Can exercise help prevent back pain?

DEAR DOCTOR K:

I get back pain every so often. It can last a week and interferes with my life. Can exercises prevent more attacks in the future?

DEAR READER:

Absolutely yes — IF you do them regularly. Exercise is a great way to prevent repeat episodes of low back pain. The right exercise program will help you build strong, flexible muscles that will be less prone to injury.

There are a lot of people like you who suffer from recurrent back pain. About 80 percent of U.S. adults report having experienced at least one bad episode of back pain. One of the reasons that back pain is so common may be that we’re out of shape.

What do I mean? Until about a century ago, most human beings were physically active most of the day. The great majority of U.S. citizens lived (and worked) on farms, and that involved a lot of walking and lifting. You may think of lifting as mainly involving the arms, but lifting something heavy involves using the back, abdominal and leg muscles as well.

Our muscles were built to support a life of frequent physical activity — particularly a lot of walking and lifting. But that’s a life few of us have today, so our muscles tend to get weak and stiff.

Weak muscles — particularly weak back and abdominal muscles — cause or worsen many cases of low back pain. Stretching and strengthening both your back and abdominal muscles can help prevent a recurrence of the problem.

The best exercises are those that strengthen and stretch the muscles that support your spine. Strong abdominal or flexor muscles help people maintain an upright posture. So do strong extensor muscles, which run up and down the full length of the back. They help keep the vertebrae, the bones of your spine, straight. In addition, two long muscles that run from the lower vertebrae to the hips and the buttock muscles help support the back during walking, standing and sitting.

Stretching is equally important for a person plagued by back problems. Supple, well-stretched muscles are less prone to injury. Stretch regularly but gently. Don’t bounce, as that can cause injury. Beginners should start by holding the stretch for five seconds or so, and then gradually build up to roughly 30-second stretches over time.

In addition to exercises that increase the strength and flexibility of your lower back, you should engage in regular aerobic exercise. It has many benefits for general health and also helps prevent back pain. Choose activities that are low in risk and high in benefit for your back. Swimming, walking and bicycling lead the list.

Talk to your doctor about working with a physical therapist. A therapist can help design a safe and effective exercise program for you. Once you’ve got that program established, do it regularly. That statement may seem obvious, but I’ve had some patients who seem to think that a week of exercises can prevent future back pain forever. If only that were so.

(This column is an update of one that ran originally in February 2013.)