risk and decreases the training benefit. To counteract this, keep your hips straight or slightly bent throughout the exercise, and avoid driving your hips backward as you roll up to the starting position.

Bottom line: Use a shorter range of motion and maintain constant tension, and you’ll get a lot more out of this exercise.

Bonus Tip

Many people do not want to work all the way to their “sticking point” range, and stop a few inches short of it when they do ab wheel rollouts. Which is understandable since this exercise can be extremely humbling.

To extend your range, try reverse-engineering the rollout. Begin the exercise from the bottom, flat out on the floor, and try to pull up from the ground. As you move, maintain all the key form points mentioned above. Keep the number of reps you perform low. You’ll find that, with practice, your “sticking point” will get farther and farther out, and eventually it won’t be an issue.

RELATED:

Rollouts Are One of Our 27 Favorite Core Exercises

Are You Planking Your Way to Back Pain?

5 Other Brutal Core Training Mistakes

Photo Credit: Getty Images // Thinkstock

How to do Ab Wheel Rollouts Correctly and Safely

THE AB WHEEL ROLLOUT TUTORIAL

The bulk of our abdominal muscle training should come in the form of core stabilization exercises. Far too often, we have been misinformed that the best way to train abs is through flexion.

Please do not do this!

The ab wheel rollout is an extremely effective exercise in training the core stabilizers and in strengthening the abs the correct way.

Don’t underestimate this exercise, performing it correctly is a lot harder than it looks.

AB WHEEL ROLLOUT FORM VIDEO

BENEFITS OF THE AB WHEEL ROLLOUT

  • Strengthens the entire core musculature including the rectus abdominis, the lateral obliques, the transverse abdominis and also the gluteus maximus

  • Effectively teaches core stabilization by strengthening the abdominal muscles’ ability to resist spinal extension

  • Performing this movement correctly will fortify spinal health and help decrease low back pain

MUSCLES WORKED DURING THE AB WHEEL ROLLOUT

  • Rectus Abdominus

  • Obliques

  • Transverse Abdominus

  • Shoulders

  • Lats

PERFORMING THE AB WHEEL ROLLOUT WITH PROPER TECHNIQUE

  • Get an Ab Wheel and position in front of you while you kneel on a mat (you can find a good one cheap on Amazon)

  • Grab the handles of the ab wheel, and place your full weight on the device

  • From this position, cross your legs behind you, and lift your feet off the mat (this will help stabilize you but make the movement a bit more challenging)

  • Lock your shoulders into place by retracting your scapula, and keep your spine in a neutral position

  • As with all functional exercises, brace your core tight and squeeze your glutes

  • Begin the movement by rolling the wheel out in front of you while keeping your core tight

  • It is CRUCIAL that your spinal alignment does not change throughout the movement

  • If your low back changes in any way, you are defeating the purpose of this exercise

  • Roll out only as far as you can keep you low back straight!

  • Pause for a second at the fully extended position, while keeping your core tight

  • Reverse the movement by tightening your ab muscles even further and returning to the starting position

COMMON MISTAKES

NOT MAINTAINING A NEUTRAL SPINE

This can lead to lumbar strain. You must keep your core tight and engaged the entire time. If your low back bends (arches) during the roll out, stop the exercise. Only roll out as far as you can keep it straight. Over time you will be strong enough to reach full extension.

LETTING YOUR SHOULDERS FLAIL OUT OF THEIR SOCKETS

This can lead to shoulder and chest tendon strain. Lock your shoulder blades into position by retracting your scapula. The only movement from your shoulder should come from flexion as your body is extending down. At no point should your shoulders move in any other direction.

FREQUENTLY ASKED QUESTIONS

Can I Do Ab Wheel Rollouts With A Barbell?

Yes, just load up the barbell with short plates (10 lb plates should do the trick). The exercise is exactly the same.

Interestingly enough, loading the barbell with heavier weights will not make the exercise more challenging.

The challenge lies in being able to maintain a neutral spinal position, not in pulling the weight back towards you.

I’m A Beginner. Can I Do Ab Rollouts With A Stability Ball?

Sure. The only thing you have to understand is that the bigger the ball, the easier the exercise becomes. If you are an absolute beginner, this can be a good variation for you to do.

Simply place your hand on the ball and rollout using the the same technique mentioned above.

How Can I Do Ab Wheel Rollouts From A Standing Position?

This is a very advanced core exercise that should only be attempted by trained individuals.

With that said, Ross Enamait has a great ab wheel rollout progression to teach you how to do this exercise from your feet.

I haven’t yet mastered this exercise, but I plan to in the future.

Watch the video below.

I Don’t Feel The Ab Wheel Rollout In My Abs. What Gives?

Many people will feel this exercise in the chest and arms rather than their core. This is because you are focusing on too much on moving the wheel back and forth.

