Back pain is one of the most common reasons for presenting to a GP. It's also an enigma. It's less likely to follow a steady pattern of improvement than other musculoskeletal issues such as an ankle sprain or a muscle strain.
There's also poor correlation between pain and imaging results. For example, back pain is most common in the middle aged, but imaging findings worsen with age, while imaging results are also found in similar percentages in pain free people as age-matched people with back pain.
More recent research on back pain is finding that it seems to be more an issue of the nervous system than with the musculoskeletal system. (Musculoskeletal pain is generally an issue of both systems, but back pain is thought to lean more towards the nervous system).
The onset of back pain can be quite variable. Sometimes it makes perfect sense. You lift a heavy box you thought wasn't going to be heavy, and suddenly your back hurts. But this presentation is rare. Sudden onset of back pain much more commonly follows innocuous movements you've done a million times before. The most severe case of sudden onset back pain I've seen came on from reaching to grab a pencil from the far side of a desk. Other times, you might wake with a moderate to severe pain in your back, or realise your back hurts when it comes time to get up from the couch, or get out of a car.
Other times, rather than having a sudden onset, the back pain might have snuck up on you over time. These are all normal presentations of back pain, and don't necessarily indicate a worse injury or longer recovery time in one case over any other.
On the past, bed rest was often encouraged for people with back pain. But more and more we're finding that bed rest is not conducive to recovery. The changes in your nervous system which are causing you to experience pain are more likely to return to normal with gently graduated exercise.
What Exercise Is Best?
There are benefits to a number of different exercise types.
Cardiovascular exercise - As well as general health benefits, there is lots of evidence that cardiovascular exercise is helpful for reducing back pain. Certain cardio exercises may irritate your back pain, but alternatives can easily be found. For example, if running aggravates your pain, cycling most likely won't, and vice-versa. Using an elliptical cross trainer, and walking in a pool are low impact cardio exercises very unlikely to aggravate your back pain.
Strengthening exercise - There is also evidence that resistance training reduces back pain (and also some evidence that it may help prevent back pain). Keep it sensible though, you may need to use lighter weights and avoid exercises like deadlifts while your back is particularly irritable.
Core stability exercise - pilates and yoga type exercises are also helpful in reducing back pain and preventing future episodes of back pain. These help improve your awareness and control of your back and pelvis, as well as improving flexibility.
A physiotherapist will be able to provide further guidance on exercises which may be of specific benefit to your particular back pain presentation. Are you suffering from back pain? See our physiotherapist in Aubin Grove for help in treating and managing your back pain today!