importance of physical fitness in managing lower back pain is often overlooked.
It's not just your heart and lungs that benefit from being fitter. Your muscles,
joints and bones all benefit greatly from regular exercise - the human body is
designed for movement.
are two important things to think about here in relation to the importance of
fitness in managing lower back pain:
you lack physical fitness you are more likely to have low back pain than
someone who takes some regular exercise (3).
you have chronic lower back pain you are probably less fit than someone who
doesn't have spine problems(4)
recent research reviews show that exercise is effective in reducing symptoms and
improving day to day activities in patients with chronic simple lower back pain
(one paper looked at 6390 participants in sixty-one different trials which is a
huge study )(1)(2).
one of the key ways to manage lower back pain is by improving your general
physical fitness with cardiovascular exercise. This works in a number of
cardiovascular exercise, or exercise that makes you warm and slightly out of
breath is excellent for improving the blood supply to all the tissues in
your body. Itís not just your heart and lungs that benefit from this
exercise. All the tissues in your body become healthier; this includes the
muscles and ligaments in your lower back. All of these tissues become
stronger and more supple.
exercise helps you to keep a healthy weight. There is some evidence that
being overweight can increase the chance of of having lower back pain.
bearing exercise increases the strength of your bones and helps prevent
osteoporosis, or thin bones.
also has a very positive effect on mood; if you exercise you release
endorphins which are the bodies own natural pain killers. Your energy levels
rise and you generally feel better. This is a crucial part of managing this
problem as low mood and feeling fearful of movement are strongly linked with
increasing your physical fitness has such a big effect on your whole body you
must make sure you are medically well enough to start exercising. You must check
with your doctor before embarking on a physical fitness programme.
much should you exercise?
amount of exercise you should do is a bit controversial but it seems that for
many people performing any kind of exercise three to four times a week seems to
be ideal (3). I would suggest 20-30 minutes- 3-4 times a week is a good target
to aim for.
this will be too much for some of you to start with
people with chronic lower back pain need to pace their return to exercise in
order to gradually build on physical fitness without causing an aggravation, or
a flare up, in symptoms which then lays them low for a few days. I would
suggest a gradual paced return to exercise if you feel that increasing your
activity levels will lead to flare up of your symptoms.
you will also lack confidence and fear movement in case it makes your symptoms
what counts as cardiovascular/fitness/ aerobic exercise?
really isnít as difficult as it seems. There are many things that can be
integrated into your daily life that will help you improve your physical
fitness. Here are some examples:
a gym and using the treadmill, cross trainer, stepper or bike
classes such as step classes
JA, van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of
non-specific low back pain. Cochrane Database of Systematic Reviews 2005
S D, Baxter G D, Gracey J H. Exercise and chronic low back pain: what works?.
Kratter−Renato, Duvoisin−Nicole, Taskin−Aydin,
Schilling−Julian. Cross-sectional view of factors associated with back
pain. International archives of
occupational and environmental health, May 2005, vol. 78, no. 4, p.
Smeets-Rob-J-E-M, Wittink-HarriŽt, Hidding-Alita, Knottnerus-J-Andrť. D o
patients with chronic low back pain have a lower level of aerobic fitness than
healthy controls?: are pain, disability, fear of injury, working status, or
level of leisure time activity associated with the difference in aerobic fitness
level? Spine, 1 Jan 2006, vol. 31, no. 1, p. 90-7; discussion 98,