Instead, you need to concentrate on simply splaying your body forward while keeping your core extremely tight. Practice pausing at the bottom of the movement for 1 second and then come back up by squeezing your abs even harder. I guarantee you will feel it it.

I Have Back Pain When I Do Ab Wheel Rollouts

If you are experiencing pain, stop the exercise. Back pain during AWR is usually due to poor technique, i.e letting your lumbar spine extend. Your back should never change its alignment during this exercise.

It actually helps to concentrate on rounding your back slightly by hallowing in your chest and core. Maintain this position throughout the movement.

If you still have pain, then focus on performing planks in the mean time.

I Have Shoulder Pain When I Do Ab Wheel Rollouts

This is probably because you are letting your shoulder internally rotate too far when doing this exercise. Before you start the exercise, retract your scapula and screw your shoulder blades back into their sockets.

Maintain this position throughout the entire movement.

Do not let your shoulders come out of their sockets.

If you still experience pain, then focus on stretching your chest and your shoulders.

Is There An Ab Wheel Rollout Routine I Should Follow?

Your core is a muscle group just like any other. You do not have to train it every single day.

Performing at least 3 sets for 6-12 repetitions, 2-3 times per week will be more than adequate to get the results you desire.

Which is Better? Ab Wheel Rollouts or Dragon Flags?

They are both great exercises. Neither is better than the other.

I personally prefer reverse crunches/dragon flags as they require less equipment.

How Can I Integrate This Exercise Into My Training?

Check out our workout template for busy individuals to learn how to incorporate the ab wheel rollout and every other functional exercise into your training routine.

AB WHEEL ROLLOUT ALTERNATIVES

  • Loaded Carries

  • Dragon Flags

  • Plank Rows

  • Alphabet Planks

  • Toes to Bar/Hanging Leg Raises

Did you like this tutorial? Be sure to check out our article on all the best exercises detailing a bunch more!

The bark of low back pain is usually much worse than its bite. The pain almost always makes it seem worse than it is.

MRI and x-ray for low back pain are surprisingly useless, because things like herniated discs aren’t actually that big a deal,1 most back pain goes away on its own,2 and trigger points (“muscle knots”) are common and can be alarmingly intense but aren’t dangerous. Most patients are much better off when they feel confident about these things. The power of justified, rational confidence is huge.

Or you could be dying! What are the odds that back pain is something scary?

There are cases of low back pain that have alarming causes, but it’s rare. Once in a while back pain is a warning sign of cancer or an autoimmune disease. Or back pain could be associated with spinal cord damage. Or a few of other scary culprits.3 Over the age of 55, about one in twenty cases turns out to be a fracture, and one in a hundred is more ominous.4 The further you are from 55, the better your odds.

But how can you tell? It’s not always easy. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. (It’s basically just a plain English version of clinical guidelines for doctors.5) In other words, this article explains the difference between “dangerous” and “just painful” as clearly as possible. Tables, checklists, and examples ahead.

Ordinary back pain can be fierce and awful … but not dangerous. It’s bark is almost always much louder than its bite.

Chronic low back pain is serious…but rarely ominous

Back pain can suck the joy out of your days for week, months, even years. It can definitely be “serious” even when it’s not dangerous. I have worked with many truly miserable chronic low back pain patients, and of course the huge economic costs of back pain are cited practically anywhere the subject comes up. But your typical case of chronic low back pain, as nasty as it can be, has never killed anyone.

“Ominous” is medical jargon for “truly scary.” Cue Jaws theme music. Low back pain is ominous when it is caused by a spinal cord trauma, or a progressive disease that can maim or kill. Ominous causes of low back pain are rare, fortunately. But they are real. Awful things do happen, even the best doctors can miss them, and “alternative” health care professionals are even more likely to.

All of the worst possible causes of back pain and their major features

None of these are common. All of them usually cause serious symptoms that are easy to take seriously. Some of them can “fly under the radar” in early stages, but usually not for long. The names of the conditions link to carefully chosen articles from good sources.

The worst possible causes of back pain

what is it? major features
cancer a tumor in or near the spine Many kinds of cancer can cause many kinds of back pain, but some strong themes are: the pain grows steadily and is mostly unaffected by position and activity, worse with weight bearing and at night, and comes with other signs of being unwell.
cauda equina syndrome pinching of the lowest part of the spinal cord Hard to mistake for anything else: hard to pee, fecal incontinence, numb groin, weak legs. Caused by ruptured discs, trauma, cancer, infection.
spinal infection infection in or near spinal structures Hard to detect, often for a long time. Usually there’s a well-defined tender spot and then, eventually, deep constant pain, a rigid spine, sometimes fever and illness but not always.
abdominal aneurysm ballooning of a large artery next to the spine Pain may throb in sync with pulse. Mostly occcurs in people at risk of heart disease: older, heavier, hypertensive smokers and diabetes patients.
ankylosing spondylitis inflammatory arthritis of spine and pelvis, mostly Long term back pain starting well before middle age and progressing slowly and erratically, improves with activity but not rest, prolongued morning stiffness, possible involvement of other areas. More common in men.

