What is the best exercise against low back pain?

You probably suffer or have suffered at some point in your life from an episode of chronic low back pain. Certainly you will have spent some time without moving, you will have taken some medication for relief and you may have even gone to the doctor or physical therapist. Perhaps one of the two told you that it is better to stay active and exercise. If only they knew what hurts…and what cripples!

10% of men and 17% of women suffer from low back pain or chronic low back pain in Spain. This places it in third position in the ranking of the main chronic or long-term diseases, only below hypertension and high cholesterol, according to data from the National Institute of Statistics (2020).

In addition, it is the most common type of chronic pain and the one that represents the greatest burden of disease globally in our health and social system. It generates a large number of sick leave and associated costs.

You don’t have to sit still

It may seem illogical or against nature, but when we suffer from chronic low back pain, the best thing we can do is not stop. Stay active, reduce bed rest, and return to work as soon as possible. But should we also exercise? And, if so, what physical activity would be the most beneficial to reduce the pain and disability caused by low back pain?

Our team has attempted to provide a science-based answer to these questions. To do this, we examine the effects of aerobic, strength, combined, stretching exercises, the so-called body-mind (such as yoga and tai-chi), activities that strengthen the core (as the muscles of the pelvis, lower back, hips, and abdomen are called), McKenzie exercises (focused on extension), and Pilates.

Thus, after reviewing 118 articles and observing how 9,710 people with low back pain evolved, we can say that any of these exercises is effective, except stretching (when the patient is in pain) and the McKenzie method (in the case of disability).

Pilates, the first on the list

And which are the most recommended? It seems that the ones that best relieve pain –in order of effectiveness– are Pilates, those of body-mind and those that focus on the core; while Pilates appears again as the most effective in reducing disability, followed by strength exercises and core.

When we assess the characteristics and frequency of training, we find that performing at least one to two sessions a week of the Pilates Method or strength exercises reduces both pain and disability in chronic low back pain. Next, programs that included one-hour sessions of content-based activities were also effective. core, force or body-mind practices. And finally, those training programs that lasted at least three to nine weeks and were based on Pilates and activities focused on the core.

Change chair and medications for mat and dumbbells

Now, when you ask your doctor about what you can and can’t do about your low back pain, you may have the clearest ideas. Get moving, get back into activity, and choose from the exercises listed above.

In any case, and despite the fact that some options are better than others, we must not forget that each person is different. There will be patients for whom the exercises that work for the majority do not work, or who have other preferences. In the end, we are the sum of many things: previous experiences, emotions, social, work and economic situation, social support, lifestyle, etc. For this reason, we must not forget to assess and identify the individual characteristics to prescribe the most effective and adapted exercise for that low back pain.

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