Clearing the Air About Back Pain and Physical Activity

People living with chronic back pain may be hesitant to begin an exercise program for reasons including the pain itself, fear of further musculoskeletal damage, depression, anxiety, and not understanding why it is important to exercise in the first place. If any of these concerns have kept you from engaging in regular physical activity, my hope is to dispel some of your fears, and ask you to consider some secondary benefits you might not have thought about.

Does pain mean no gain?

Could physical activity make your back pain worse by causing additional joint deterioration, tendon, and ligament problems? Whether a given exercise increases your risk depends on the type of activity and how you implement it. As a corrective exercise trainer, I was taught to “start low and go slow” when working with chronic pain patients. The human body is remarkably good at adapting to increased demand, given adequate time. This is where S.M.A.R.T. goals come in. If you have been sedentary for an extended period (more than a couple of weeks), you need to begin with small bouts of activity, such as two five-minute walks spread out over a day. Once you feel comfortable with that, you can safely consider adding on. Avoid activities that involve a lot of jumping or repetitive pounding (running, tennis, basketball), all of which can be hard on the joints and soft tissue.

Power in numbers

Group activities are great motivation for exercise, particularly for beginners. Look for classes appropriate to your level of fitness, that fit comfortably within your schedule. Some Medicare Advantage plans now include recreation facility memberships, at community and fitness centers geared towards older adults. Numerous studies have shown benefit of Tai Chi for persons living with chronic back pain. Other forms of gentle and/or non weight-bearing movement include aqua aerobics, SilverSneakers (TM) fitness classes and walking groups. You might be surprised at the number of enduring friendships that start with these groups.

Your emotional state matters

If you have read chapter one of Chronic Back Pain: A Self-Management Guide, you may recall that two parts of the brain- the amygdala and hippocampus- are involved in processing both pain signals and emotional distress. Put simply, stress, anxiety and depression amplify your experience of pain. While you?re paging through the back book (available as a free upload on this website), read chapter two on cognitive distortions. Do any of these thought patterns sound familiar? Are you ruminating about your pain, seeing everything in all-or-none terms, or making mountains out of molehills? How might you modify these behaviors to have a more positive outlook? Look at the chapter for some suggestions.

Expect setbacks, and frame them as learning experiences

Forward progress is rarely a straight line. Setbacks are part and parcel of development. Expect them and use them as learning experiences. Sometimes our darkest moments lead to opportunity. I would not have written a book on back pain had I not suffered a broken back in a cycling accident.

Learning to successfully manage chronic pain is an ongoing process that will change in response to work and family demands, other health challenges, and as part of the aging process. There is no formula for success. However, the research is strong in support of physical activity to maintain and build on existing muscle strength, improve your ability to perform activities of daily living, maintain a healthy weight, and make life more enjoyable by getting out of the house and meeting new friends. You don?t have to jump into the deep end of the pool, but at least consider testing the waters.

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