The worst back pain is rarely the scariest

People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness,6 and some of the worst causes are actually the least painful (especially in the early stages). Pain intensity is a poor indicator of back pain ominousness & some of the worst causes are actually the least painful.For instance, someone could experience the symptoms of cauda equinae syndrome, and be in real danger of a serious and permanent injury to their spine, but have surprisingly little pain — even none at all in some cases!

Meanwhile, many non-dangerous problems can cause amazingly severe back pain. A muscle cramp is a good analogy — just think about how painful a Charley horse is! Regardless of what’s actually going on in there, muscle pain is probably the main thing that back pain patients are feeling. The phenomenon of trigger points — tiny muscle cramps, basically7 — could be the entire problem, or a complication that’s more painful and persistent than the original problem. It’s hard to overstate how painful trigger points can be, but they are not dangerous to anything but your comfort.

Two back pain situations you should take seriously right away, no delay

These two back pain scenarios might be medical emergencies. They do not necessarily mean something horrible is wrong, but it’s extremely important to make sure.

  1. incontinence and/or true numbness around the groin and buttocks in a “saddle” pattern8
  2. any accident with forces that may have been sufficient to fracture your spine9

If you are experiencing true numbness10 around the groin and buttocks and/or failure of bladder or bowel control, please consider it a serious emergency — do not wait to see if it goes away. These symptoms indicate spinal cord injury or compression11 and require immediate medical attention. (Few people will have symptoms like this without having already decided it’s an emergency, but I have to cover all the bases here.)

And, of course, if you’ve had an accident with forces that may have been sufficient to fracture your spine, please seek thorough medical assessment promptly, including an X-ray to look for a fracture. You need an X-ray to ensure that your spine is not actually broken.

You’d think so. But consider this story of a motorcycle accident: many years ago, a friend hit a car that had pulled out from a side street. He flew over the car and landed on his head. Bystanders showed their ignorance of spinal fracture by, yikes, carelessly moving him. In fact, his thoracic spine wassignificantly fractured … yet the hospital actually refused to do an X-ray because he had no obvious symptoms of a spinal fracture. Incredible! The next day, a horrified orthopedic surgeon ordered an X-ray immediately, confirming the fracture, and quite possibly saved him from paralysis.

Isn’t it rather obvious that a potential spinal fracture is an emergency?

The Big Three signs that you should investigate for an ominous cause of persistent low back pain (but it’s not an emergency)

You shouldn’t worry about low back pain until three conditions have been met:

  1. it’s been bothering you for more than about 6 weeks12
  2. it’s severe and/or not improving, or actually getting worse
  3. there is at least one other “red flag” (see more list items below)

The presence of the big three does not confirm that something horrible is going on. It only means that you need to check carefully.

Andy Whitfield as Spartacus

At his physical peak, not long before getting sick. The first sign of his cancer was steadily worsening back pain. He may have already been in pain at this time.

The story of actor Andy Whitfield is a disturbing and educational example of a case that met these conditions — for sure the first two, and probably the third as well if we knew the details. Whitfield was the star of the hit TV show Spartacus (which is worthwhile, but rated very, very R13) The first sign of the cancer that killed him in 2011 was steadily worsening back pain. It’s always hard to diagnose a cancer that starts this way, but Whitfield was in the middle of intense physical training to look the part of history’s most famous gladiator. Back pain didn’t seem unusual at first, and some other symptoms may have been obscured. Weight loss could have even seemed like a training victory at first. It was many long months before he was diagnosed — not until the back pain was severe and constant. A scan finally revealed a large tumour pressing against his spine.

All the red flags for ominous causes of back pain

“Red flags” are signs or symptoms that something medically ominous may be going on. A red flag is not a diagnosis. Red flags only indicate a need to look more closely. Check off all that apply … hopefully none or few or only the least alarming of them!

  • The risk of an ominous cause for low back pain is generally higher if you are under 20 or over 55. (Andy Whitfield was a tragic exception.)
  • Light tapping of the spine is painful.
  • Unexplained fever or chills.
  • Pain in the upper back is associated with a greater cancer risk.
  • Weight loss is particularly a potential sign of cancer.
  • Steroid use, other drug abuse, and HIV are all risk factors.
  • If you are generally feeling unwell in addition to having low back pain, this may be an indication that a disease process is underway.
  • Indicators of autoimmune disease include a family history of autoimmune disease, gradual but progressive increase in symptoms before the age of 40, marked morning stiffness, pain in other joints as well as the low back, rashes, difficult digestion, irritated eyes, and discharge from the urethra.
  • Symptoms that spread equally into both legs, especially numbness and/or tingling and/or weakness, and especially if it is aggravated by lifting. The same symptoms limited to one side are also a concern, but less so.
  • Difficulty urinating, incontinence, numbness around the groin, foot drop (a toe that drags), and significant weakness in the legs are all potentially serious signs of a neurological problem. These symptoms can develop over time, so it’s important to keep considering them.

