The physically active find back pain relief.

there seems to be no shortage of people, young and old alike, who suffer from some form of back pain at one time or another, and many suffer chronically. Patients with chronic back pain, as well as their doctors, often harbor apprehensions that exercise will harm their backs further and cause significant pain. The theory that excessive wear on spinal structures (through vigorous physical activity) causes back pain, however, does not account for the many times when the pain is brought on by trivial events, for example, sneezing or reaching.

The current literature indicates that exercise poses no additional risk to the development of back pain. It seems exercise may have a protective effect against it.

In 1995 an article in Spine reported that lower back pain occurred less frequently among former elite athletes than less active controls. Research has shown that exercise has no effect on the development of sciatica, and that trunk muscles in lower back pain patients are frequently weaker than in healthy individuals. In the 80s both Spine and JAMA reported that many patients with chronic back pain have significant impairments in back function related to disuse and deconditioning. Could this be because their pain prevents them from exercising? Yes. But this indicates, too, that prolonged inactivity isn't the answer to back pain. It appears that people with high levels of back fitness have less back pain than those with less back fitness because exercise strengthens muscles. Exercise can reverse these impairments and produce a more functional spine.

If you suffer from back pain, ask your doctor about stretching and strengthening exercises. You will likely be advised to stretch in the six directions of trunk motion, plus hips, hamstrings and quadriceps. Pain is a natural part of stretching, so don't be discouraged or suspect you're inducing injury. As long as the stretching is gradually brought to the point of maximum range of motion, it can be performed up to four times per session with additional flexibility benefits. After a month, it's common to see flexibility improvements by 20%.

There are numerous back-muscle strengthening exercises that you can perform anywhere, as they use only your own body as resistance. Remember soreness is normal in the days following strengthening exercise and should not be taken as a sign of setback (see "Current Muscle Soreness Treatments" on page one). As with a stretching regimen, the key is progressive training that suits your ability level and ramps up gradually over the course of many weeks. A program of substantial intensity you adhere to even if there is some discomfort may be the most effective. Researchers at Harvard Medical School report the average reduction in back pain with this type of non-pain-contingent strengthening treatment is 35%. They note improvements in 80% of patients.

(Biomechanics, 2003, Vol. 10, No. 7, pp. 67-76)