Even if you’re active and healthy, there’s a good chance you’ll be troubled by lower-back pain at some point. In a given year, 10 to 15 percent of adults experience significant lower-back pain. Most of these events subside without any treatment within a month or two. And even when it persists, a minimalist approach, including some form of regular exercise, may be all you need to manage it and prevent future disabling episodes.
It often can’t be traced to a specific spinal injury or defect that can be fixed with surgery or other single-focus treatment. The pain might arise from strained muscles or it might be a result of arthritis, joint irritation or subtle degenerative changes in the spine that fail to show up even in high-tech scans. In women and men age 60 and older, bone degeneration due to aging can lead to spinal stenosis, or a narrowing of the space around the spinal cord. Nerves become vulnerable to compression from bony overgrowth.
While they can’t cure spinal defects, strength and conditioning workouts can help people cope with degenerative changes and pain. Muscle training, for instance, can help stabilize the spine. Weak muscles in the back, trunk and abdomen make it difficult for the spine to support itself in an upright position. Strengthening those muscles takes stress off the spine and builds stamina.
Exercise can also help back-pain sufferers overcome a tendency to avoid movement they fear will cause more pain. It has been found to help quell depression and increase physical capability. Exercise can also reduce the need for pain medication.
Yoga. Unlike medical therapies aimed at fixing one problem, yoga works on many levels simultaneously. The poses can increase flexibility, build muscle strength and improve balance. Meditation and breathing practices reduce stress and promote a sense of well-being. In one of the most rigorous clinical trials that looked at yoga for back pain, researchers in Seattle randomly assigned 101 volunteers to a yoga class, an aerobic and strength-training program, or a self-care program guided by a book. After 26 weeks, participants in the yoga and the exercise groups reported greater relief and gained more back function than those doing self-care.
Pilates. Like yoga, Pilates focuses on controlled movement, poses and breathing. Long favored by professional dancers, this type of exercise aims to improve balance while building muscle strength, endurance and flexibility. In a 2006 clinical trial, researchers randomly assigned 21 volunteers with back pain to a Pilates training program and 18 to a control group that continued their usual physical activity and consulted a doctor when necessary. After a year, the average pain levels reported by people in the Pilates group were about half of those reported by those in the control group.
Aerobic training. Conventional aerobic exercise might be as effective as exercises specifically for the back. Treadmill walking, stationary cycling or stair climbing helped significantly, according to a study this year involving 101 male and female power-plant workers with chronic lower-back pain, including many with herniated disks or degenerative bone spurs.
Aquatics. A systematic review of the evidence by Finnish researchers published in 2009 concluded that aquatics were at least as effective as other exercise programs for lower-back pain. Swimming and exercising in water shift weight away from the back, which might make such workouts more appealing to people who experience back pain when walking on a treadmill, lifting weights or doing other types of load-bearing exercise.