• Fiona

Why exercise is medicine for lower back pain

So, what exactly is pain?

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. 

In other words, pain is an alarm system to protect us from danger. Pain is essential for survival (for example, learning to wear appropriate foot protection after stepping on a prickly area of your garden so it doesn’t happen again), however, sometimes the pain response can be overdone and actually cause more suffering in the long run. 

Around 70-90% of people will suffer from lower back pain in one way or another, at some point in their lives. Sounds like a lot, doesn’t it?! 

Most of this will be acute (or temporary) because you’ve moved awkwardly, slept uncomfortably, or did a bit more gardening than you should've yesterday. Tissue damage or injury can result in chronic pain (pain lasting longer than 3 months), however evidence suggests that pain, in most cases, still persists even after the tissue injury has healed. We need to acknowledge that the brain plays a key role in the pain experience. 

Why do I get back pain?

Think of it this way: use it or lose it! 

Like natural selection, but in the short run, the human body does amazing things to allow us to “function” in our everyday activities. But what if your daily activity consists of working at a desk for hours on end? 

Simple answer: when you sit for 7 hours a day, every day, your body adapts to this shape because that’s what it thinks your body needs to continue “functioning.” As a result, the muscles in front of your body become shortened and tight, while the posterior muscles become lengthened and weakened (especially the butt! I mean, you’ve been sitting on that precious thing all day…).

Our body is made to move! So, when those lengthened and weakened muscles are “switched off,” doing other activities (such as lifting grocery bags out of the trolley and into your car boot, or even bending down to pick up the pen that you dropped), means those muscles will “switch on.” Those muscles haven’t fully awoken as they are so used to being idle, so as a result, we have asked too much of these muscles, the body compensates by using other muscles inefficiently, and then comes the “flare-ups” where those muscles angrily talk back to you. 

Anatomically speaking, your spinal muscles are made up of 3 layers: the deep layers (which attach directly onto the vertebrae and provide stability, but not movement), the intermediate layer, and the superficial layer (both responsible for movement).

Constant flare-ups of back pain is what causes the deepest layers to weaken, and therefore become less support for your trunk stability.

What can I do to stop back pain?

For those suffering chronic back pain, a graded exposure is vital in allowing our body to adapt to changed environments. This can simply be done with, you guessed it, exercise! 

Here are 3 main goals of an exercise program to manage lower back pain:

  1. Increase neuromuscular connection - that’s the “brain to muscle” connection. You want your brain to effectively communicate with the muscles that need “waking up.” The most important muscles of them all are your glutes! They’re supposed to be the strongest muscles in the body, and should be responsible for the bulk of our movements, but tend to be the weakest due to the nature of what humans do. It’s job is to stabilise your pelvis (which, surprise surprise, is the base of support for your spine!). By not being able to recruit the glutes for simple everyday activities, other muscles have to compensate, and hence the tightness in the lower back results.

  2. Lengthen, stretch and release - remember those muscles I mentioned that tend to shorten and tighten? They need to open up for optimal function, otherwise they continue to tighten and pull on other joints, tendon and muscular structures that surround it (also the cause of postural changes). The main muscles that tighten up will be your neck, shoulder and chest. It is the myofascial tissues that surround the muscles (to protect it) that tighten up, so releasing this myofascial tissue by locating trigger points, foam rolling and stretching is required to return them to optimal function.

  3. Don’t aim to be ‘pain-free’ - especially if you have had tissue injuries and degeneration. Instead, focus on returning to optimal function. Focus on being able to do the things that cause pain more comfortably as opposed to fearing the movement (remember, use it or lose it!). Be prepared to go on a journey of recovery and change, not a magical quick fix. It takes just as long to return to some sort of ‘optimal’ function as it does for pain to become chronic (usually 8-12 weeks of consistent exercise rehabilitation to see the physiological changes). 

There is not one exercise regime that fits all, so consider addressing your personal pain experience with an exercise expert, such as an accredited exercise physiologist (AEP). AEP’s are university-trained exercise professionals who understand the physiological system’s responses to exercise. 

At Boundless Health & Wellness, we can help you with improving your general exercise tolerance and assist you in getting back into those meaningful activities that you may have been fearful of doing with your chronic back pain. Speak to us now and delay no longer! 

With the COVID-19 affecting us on a global scale, those who have been lucky enough to transition to “work from home” may benefit from reading the next blog which comes with an array of basic exercises you can do from home to prevent or manage your back pain - stay tuned! Boundless acknowledges the negative impact the virus has had on everyone, but we are also here to focus on solutions, not problems. So, from Boundless, don’t just stay safe, we hope for you to BE safe - play your part in practicing good hygiene and etiquettes put in place to save lives. 

On a completely different note, your health and wellbeing (both mental and physical) can be enhanced by giving back to your local community! Instead of focusing on the outrageous media reports about citizens fighting over toilet paper, let’s take a step back and think about the vulnerable who have and still continue to live in isolation and circumstances less than desirable.

Sacred Heart Mission is an Australian not-for-profit organisation that assists hundreds of adults of all ages and backgrounds who are experiencing homelessness, disadvantage and social exclusion to a free meal, care and support (among many other ways which you can learn about here). In response to the Federal Government banning gatherings of large numbers of people, Sacred Heart Mission is still offering takeaway meals for breakfast and lunch.

As the situation becomes more alarming, let us be more kind and compassionate in whatever our capacity allows us to!

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