Should you stop exercising if you have back pain?
Has low-back pain been holding you back in the gym or with your active lifestyle?
Back pain is the most common “injury” among Americans and can sideline athletes and non-athletes alike. It has the potential to stop people in their tracks, oftentimes leading to time missed from work, skipping workouts, and even canceling gym memberships due to fear of making things worse.
It’s understandable; back pain is a scary thing to go through. The uncertainty surrounding whether or not surgery will be necessary, if it will be a long-term issue, or if your exercise and physical activity habits will make things worse are extremely common and valid concerns, especially for those of us who know somebody in our lives who has experienced debilitating back pain.
If you’re an athlete, these uncertainties can be even more prominent when it comes to your active lifestyle. Back pain can be a huge barrier to training and exercise just due to the pain alone, not to mention the fear that your training program might make your condition worse.
The good news is, you can have your cake and eat it too. For the vast majority of back pain cases, exercise is one of the MOST effective solutions. Yes, more so than surgery, medication, infrared therapy, acupuncture, bed rest, and heating pads.
Outside of a few select scenarios, the recommendation in the research is to continue your exercise program as much as you can tolerate with modifications here and there to keep things from worsening. To simplify this process and help you get back to exercise as quickly as possible, I’ve broken down my exercise recommendations based on the most common types of back pain.
Recent, localized back pain (less than 3 months)
This is the most common form of back pain, where a tweak either during training, competition, or daily life has led to pain that is localized to the low back or upper glute region with no numbness, tingling, or shooting pain going down the leg.
With this type of injury, getting moving early and often is critical. Over the first few days, keep it light and simple, whether that be with some steady-state cardio, yoga, or bodyweight exercises. After the first few days, it is important to make an effort to return to as much normal activity as possible. That may not be full intensity Rx CrossFit wods, but it is entirely safe and beneficial to start returning to your workouts in a scaled fashion within your tolerance level and gradually ramping up as you start to feel better.
The most important thing is that exercise is safe and beneficial for recovery. Your best bet to ensure recovery is to refuse to be sidelined completely, continue at the gym to the best of your ability, and modify as necessary in order to accelerate the recovery process.
Prolonged, localized back pain (longer than 3 months)
If you fall into this category where your back pain has been refusing to go away after months, you will benefit from sticking with exercise more than anyone else. Even better, you don’t need to be quite as cautious as those with a more fresh injury.
Generally speaking, this type of back pain responds best to cardiovascular exercise, interval training, and even certain strength training movements with the stipulation that the athlete proceeds cautiously with intensity. Not only are these exercises safe, they are actually beneficial for the treatment of prolonged (chronic) low back pain and can help accelerate your recovery.
As with any type of injury and exercise, it is important to first stick with the exercises and movements that feel tolerable and modify the ones that don’t so that they feel more in your comfort zone. Furthermore, it is important to seek out a sports physical therapist if you’ve had back pain for several months, as this can accelerate your recovery and help you return to your prior levels of strength and intensity in the gym without pain.
Back pain with nerve involvement
This is the type of back pain that also involves shooting pain, numbness, and/or tingling down the hip, leg, or foot. It is certainly safe and important to exercise gently with this type of injury, but because these symptoms can be the most irritable, it is important to proceed with caution in regards to intensity and possibly seek out Physical Therapy prior to going extremely hard or heavy.
In the meantime, it is very important to stay mobile to prevent disabling pain. This will look very different for different people, but a low hanging fruit is to start with a steady state cardiovascular routine with some light mobility exercises on the off days. Light planking and upper body strengthening can also be beneficial in the early stages if tolerable.
The most important takeaway for this type of back pain is that while some caution is necessary, movement and exercise are paramount even in the early stages to help accelerate recovery and prevent disability from occurring in the future. Additionally, seeking out a sports physical therapist who understands the demand of your sport can help ensure your healing and get you back to performing at a high level without pain.
—---------------------
By this point you may have picked up on a theme: exercise remains important for the vast majority of back pain occurrences. It will help accelerate your recovery and reduce the risk for future disability. There is an infinite selection of potential modifications to help keep you in the gym without worsening pain, while continuing to move the dial in a positive direction with your recovery. Don’t be the person who cancels their gym membership due to pain. You are in charge of your pain, not the other way around. Keep hold of the reins, be stubborn, take action, and tell that back pain who’s boss.
Dr. Brooks Kenderdine
PT, DPT, CSCS, USAW-1
Co-owner | The PATH Rehab & Performance
