The advice is unanimous. When you have low back pain, healthcare professionals around the world say that the best treatment is exercise. Aerobic exercise is a great way to increase the blood flow and deliver much-needed nutrients to the soft tissues in your back. Improving your circulation can also lead to less stiffness and, ultimately, less low back pain. When we take the time to exercise and we increase our core muscle strength we can help our bodies better support our spine, reducing the impact of every day activities on our spines and helping improve spine health.
There’s only one problem.
Sometimes it can be scary to exercise when you have low back pain.
Fear Of Exercising With Low Back Pain
Many people who struggle with chronic low back pain are scared of exercising in case it makes the pain worse. Lower back pain can be excruciating and debilitating and it is no surprise that people don’t want to exacerbate that. Fear of injury is a valid concern. So much so that researchers have investigated what lies behind the fear of further injury and have tried to find ways to address these concerns. If we are going to be able to improve people's quality of life and help people get back to participating in their normal activities, fear needs to be addressed.
When it comes to fear threats, researchers have identified 3 major issues:
1. Fear-avoidance beliefs (For patients with low back pain, fear-avoidance beliefs (FABs) represent cognitions/thoughts and emotions that form the foundations for the concerns and fears regarding the potential for physical activities to produce pain and do more harm to the spine).
2. Fear of falling (this refers to the fear of losing your balance, falling, and causing further injury to the spine).
3. Kinesiophobia (defined as “an excessive, irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability due to painful injury or reinjury”).
It can be hard to stay active when you are already in pain but as long as your doctor has ruled out any rare or serious causes of your lower back pain then there isn’t really any reason to be scared of moving.
Kinesiophobia And Its Effect On Low Back Pain
Kinesiophobia (fear of pain to movement or re-injury) combined with emotions and physical variables plays a key role in the assessment and management of low back pain. Studies have found that kinesiophobia is a significant predictor of pain intensity and functional performance in individuals struggling with low back pain.
Kinesiophobia also impacts something called proprioception. Proprioception (also known as kinesthesia) refers to your body's ability to sense location, movement, and action. It's how our bodies read all the data from our surroundings and our movements so we don't have to think too much about our next steps. Kinesiophobia can actually cause changes in our somatosensory system and increase our sensitivity to pain.
The Importance Of Exercising
When you don’t exercise it can cause your core muscles to weaken and that can actually make your pain worse in the long term. Engaging in regular physical exercise has been shown to strengthen muscles and reduce pain and it can also help keep you mobile and able to engage in your regular daily activities.
When it comes to exercising there are numerous studies to support its effectiveness in managing lower back pain. One study looked at whether or not strengthening exercises, endurance training and aerobic exercise could help prevent non-specific low back pain. They looked at 21 different studies which included more than 30,000 participants.
The different studies looked at all different types of exercises such as core stabilizing exercises and stretching exercises. The length of the exercises varied from just 5 minutes a day to one or two 60 minute sessions per week. The researchers found that without exercise around 50% of people had low back pain again within one year compared to only about 30% of people who did exercise.
When it comes to overcoming the fear that sometimes accompanies low back pain there are certain treatments that have been found to be beneficial. Manual therapy and electrotherapy have been found to make patients feel more comfortable with their exercise programs. Taking a multidisciplinary approach to treatment can help reduce the fear of falling and kinesiophobia.
Top Safe Exercises For Low Back Pain Sufferers
While there is no perfect exercise for those struggling with low back pain, there are some exercises that are lower impact and that have additional benefits. Some exercises that have proven effectiveness are:
Generally speaking, lower impact exercises are the most effective and the most gentle for low back pain.
No matter what type of exercise you pick, finding something that you enjoy is key. You can also speak with your doctor or physical therapist to help you find something that specifically addresses your unique condition and concerns. For some people, having a personal trainer that understands low back conditions can also help guide and support you through your workouts.
When you first start working out is is also important to be patient with yourself. Your body will need some time to get used to the new program and to using your muscles again. You may feel a bit sort and tired in the beginning and sometimes the pain might even feel a bit worse. Give yourself time to get used to the new workout plan and allow your body to feel and learn the difference between pain and a little bit of appropriate "soreness" after an exercise session. Over time you will start to feel the benefits of the strengthening exercises and you will also start to feel the benefits of the awesome feel -good endorphins that come with working out.