Back pain is the most common cause of temporary and permanent disability in the world, with almost 80% of adults reporting an episode of back pain that has had a negative effect on their quality of life. When it comes to back pain everyone has an opinion on how to manage it “rest, painkillers, swimming, surgery”, but when you are suffering and none of these options are working for you the question should not be ‘how to quickly get rid of the pain’ but ‘how can I manage away the pain and make my body more resilient so that this doesn’t happen again’. In this blog we will explore some of the most common causes of back pain and how we think you should be managing it.

Pin-pointing the exact cause of your lower back can be almost impossible, with the body being a complex interconnected system the pain you experience can be multifactorial and hard to label. A 2016 article (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934575/) showed that almost 85% of back pain cases are undiagnosable even following investigations such as MRI scans, X-rays and blood tests. Although this may be frustrating when you are suffering and in pain, the good news is that a general approach to the treatment of back pain has been shown to be as effective as a specific targeted approach in many cases.

Before we discuss the best exercises and treatment options for back pain I would like to point out that back pain can be a sign of serious damage or other underlying health conditions. Warning signs include pain that can’t be eased in any position, associated pain in the buttocks and legs or a change in bowel and bladder habits. If you have any of these symptoms or feel like your back pain is more than ‘mechanical-type’ back ache you should seek advice from your GP as soon as possible.

"The largest cause of back pain in the UK is inactivity"

What is the most common cause of back pain in this country? Gardening? Moving home? Lifting weights? The answer is in fact inactivity. Incidence of back pain in western countries where desk-based jobs are the norm are far greater than in countries where manual labour based jobs are more common. In fact, even within this country incidence in sedentary individuals is much higher than even those in hard manual labour type jobs. Once back pain has set-in it can be as hard for the brain to unlearn that pain and avoidance of movement can become a habit that many find hard to break.

Exercise has proven to have a positive effect on reducing back pain and the likely hood of future events of back pain. When people think of training their ‘Core’ muscles, traditionally the go-to exercises have been crunches and sit ups. These exercises while used to develop abdominal muscles can actually cause or increase lower back pain due to the increased pressure they put on the vertebrae due to the extreme spinal flexion needed to do a full crunch. It is often more effective to start with basic isometric exercises to build a solid foundation upon which to develop the rest of your training and help relieve your back pain.

We will often start our clients with simple exercises such as a plank, side plank, bird dog or dead bug. These exercises allow our clients to develop strength through the core area and helps them to develop an idea of how to contract these muscles and help to stabilise the movement of the lower back. At this stage it is paramount that you have a great coach or clinician teaching you how to perform the exercise safely and with correct form.

"A huge factor in preventing lower back pain is weight management"

As we progress through our training it is important to focus on various muscles of the trunk and the role in which each one plays in movement and exercise. The Quadratus lumborum is an often-neglected muscle which plays a role in stabilising this area of the body, if there are compensations on either side this can lead to imbalances and back pain. We often have clients progressing on to single sided exercises such as a suitcase carry to strengthen this area and replicate the demands placed on the muscles during everyday life. Getting stronger through weightlifting will have a positive effect on back pain and can help bullet proof the body against future incidences. Heavy compound exercises such as squats and deadlifts, when executed properly, will not only target the muscles of the lower body but will give the core muscles a full workout leading to increased strength in that area.

Another huge factor in preventing lower back pain is weight management. A high level of body fat has been shown to increase the likelihood that a person will suffer with back pain at some point in their life. Sometimes the first step in helping relieve back pain can simply be to follow a calorie controlled diet and begin moving more by increasing daily step count. Following a personalised exercise program that builds on the solid foundations formed in the initial stage, means our clients can not only reduce their back pain but also their waistlines leading to an increased feeling of health and wellness. Back pain doesn’t need to be a life-long sentence, with a properly designed exercise program you could reduce those pain levels and get back to doing all the things you love pain free.

Article written by Tom Ward - Director of Training, London