Exercise and back pain

Many different forms of exercise seem to help low back pain, including aerobic exercises like walking, cycling and swimming, as well as exercises aimed at improving the posture, strength and mobility of the spine.

It does not appear that any one of these is always better than the others. The most relevant factor is whether people continue with their exercise programme over time. Therefore you should consider which form of exercise you enjoy most, and which you can do with little or no inconvenience. Remember that many hobbies and daily routines can be considered exercise also, for example gardening, cutting the lawn, and using the stairs instead of the lift. Importantly, exercise is most effective when we also change the way we think about low back pain.

What if exercise increases your pain?
When you haven’t exercised for a while some initial soreness is common in people with low back pain at first. This can result in people with low back pain becoming fearful about exercise if they believe the pain is caused by more ‘damage’ to their spine. This initial soreness is, however, a relatively normal response to exercise, and does not indicate any harm being done to your body.

Instead, this can reflect the ‘over-activity’ of the nervous system in response to movement mentioned earlier, which can reduce over time. And remember if you haven’t exercised for a while your body needs to build up a tolerance to the new challenge!

Your physiotherapist can help you with a programme to gradually increase your levels of activity and exercise tolerance – a bit like training for a marathon!

In conclusion, low back pain is a common problem affecting the quality of life of many people. It is now clear that the beliefs of people with low back pain can have a major effect on their prognosis. Low back pain patients who are most fearful about their future low back pain, who rest excessively, who cannot cope with, or control, their pain, or who believe there is a serious structural problem in their back are at greater risk of developing chronic low back pain.

These are understandable concerns when one considers common beliefs about low back pain. The good news is that most of these beliefs are incorrect and can be changed. International research shows that improving beliefs about low back pain can make a big difference to people with low back pain. Research shows that exercise is safe and effective in the management of low back pain, and that people with low back pain should not be fearful of exercise, and thus reap the important benefits of exercise.

There are many resources on the Internet that give good advice in an entertaining way, but based on current evidence about managing low back pain. A few are listed here:


For further information on the management of low back pain visit the Orthopaedic Manipulative Physiotherapists’ website here or contact chair.gec@omptg.co.za.

For further information and for a complete list of physiotherapists in your area with a special interest in the management of chronic pain visit the Pain Management Physiotherapy Group (PMPG) here.

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