Back pain is one of the most common medical problems in the United States, with over 80 percent of adults experiencing low back pain at some point in their lifetimes (Hoy et al., 2012). It is the most prevalent cause of job-related disability and a leading contributor to missed work days. In a large survey, more than a quarter of adults reported suffering low back pain during the past 3 months (NIH, 2018).
Back pain has become a more significant issue in recent years. In 1990, a study assessing the most burdensome conditions in the U.S. ranked low back pain in sixth place in terms of morbidity or mortality. In 2010, low back pain jumped to third place, and only ischemic heart disease and chronic obstructive pulmonary disease ranked higher.
Chronic back pain is defined as lasting 12 weeks or longer, and approximately 20 percent of those with acute low back pain develop chronic pain with persistent symptoms at one year (NIH, 2018). Back pain is more common in those who are not fit and being overweight can stress the back and cause pain. Other common factors related to back pain are muscle imbalance (such as weak hip, back, or gluteal muscles) and tight lower extremity muscles (especially the hamstring muscles).
Here are 5 common strategies I discuss with patients to tackle low back pain:
- Physical Therapy: Finding a physical therapist (PT) in your area who specializes in back pain can be a great way to learn where you should focus on getting stronger and how to develop a home exercise program (HEP) that you can stick with to manage pain long-term.
- Water Exercise: Swimming, water walking, and water aerobics are all excellent ways to build strength and endurance. The water supports joints and provides a low-impact environment. As a bonus, heated pools (typically 82-88 degrees) can help ease pain. Most community centers and fitness centers offer a variety of water (also called aqua) classes.
- Yoga and Pilates: Build strength, flexibility, and balance through practicing yoga or pilates. There are countless options of live classes and online videos to help get started- https://www.youtube.com/user/yogawithadriene is an example of free online classes that makes trying yoga affordable and can be done at home or on the go!
- Strength Training: You don’t have to be a body builder to benefit from resistance training! Strength training can involve weight lifting, resistance bands, or simply your own body weight. It may be helpful to work with a fitness instructor to learn the ropes. This educational handout from Princeton University is also a great example of exercises that can be done at home- https://uhs.princeton.edu/sites/uhs/files/documents/Lumbar.pdf
- Walking: Walking is convenient, easy, and safe to access as a primary exercise for low back pain (National Institute of Arthritis and Musculoskeletal and Skin Disease, 2014). Studies have shown positive outcomes for lowering back pain with both treadmill or outdoor walking (O’Connor et al., 2015), and a recent study supported the combination of walking plus strength exercise (Lee & Kang, 2016).
Make sure to track your symptoms and progress. Back pain can be a symptom of a serious medical issues. Please consult your medical provider if you have:
- Numbness, tingling, or weakness of the lower extremities.
- Severe back pain that does not improve with rest.
- Back pain after a fall or an injury.
- Back pain plus any of these symptoms:
- Trouble with bowel or bladder function
- Numbness in your legs
- Weight loss without diet changes