Back pain: Exercise can provide relief and that's safe

After many months in lockdown, many of us find that we have back pain that we were not previously affected by. There could be many reasons for this, including increased stress during the pandemic, less exercise, and more time in one position.

But while you may think that you should take care of your back when it hurts, active action can actually help reduce your pain and protect you from developing back pain again in the future. This is because our spines are designed to move, flex, and lift, which keeps our bones and soft tissues strong and supple.

Regular exercise and exercise can help improve and restore strength, endurance, and flexibility, and help us recover faster from acute lower back pain. Because of this, physical activity is one of the most consistent and recommended methods of treating low back pain.

Why physical activity works

Although exercise and physical activity are generally recommended for people in pain, researchers are still researching how and why it works and what dose is best for pain relief.

The traditional view of how exercise helps relieve pain has focused on how exercise affects the structures surrounding the spine – for example, by strengthening the muscles in the spine and abdomen. While some research backed these ideas, they don’t fully explain why exercise can relieve back pain.

There is growing evidence that exercise leads to positive changes in certain functions of the nervous system, including the brain. In essence, movement directly affects how we experience pain by reducing our sensitivity to potentially harmful stimuli. This phenomenon is known as exercise-induced hypoalgesia.

In research on pain-free adults, a single high-intensity aerobic exercise (such as cycling or 15-minute running) can trigger this pain-relieving effect for about 30 minutes afterwards.

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This pain-relieving effect is underpinned by several interacting mechanisms – above all the release of the body’s own painkillers such as endocannabinoids, adrenaline, noradrenaline, endorphins and serotonin – within the nervous system and via the circulatory system. Not only do these chemical signals help relieve pain directly, but they have the added benefit of improving mood. This is an important benefit as it is known that the feeling of pain is directly influenced by our own thoughts and feelings and by our perceived pain control.

Another key mechanism believed to be involved in exercise-induced hypoalgesia involves the formation of new and helpful connections within the nervous system, a process known as neuroplasticity. These structural changes in the nervous system act more slowly than the chemical changes that occur as a result of exercise-induced hypoalgeisa, but are believed to lead to a decrease in pain associated with movement over time.

While the search for the exact mechanisms underlying exercise-induced hypoalgesia continues, the good news is that exercise helps activate these pain-relieving effects even in the face of pain.

move

Thankfully, no particular type of exercise or activity is required to relieve back pain. The combination of physical activity (the cumulative amount of exercise we get every day) and exercise – regardless of the type – can help.

But that doesn’t mean you should just start running or lifting weights expecting it to heal your back pain. It is important to adapt what you are doing to your current skills and gradually increase the intensity to avoid injury. Most importantly, do things that you enjoy and are likely to stick with – this will better help relieve pain and hopefully prevent it from coming back.

There are also many simple ways you can get more exercise every day by sprinkling in short periods of activity throughout the day – such as exercising. Try to reduce the amount of time you spend in one position, or even consider a standing desk.

Back pain is rarely caused by anything serious. Typically, it’s the result of a simple sprain or strain and will settle within a few weeks. Staying active and exercising are the best we can do – and are usually recommended over injections or surgery. Even if your back pain is persistent and lasts for a few months or more, increasing your physical activity and exercising is one of the best ways to deal with it.

Suzanne McDonough, Professor of Health and Rehabilitation, RCSI University of Medicine and Health Sciences; Joanne Marley, Lecturer in Musculoskeletal Physiotherapy, Ulster University; and Michael Thacker, Professor of Pain and Rehabilitation, RCSI University of Medicine and Health Sciences

This article was republished by The Conversation under a Creative Commons license. Read the original article.