Some of these red flags are much less red than others, especially depending on the circumstances. For instance, “weight loss” is common and often the sign of successful diet! (Well, at least temporarily successful, anyway. 😃) Obviously, if you know of a harmless reason why you have a red flag symptom, it isn’t really a red flag (duh!). But every single actual red flag — in combination with severe low back pain that’s been going on for several weeks — is definitely a good reason to get yourself checked out.

Most people who check off an item or two will turn out not to have an ominous cause for their low back pain. But why not check?

The tricky one: Cancer as a cause of low back pain, and the necessity of testing “just in case” when the symptoms justify it

Sorry I have to use the C word — I know it’s kind of a bummer. But C happens.

A few cancers in their early stages can be hard to tell apart from ordinary back pain — a bone cancer in the vertebrae, for instance — and these create a frustrating diagnostic problem. They are too rare for doctors to inflict cancer testing on every low back pain patient “just in case.” And yet the possibility cannot be dismissed, either! It’s an unsolveable problem.

Most cancers and ominous problems will inevitably start to cause other, distinctive, ominous symptoms, and it won’t be long before someone catches on that there’s more going on than just back pain. Being “freaked out” about persistent back pain poses a genuine threat: it can make low back pain much worse.So it truly is an extraordinary circumstance for back pain to be ominous without causing other symptoms that raise the alarm.

Meanwhile, it’s extremely common for non-life-threatening low back pain to be alarmingly severe and persistent — to have a loud bark! Your doctor may not appreciate how true this is, and may over-react to all persistent low back pain, even without other red flags. In most cases, you shouldn’t let them scare you. Being “freaked out” about persistent back pain is the real threat: it can make low back pain much worse, and much more likely to last even longer (a tragic irony).

This is an unholy combination of factors: the exact same symptoms can have either an extremely rare but serious cause, or an extremely common but “harmless” cause that can be greatly aggravated by excessive alarm!

The good news is that it’s easy enough to diagnose cancer if you look for it, so the answer to the dilemma is to simply do the testing when the time is right, but not before. There’s every reason to screen for cancer when the conditions merit it — that is, when the red flags appear in combination with persistent, severe pain.

Is lower right back pain worrisome?

Many people find this article because they are searching for information on “lower right back pain” or “pain in lower right back,” so I’ve made a point of including extra information exactly about this question.

Pain on the right side of the back is not particularly worrisome, no. Same with the left. There are two main kinds of back pain that occurs only on one side:

  1. Back pain that could occur on either side, but just happens to be on the right or the left exclusively. This is very common. Most ordinary back pain dominates one side of the back.
  2. Back pain that comes specifically from structures that exist only on one side. This is a small category.

Most of the anatomy of the low back and abdomen is symmetrical. Some of the guts are not symmetrical, and only some of those is a plausible cause of right-sided back pain. Here’s some of the key anatomy to consider:

    • Bones & muscle — All the musculoskeletal structures of the low back are 100% symmetrical, except for small local variations. Injury, pathology, and developmental can occur more one side of course. For instance, intervertebral discs rarely bulge exactly in the centre, but to one side or the other.
    • Kidneys — The kidneys are a matched pair. One painful kidney can cause back pain on one side or the other. Kidney pain can feel like back pain, and may occur on only one side. It is usually quite lateral, and just barely low enough to qualify as “low” back pain. However, when kidney stones descend through the ureters, they can cause (terrible) pain in the low back. Kidney stone pain is often so severe and develops so rapidly that it isn’t mistaken for a back pain problem.
  • Aorta — The aorta is the largest artery in the body. It descends from the heart through the rib cage and along the left side of the spine. An aortic aneurysm can cause pain on the left side of the back.
  • Appendix — The appendix is one of the few clearly one-sided structures in the region. It is on the right. However, appendicitis rarely causes back pain (or at least not without a great deal of abdominal pain as well).
  • Intestines — The intestines are a mostly symmetrical mess of tubes, with an equal chance of causing pain on either side — but almost exclusively abdominal pain, not back pain.
  • Gall bladder — The gall bladder is on the right. Gall bladder pain can be felt in the back. However, it is usually quite high — even the shoulder blade — and almost always overshadowed by abdominal pain.
  • Pancreas — The pancreas is roughly central, and conditions affecting it can cause pain in the mid-back on either side, but usually fairly central. As with all the other viscera, abdominal pain is more likely and likely to be more prominent.
  • Spleen — The spleen is on the left, and when it hurts it usually comes with a feeling of fullness and vague pain “somewhere” in the upper left abdomen and the upper part of the low back.

