How does regular exercise reduce chronic pain in back ?

Regular Exercise

Chronic pain is defined as pain lasting beyond normal tissue healing time, generally considered to be more than 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life, and healthcare costs. The stress of persistent pain quickly takes a toll on the body; muscles tighten and become stiff, making even the simplest tasks difficult. Our tendency to stop moving when we hurt is a protective human reflex, but it deconditions muscles and perpetuates pain. Although resting for short periods can help with pain, too much rest may actually make it worse and put you at greater risk of injury.

For many years, the treatment choice for chronic pain included recommendations for rest and inactivity. However, exercises have shown specific benefits in reducing the severity of chronic pain, as well as more general benefits associated with improved overall physical and mental health, and physical functioning.

Research has shown that regular exercise can ease pain long term by improving muscle tone, strength, and flexibility. Whether suffering from the first bout of low back pain or following extensive treatments or even surgery, the best way for patients to avoid or minimize the severity of recurrences is to rehabilitate the back through appropriate back exercises.

Benefits of Exercise:

When done in a controlled, progressive manner, exercises for relieving back pain have many benefits, including:

  • Strengthening the muscles that support the spine, removing pressure from the spinal discs and facet joints.
  • Alleviating stiffness and improving mobility.
  • Improving circulation to better distribute nutrients through the body, including to the spinal discs. It helps to speed up the healing process.
  • Releases endorphins, which can naturally relieve pain “Body’s natural painkiller”. A frequent release of endorphins can help reduce reliance on pain medication. Endorphins can also elevate mood and relieve depressive symptoms, a common effect of chronic pain.
  • Minimizing the frequency of back pain episodes, and reducing the severity of pain when it does occur; thereby improving overall day-to-day functionality.

How exercise helps to relieve pain:

Engaging in exercise and fitness activities helps keep the back healthy by allowing discs to exchange fluids which is how the disc receives its nutrition. A healthy disc will swell with water and squeeze it out, much like a sponge. This sponge action distributes nutrients to the disc. In addition, fluid exchange helps to reduce the swelling that occur naturally in other soft tissues surrounding the injured discs. When there is a lack of exercise, swelling increases and discs become malnourished and degenerated. Exercising the back reduces stiffness by keeping the connective fibres of ligaments and tendons flexible. Improved mobility through back exercise helps to prevent the connective fibres from tearing under stress, which in turn prevents injury and back pain. Another important effect of exercise is that it stretches, strengthens, and repairs muscles that help to support the back. The back and abdominal muscles act as an internal corset supporting the vertebrae discs, facet joints, and ligaments. When back and abdominal muscles are weak they cannot support the back properly. Back & core strengthening exercises help to strengthen these muscles in order to prevent straining of soft tissues (e.g. muscles, ligaments, and tendons) and provide sufficient support for the structures in the spine.

What exercises to do ?

Back exercises are almost always necessary to rehabilitate the spine and alleviate back pain. A controlled, gradual exercise program that is tailored to an individual is usually the most effective.

Studies have shown a general exercise programme which combines muscular strength, flexibility and aerobic fitness to be beneficial for rehabilitation of non-specific chronic low back pain.

  • Stretching – Lower back, glutes, piriformis, & hams.
  • Back strengthening exercise
  • Core strengthening exercise
  • Pilates & Yoga
  • Low impact aerobic (Cardiovascular) exercise – Walking, Stationary cycle.
  • Aqua therapy.

Dr.Shriya Patel (PT)