Many people have been told the best course of action when dealing with back pain is to stabilise the back, strengthen the core muscles, and then rely on massage and other forms of manual therapy. Although these things can definitely help with back pain, there is very limited evidence to support that having a weak or unstable core has any bearing on the severity of your back pain. Similarly, research also indicates that core or motor control (stability exercises) are no more effective than any other form of general exercise in relieving back pain.
The most important thing to support recovery from common back pain is, therefore, to simply stay active with activities that can comfortably be tolerated. The worst thing to do for back pain is to remain sedentary - staying active within your threshold as well as gradual return to previous activity level is key.
There is no one activity that seems significantly better than another when it comes to back pain recovery. Since adhering to exercising can be a struggle for some, most people should probably choose something they enjoy, are happy to do regularly, and that the body can tolerate. If you love doing core exercises, great! Keep doing them as they can help with pain and increasing strength. But don’t think that the reason they help is because you have a weak and unstable spine and that doing stability exercises makes the “core” stronger and more stable. It’s more likely that it’s because exercise and movement in general is analgesic (pain-killing) and that doing exercises and staying active increases the physical and mental resilience of your body including the back.
There has been a recent study that has found strengthening exercise to be marginally more effective than other interventions, so incorporating a strength-focused exercise plan into your routine can be recommended.
Research has also shown that walking, which is easy to do and quite accessible for most people, is as effective at improving back pain as other non-pharmacological interventions such as yoga and stress-reduction tools.
Walking is a good activity to help back pain, as it is low-load and low-stress, and can be low-intensity as well. Taking a few steps is not as demanding as many other types of exercises, so it’s often one of the first exercises that people with back pain choose to start building their activity levels with.
When starting a walking program, find a threshold (whether that’s time or distance specific) that you can tolerate comfortably, and then build it up from there.
If it is difficult at first, take it slow - smaller, but more frequent walks are easier to tolerate than one long walk.
As tolerance builds and back pain improves, return to more strenuous activities and increase intensity.
Here at Ascenti, keeping active and building back up to the life you want and see for yourself is what we preach, and what we aim to help you achieve.
If you are unsure about how to progress your walking or unsure if this is the right advice for you, please consult with a healthcare professional.