By now you should be getting the idea that there the side of the pain on its own doesn’t tell us much, and most of the one-sided sources of pain are viscera that usually cause more abdominal pain. In other words, the only reason to worry about right or left lower back pain is if it is otherwise worrisome: if you have other significant non-back symptoms, or red flags from the lists earlier in this article.

Notes

  1. People often have no pain or other symptoms despite the presence of obvious arthritic degeneration, herniated discs, and other seemingly serious structural problems like stenosis and spondylolistheses. This surprising contradiction has been made clear by a wide variety of research over the years (particularly see several studies in the 1990s: Boden, Jensen, Weishaupt, Stadnik and Borenstein), and was well-established by 2001 when low back pain expert Dr. Richard Deyo wrote in a physician tutorial for New England Journal of Medicine that “…disk and other abnormalities are common among asymptomatic adults” (see Deyo). The point has been emphasized by many other experts since, and continues to be clarified by new research in many different ways, such as a 2006 experiment (see Haig) showing surprising evidence that even spinal canal stenosis (narrowing) is routinely painless; or a 2009 paper (see Chou) concluding that most therapies that try to treat low back pain by addressing alleged mechanical problems are still controversial and unproven after all these years .
  2. Costa Ld, Maher CG, McAuley JH, et al. Prognosis for patients with chronic low back pain: inception cohort study. BMJ. 2009 Oct;339:b3829. PubMed #19808766. PainSci #55422.This Australian study concluded that “prognosis is moderately optimistic for patients with chronic low back pain,” contradicting the common fear that any low back pain that lasts longer than 6-9 weeks will become a long-term chronic problem. This evidence is the first of its kind, a rarity in low back pain research, a field where almost everything has been studied to death. “Many studies provide good evidence for the prognosis of acute low back pain,” the authors explain. “Relatively few provide good evidence for the prognosis of chronic low back pain.”

    Their research differs from past studies of chronic low back pain, which tended to focus on patients who already had a well-established track record of long-term problems (in other words, the people who had already drawn the short straw before they were selected for study, and are likely to carry right on feeling rotten). Instead they studied new cases of chronic low back pain, and found that “more than one third” recovered within nine more months. This evidence is a great foundation for more substantive and lasting reassurance for low back pain patients.

  3. The complete list, from Low Back Pain: Clinical Practice Guidelines:

    In the vast majority of patients with low back pain, symptoms can be attributed to nonspecific mechanical factors. However, in a much smaller percentage of patients, the cause of back pain may be something more serious, such as cancer, cauda equina syndrome, spinal infection, spinal compression fractures, spinal stress fractures, ankylosing spondylitis, or aneurysm.

  4. Enthoven WT, Geuze J, Scheele J, et al. Prevalence and “Red Flags” Regarding Specified Causes of Back Pain in Older Adults Presenting in General Practice. Phys Ther. 2016 Mar;96(3):305–12. PubMed #26183589. How many cases of back pain in older adults have a serious underlying cause? Only about 6% … but 5% of those are fractures (which are serious, but they aren’t cancer either). The 1% is divided amongst all other serious causes. In this study of 669 patients, a vertebral fracture was found in 33 of them, and the chances of this diagnosis was higher in older patients with more intense pain in the upper back, and (duh) trauma.
  5. Chou R, Qaseem A, Snow V, et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478–491. PubMed #17909209. PainSci #56029.Marvelously progressive, concise, and cogent guidelines for physicians on the treatment of low back pain. These guidelines almost entirely “get it right” in my opinion, and are completely consistent with recommendations I’ve been making for years on PainScience.com. They are particularly to be praised for strongly discouraging physicians from ordering imaging tests only “for patients with low back pain when severe or progressive neurologic deficits are present or when serious underlying conditions are suspected.”
  6. Or anything else. Pain is a poor indicator, period! The human nervous system is really terrible about this: it routinely produces false alarms, and alarms that are much too loud. See Pain is Weird: Pain science reveals a volatile, misleading sensation that is often more than just a symptom, and sometimes worse than whatever started it.
  7. There is controversy and scientific uncertainty about trigger points. It’s undeniable that mammals suffer from sensitive spots in our soft tissues … but their nature remains unclear, and the “tiny cramp” theory could be wrong. The tiny cramp theory is formally known as the “expanded integrated hypothesis,” and it has been prominently criticized by Quintner et al (and not many others). However, it’s the mostly widely accepted explanation for now.
  8. That is, the parts of your body that touch a saddle when riding a horse: groin, buttock, and inner thighs. I experienced rather intense, terrifying awareness of symptoms in this area in the aftermath of my wife’s car accident in early 2010. With a mangled T12 vertebrae, she was at real risk of exactly this problem. Fortunately, she escaped that quite serious problem. But, sheesh, I was vigilant about it for a while! “Honey, any numbness in your saddle area today?”
  9. Example: a friend of mine went to the hospital after a motorcycle accident. He’d flown over a car and landed hard on his head. Bizarrely, he was sent home with very little care, and no imaging of his back, even though he was complaining of severe lower back pain. A doctor reassured him that it was just muscle spasms. (This all happened at a hospital that was notorious for being over-crowded and poorly run.) The next day, still in agony, he went to see a doctor at a walk-in clinic, who immediately took him for an x-ray… which identified a serious lumbar fracture and imminent danger of paralysis. He had been lucky to get through the night without disaster! He was placed on a spine board immediately and sent for surgery. The moral of the story? Sometimes, when you’ve had a major trauma and your back really hurts, it’s because your back is broken.
  10. True numbness is not just a dead/heavy feeling (which is common, and caused even by minor muscular dysfunction in the area), but a significant or complete lack of sensitivity to touch. You have true numbness when you have patches of skin where you cannot feel light touch. Such areas might still be sensitive to pressure: you could feel a poke, but as if it was through a layer of rubber. Most people have experienced true numbness at the dentist.
  11. The condition is cauda equina syndrome. It involves “acute loss of function of the neurologic elements (nerve roots) of the spinal canal below the termination (conus) of the spinal cord,” where the nerves spread out like a horse (equina) tail. Again, this condition causes symptoms in the “saddle” of the body: butt, groin, inner thighs.
  12. This standard recommendation reinforces the alarming idea that low back pain that lasts longer than a few weeks is Really Bad News. It’s not. It’s a clue. It’s a reason for concern and alertness. But many cases of low back pain that last for 6 weeks will still go away. Once again, see the 2009 research published in the British Medical Journal, which showed that more than 30% of patients with “new” chronic low back pain will still recover without treatment.
  13. Spartacus is worthwhile, but the sex and violence is over-the-top: there’s no sugar-coating it. Definitely not a family drama. But the dramatic quality is excellent. After a couple of campy, awkward episodes at the start, the first season quickly gets quite good: distinctive film craft, interesting writing, and solid acting from nearly the whole cast. Andy Whitfield’s Spartacus is idealistic, earnest, and easy to like. I found it downright upsetting when I learned that he had passed away — as did many, many other fans I’m sure. See my personal blog for a little bit more of a review of Spartacus.

