Exercise Your Back Back to Health

Low back pain can be debilitating. However, many methods are available to successfully treat this condition. If spinal joint dysfunction is causing your back pain, your treatment may include manual (hands-on) therapy, a short course of nonsteroidal anti-inflammatory medications (e.g., ibuprofen), or spinal injections. Once back function is restored, an appropriate exercise program may help you maintain and control joint motion to prevent injury, develop muscle strength, and gain pain relief.

Strength and motion

Exercise for the low back is only beneficial if it is prescribed for your needs. One-size-fits-all exercise programs are not appropriate and can cause injury and pain. The appropriate exercise program for you is based on your injury and the condition of your spine. If you have osteoporosis (porous bones), osteoarthritis, or limited spinal joint motion, the program is designed to prevent more irritation and injury to the joints than the disease is already causing. If you have restricted joint movement, the program includes exercises that help maintain the motion you have regained through manual therapy. These exercises are done a few at a time throughout the day. If your muscles are not strong enough to control movement in the back, you participate in strengthening exercises. Strong back and abdominal (stomach area) muscles help stabilize the back and control its movement.

Two examples of exercises that can help strengthen the back-stabilizing muscles include trunk curl with a twist and the push/pull (Figs. 1 and 2). These exercises focus on the muscles that control trunk rotation. Strengthening the muscles that control back extension (bending backward) is also important. Pointers and prone leg lifts work these extensors (Figs. 3 and 4).

The objective of exercise is to stress the back muscles without overloading the spinal joints. This exercise method helps improve muscle performance without further injuring the spine.

Endurance and stamina

Building endurance and stamina is another important aspect of this exercise program. In addition to strengthening your muscles, you must develop a high level of cardiovascular fitness. Many cardiovascular activities such as walking, swimming, circuit resistance training, and bicycling can help increase endurance and stamina. Talk with your doctor and physical therapist before beginning a cardiovascular activity. They can help you design a program best suited to your needs and abilities. In addition, pick an activity that you enjoy; you'll be more likely to stay with it. Under the guidance of your physical therapist, gradually work toward participating in your chosen activity three to four times each week for 20 to 40 minutes each session. Even being in good physical condition may not prevent back injury and pain if you ask your back to do more than it can. However, if an injury occurs, it usually is less severe, and recovery is faster in a physically fit person.

Exercise can help strengthen the muscles that support your back and control its motion. For certain types of low back pain, an exercise program designed for your needs can be a beneficial part of your treatment.

Mike Balkcum, P.T.
Columbus, Georgia