Are you struggling with low back pain? Do you find that exercise makes your pain worse? If so, you're not alone.
Many people with low back pain are afraid to exercise because they're afraid of making their pain worse. So what do you do if exercise causes more back pain? Will it really make it worse?
The Truth About Exercise And Back Pain
When it comes down to it, exercise is actually one of the best things you can do for your low back pain. When done correctly, exercise can help to strengthen the muscles in your back and improve your flexibility. This can help to reduce pain and improve your function.
But we get it. Back pain can feel so excruciatingly painful that once it has happened you are terrified of it happening again, or of making things worse than they already are. So how do you find the balance between staying safe and not pushing yourself too far, and making sure that you're exercising effectively so you can get better faster?
In this article, we'll discuss some tips for overcoming your fear of exercise and for starting an effective exercise program for your low back pain.
Exercising With Low Back Pain - What To Keep In Mind
Physical therapy and exercise are two of the most recommended treatments for managing low back pain. But the fear of hurting yourself even more when you do that exercise can be extremely scary and put you off the treatment completely.
When we exercise there are two main things to keep in mind:
Staying safe and not pushing ourselves too far.
Making sure that we are exercising effectively for the best results.
Finding a balance between these two things can be a bit tricky. If we add our own fear-avoidance beliefs into the mix, things often get even trickier.
Why Is Exercise So Important For Healing Back Pain?
When we don't move enough it can have a major impact on our muscles and how strong and flexible they are. When a back pain injury happens, sometimes our first instinct is to protect it and to stop moving altogether. We think we should lie on the sofa and rest.
Studies have shown, however, that this approach might be the complete opposite of what we actually should be doing to help our backs heal faster. New advice from healthcare professionals from around the world encourages people to "stay active" and "keep moving".
Exercise For Pain Relief
Studies have shown that regular physical exercise is actually a great pain reliever. Movement can keep us mobile and flexible, it can produce "feel good" endorphins, and it can decrease our sensitivity to pain.
When we lie down and rest, we also end up isolating ourselves, and this isolation can lead to depression which can make our pain worse in the end.
The best advice, it seems, is to keep going about your daily activities as much as possible, while trying to not let your back pain limit your activities too much.
There are more than 100 studies that have looked at the effects of exercise on low back pain. All of these studies have shown how helpful exercise is for reducing back pain and boosting the healing process. This is why global guidelines recommend exercise as a first line treatment for low back pain.
Fear Avoidance
What happens, however, if exercise makes your pain worse? What happens if you are worried that exercise will make your pain worse?
These are two very valid concerns that many people with low back pain have. They also need to be addressed as two separate things, because being worried that you will hurt yourself, and actually hurting yourself when exercising are two very different things.
For patients with low back pain, fear-avoidance beliefs (FABs) represent thoughts and emotions about the possibility that exercise is going to hurt them or make their back pain worse.
Fear Avoidance Beliefs are very real emotions and need to be addressed in the context of back pain rehabilitation. When individuals have excessive FABs it can really get in the way of progress and healing. They are a major obstacle for recovery from chronic low back pain.
Where Do FABs Come From?
Fear avoidance beliefs can come from a few different places:
Emotionally-based fears of pain and injury
Information-based beliefs about how strong/healthy your spine is.
The causes of your spine injury/degeneration.
Knowing that there are some different reasons people may have for their fear-avoidance beliefs can help healthcare professionals address these beliefs on a personalized level that helps each individual overcome their specific fears.
Treatments For FABs:
1. Information/Education
Helping patients understand why they might be scared about exercising or what is causing their low back pain is a great place to start. Education is a first-line recommended therapy for back pain as people feel more empowered about their health when they understand it better.
2. Pain Desensitizing Treatments
Using pain desensitizing treatments and fear desensitization through counseling can help patients overcome their fear-avoidance beliefs.
There are specific therapies (like cognitive behavioral therapy) that can help patients overcome their fears and feel more comfortable participating in exercise therapy.
So What Do I Do If Exercise Causes More Back Pain?
In some cases specific exercises can actually make your low back pain worse. There are some tips that can help you get the most out of your back pain rehabilitation exercises while still staying safe and not doing any further damage to your spine or back.
Tips to help you manage your low back pain while exercising
1. Identify the cause of your pain
Low back pain can be caused by various factors like muscle strain, poor posture, herniated discs, or arthritis. It is important to identify the cause of your pain before you start any exercise program. Your physical therapist or healthcare provider can help you determine the cause of your pain and develop an appropriate exercise plan.
2. Warm up before exercising
Warming up before exercising can help prepare your body for the workout and reduce the risk of injury. A warm-up should consist of light aerobic activity, such as walking or cycling, and stretching exercises to loosen up your muscles and increase blood flow.
3. Focus on core strengthening exercises
Strengthening the muscles in your core, including your back and abdominal muscles, can help support your spine and reduce the risk of low back pain.
Some core strengthening exercises include planks, bridges, and bird-dog. Your physical therapist can help you develop a safe and effective exercise program to target these muscles.
4. Avoid high-impact exercises
High-impact exercises like running or jumping can put additional stress on your low back, making your pain worse. Instead, focus on low-impact exercises such as swimming, cycling, or walking.
5. Pay attention to your posture
Poor posture can play a big part in low back pain. Make sure that when you exercise, your posture is good - keep your head and shoulders up and your chest out.
Your physical therapist can show you the proper posture for different exercises to help you avoid putting unnecessary strain on your back.
6. Avoid exercises that aggravate your pain
If a particular exercise is making your low back pain worse, stop doing it and avoid it in the future. It is important to listen to your body and avoid exercises that cause pain or discomfort.
7. Stretch regularly
Stretching can help improve flexibility and reduce muscle tension, which can alleviate low back pain. Make sure to stretch after exercising and throughout the day to help keep your muscles relaxed.
8. Modify your exercise routine
If you are experiencing low back pain, you may need to modify your exercise routine. For example, you may need to reduce the intensity or frequency of your workouts until your pain subsides.
Your physical therapist can help you determine the appropriate modifications to your exercise routine to help you manage your pain.
9. Use proper form
Poor form during exercise can put unnecessary strain on your low back and make your pain worse.
Make sure to use proper form while exercising and to avoid exercises that you are not comfortable with or that cause pain. Your physical therapist can show you proper form for specific exercises to help you avoid injury.
10. Gradually increase the intensity and duration of your exercises
Once you are able to exercise without pain, you can gradually increase the intensity and duration of your exercises to help build strength and improve your fitness.
However, it is important to do so gradually to avoid overdoing it and making your pain worse.
Conclusions
When starting a new exercise program, if you find yourself making excuses for not doing it, might want to look at what is causing you to put it off. Have you done the exercises and hurt yourself before? Or are you just worried that you might hurt yourself?
If you find that worry is behind your excuses, more than an actual injury, your reasons might be more fear driven and based in fear-avoidance. When we understand what drives our decisions we can work on them and make changes.
Understanding your fear, and acknowledging it, means that you can then share those fears with your physical therapist or healthcare provider. They can then develop the right plan for you that addresses your fears, puts your mind at easy, and gets you back on the road to recovery.
If exercise is actually making your low back pain worse, it is important to take steps to manage your pain and modify your exercise routine.
Your physical therapist can help you determine the cause of your pain, develop a safe and effective exercise program, and provide you with the tools you need to manage your low back pain and stay active.
By following these tips, you can continue to exercise and improve your physical health while managing your low back pain.