Article Featured on Pain Science | By Paul Ingraham

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions — such as sports injuries and fractures — to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

The Best and Worst Exercises for Back Pain

If you think treating a backache means going to bed or taking it easy, you couldn’t be more wrong. According to the Mayo Clinic, most acute back pain resolves within a few weeks with home treatment, and bed rest is not recommended.

Exercise is one of the best ways to get rid of back pain and keep it from returning. “There is an exercise for almost anyone with back pain. We even start people on exercise the day after back surgery,” says Maria Mepham, a physical therapist at the Cleveland Clinic in Ohio. But there are some types of workouts for bad back pain that are more beneficial than others.

Whether from an injury or degenerative disease (such as osteoarthritis), most cases of back pain can be reduced with regular exercise and tailored workouts. Stretching, strengthening, and conditioning exercises can result in stronger muscles that support the spine and your body’s weight. When your body’s skeleton is supported, you are less likely to suffer injury and back pain.

Studies confirm that when back pain sufferers start a regular exercise program, including resistance exercise or strength training, they are more likely to have less pain, and be able to return to work and be active again.

Here are five ways workouts for back pain can help:

  • Strong muscles give support to the back.
  • Strong abdominal muscles improve posture.
  • Increased flexibility aids in movement.
  • Stronger bones prevent fractures.
  • Exercise boosts natural endorphins in the body.

There are many types of exercise recommended for back pain, including:

  • Biking
  • Daily activities such as housecleaning and gardening
  • Low-impact aerobics
  • Resistance exercises
  • Stationary cycling
  • Stretching exercises
  • Swimming
  • Tai chi
  • Walking
  • Water exercises
  • Yoga

Before you get started — check with your doctor or therapist — if you haven’t exercised much in the past, start slowly and work your way up gradually. If you have pain or low back pain after working out stop and call your doctor.

One of the worst mistakes is trying to do too much too soon. Always leave time for warm-up and cool-down before and after workouts for back pain. “Let your doctor or therapist know if any exercise makes your back pain worse,” says Mepham.

The good news is that back pain can be prevented. Improper body mechanics such as incorrect posture or lifting heavy objects often leads to back pain. Knowing this, be aware of how you sit, lift, bend, twist and walk. Make sure your workplace uses ergonomically correct furniture, and ask for help if you need to move a heavy object.

Enjoy the SilverSneakers store!

Prevent and relieve back pain with this helpful guide.

If you’re reading this, you’ve probably dealt with back pain. In fact, most of us have—or will. Research shows more than 80 percent of the population will experience lower back pain at some point in their lives.

“Lower back pain is often a result of our lifestyles,” says Maxine Yeung, R.D., a personal trainer and founder of The Wellness Whisk. A few of the causes: poor posture, sitting most of the day, being overweight or obese, and lack of adequate physical activity, she says.

Getting older doesn’t help. “As we age, our bones and discs begin to degenerate,” Yeung says, “which can increase our risk of developing osteoarthritis, bulging discs, and spinal stenosis.”

No matter the cause, you don’t have to sit back and endure the pain. Incorporating certain exercises into your routine—and steering clear of others—can improve your symptoms.

Here are the dos and don’ts of working out to protect your back. As always, safety is key. The exercises here may be different or more advanced than those you’ll experience in a SilverSneakers class. If you have a chronic condition (including osteoporosis), balance issues, or injuries, talk to your doctor about how you can exercise safely.

The Best Exercises for a Bad Back

Anyone suffering from back pain or stiffness should work to improve both their strength and flexibility, says Lisa Woods, a personal trainer and yoga teacher in Eagle, Colorado.

When it comes to building strength, Woods recommends focusing on your core. “Doing abdominal exercises can be very helpful in reducing back pain because it provides support to the spinal muscles,” she says.

But remember: Your core extends far beyond your abs. The exercises below help strengthen the core muscles in your back too.

1. Seated Row

Tie a resistance band around your feet when you’re seated with legs extended and your back straight. Grab the two ends of the band, palms facing each other, and extend your arms forward.

Pull the band straight back until your hands reach the sides of your ribs, squeezing your shoulder blades together as you do so. Pause, then slowly extend your arms to return to starting position. Aim for three sets of 10 reps.

2. Pelvic Tilt

Lying on your back, bend both knees and place feet flat on the floor hip-width apart. Flatten your lower back against the floor by tightening your abdominal muscles and bending your pelvis up slightly. Hold for up to 10 seconds, then release. Repeat for 10 to 12 reps total.

3. Bridge Pose

Lie on your back with knees bent, feet flat on the floor about hip-width apart, and heels a few inches away from your buttocks. Press your arms into the floor for support, and brace your core to minimize the arch in your lower back.

Push through your heels and squeeze your glutes to lift your hips up until your body forms a straight line from your knees to shoulders. Hold this position for four to eight breaths. Slowly lower your hips to return to starting position. Repeat for three to five reps total.

4. Bird Dog Pose

Start on your hands and knees with your palms flat on the mat or floor and shoulder-width apart. Your neck should be in line with your back, and your gaze should be down or slightly forward.

Brace your core, and raise your left arm and right leg until they’re in line with your body. Hold for five to 10 seconds, and then return to the starting position. Repeat on the opposite side (right arm and left leg) to complete one rep. Aim for five to seven reps total.

Make it easier: Keep your hands on the floor, and only extend your leg.

5. Other Core Workouts

Like working out on your own but can’t get down on the floor? No problem. Try this 10-minute seated core workout.

Prefer group fitness classes? Many SilverSneakers classes emphasize core strength. Pilates and barre classes are also great for the core, Yeung says. Exercises can often be customized for your needs. Just let the instructor know of any conditions or back issues in advance.

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Don’t Forget Flexibility

Developing core strength is key for protecting your back, but it’s only one part of the pain-free puzzle. “The ideal exercise routine for a bad back combines strength-building exercises with flexibility training,” Woods says. “Improving flexibility can boost range of motion and balance, both important factors in injury prevention.”

And consistency is key. “Often, I see people have an injury, do physical therapy, feel better, and then stop with their exercises because they think they’re fixed,” Yeung says. That’s a bad idea. To prevent relapse, you’ll want to keep up the strength and flexibility exercises.

Luckily, many group fitness classes, like SilverSneakers and yoga, include flexibility training. You can also stretch on your own.

Woods recommends the following two exercises. If you have chronic back pain, back injuries, or degenerative disc disease, it’s best to do them under the guidance of an experienced instructor.

1. Gentle Twist

Stand tall with your feet hip-width apart and hands on your hips. Inhale as you lengthen the crown of your head up toward the sky. Keeping your hips facing forward, exhale and twist to the right from your belly button to your head. Gaze over your right shoulder. Hold for 10 breaths, and repeat on the opposite side.

Make it easier: Try the pose in a chair. Cross your arms over your chest, and gently twist. Hold for 10 breaths, and repeat on the opposite side.

Make it harder: Try the pose on the floor. Sit with your legs crossed in front of you. Align your head, neck, and spine. Place your right hand on the floor behind you. Bring your left hand to the outside of your right knee, gently twisting to the right. Hold for 10 breaths. Change the cross of your legs, and twist to the opposite side.

2. Modified Camel Pose

Stand with your feet hip-width apart and feet, knees, and hips facing forward. Make fists with your hands, and gently place them on your lower back, about the height of the waistband of your pants. Draw your elbows together, keeping your wrists in line with your forearms. Pull your belly in toward your spine, and lift your chest, keeping your hips level and steady. Hold for 30 to 60 seconds, and release gently.

Make it easier: Try the pose in a chair. Sit tall, reach your arms behind you, and grasp the back of a chair for a supported stretch.

Make it harder: Continue to lift your chest toward your chin as you keep your chin lifted away from your chest, finding length in the front of your body from belly button to collarbone.

The Worst Exercises for a Bad Back

Now, what shouldn’t you do? First, a general rule: Avoid any exercise that causes pain, Yeung says. More specifically, steer clear of the following:

  • Contact sports or high-impact sports like running, which may aggravate back pain or result in additional injuries
  • Sports that involve quick movements and twisting, such as tennis or golf, which can stress the spine
  • Heavy lifting, which can escalate back pain by compressing the discs or stressing the spine
  • Situps and leg lifts, which can put a lot of pressure on the lower back and may cause unnecessary straining if you lack adequate core strength
  • Excessive bending like toe touches, which can place undue strain on the back
  • Exercises that require forward flexion for long periods of time, such as cycling

While not recommended, if you are going to perform any of the activities above, you can help protect your back by moving slowly, engaging the abdominal muscles, and resting frequently, Woods says.

The bottom line: Developing a consistent fitness routine that combines core strengthening exercises, flexibility training, and low-impact cardio such as swimming or walking will help protect your back and alleviate pain for years to come.

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So if you’re a part of the 80 percent of adults who will suffer from back aches, listen in: New guidelines from the American College of Physicians suggest non-drug options are best for beating back problems. And that includes exercise for back pain relief. Here are seven reasons why being active may be your saving grace.

RELATED: 5 No-Equipment Back Exercises You Need in Your Life

7 Reasons You Should Exercise for Back Pain Relief

1. Exercise helps you recover.

The majority of back pain isn’t serious, says Robertson. In fact, most cases last a few days to a few weeks and heal on their own, according to the National Institutes of Health. That’s why experts generally recommend continuing your daily activities when you feel discomfort. For example, if you walk your dog in the morning, keep up your pup date. If you’re a runner, go ahead and fit in that 5K.

Keep in mind, there are a few clues that your back pain is something you need to see a doctor about, says Robertson. Make an appointment if you have unrelenting pain and no position feels comfortable. And take note if you have any neurological changes in your legs (like tingling, numbness or weakness) or experience any bladder or bowel issues.

RELATED: 5 Exercise Modifications to Ease Lower Back Pain

2. Running strengthens your spine.

Speaking of running, science shows it has your back. A 2017 study published in the journal Scientific Reports found that a regular long-distance running regimen improves the health of intervertebral discs (which help absorb shock to the spine) by keeping them more hydrated and nourished. The researchers also found benefits from jogging, speed walking and regular walking. The key for all of the above: running with good posture and technique. (You can brush up on that here.)

RELATED: Why I Started Running — And Never Stopped

3. Core work keeps you stable.

Core exercises aren’t all about that six-pack. One review in the Journal of Physical Therapy Science found that core strengthening, specifically, was superior to resistance training when it comes to alleviating chronic lower back pain. The muscles of your midsection include those in the front of your body (aka your abs), the muscles in your back and around your spine, as well as your hip muscles, pelvic floor and diaphragm, says Robertson. “These deep, supporting muscles help stabilize your back as you move,” he says. Make ‘em strong to move your spine sans pain.

4. There’s nothing like total-body strength, plus cardio.

A program that combines strength training and walking can boost spinal function and reduce pain in overweight individuals, according to recent research. That’s likely because it helps balance and strengthen back muscles, as well as boost blood flow to tissues in the area, which can speed healing. In addition to bettering back health, this cardio and strength combo program also burned body fat, which may help reduce the load on the spine, too.

5. Yoga is like a gentle back massage.

With its soothing poses, breathing techniques and relaxation benefits, fitting in a few oms can do good for your spine. In a new study in the Annals of Internal Medicine, researchers compared people taking weekly yoga classes, visits with a physical therapist, or standard education (such as a self-help book on back pain). After three months, the yoga and physical therapy groups experienced similar improvements in pain levels and were less likely to use pain meds. Time to say namaste.

RELATED: 8 Yoga Poses to Help Ease Lower Back Pain

6. Tai chi is a back-bolstering activity.

With roots in Chinese culture, tai chi is a sequence of slow, meditative movements, which help reduce more than just your stress levels. In a 2016 review of 18 randomized controlled trials that looked at tai chi for chronic pain conditions, researchers found that it can relieve lower back pain after 10 to 28 weeks of practice.

7. Staying couch-bound stymies healing.

Staying in your seat all day can affect your ability to heal quickly and that can lock you into a cycle of pain, says Robertson. “When you stop moving in an effort to protect the joint, over time, the joint becomes more sensitive. The result is that you need less stimulation to make the body part hurt again,” he explains. The remedy to prevent a touchy, irritable back from getting worse? Get up and get moving.

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