Role of Exercise in Managing Back Pain

Exercise as a back-pain remedy is universal. But so is aspirin and spinal manipulation. Each therapy has value depending on the situation.

For the moment, let’s consider acute versus chronic back pain. I seldom recommend exercise in acute situations. In most acute situations, sprains, and strains, the immediate issue is inflammation and stabilization. If structural integrity is violated like a ruptured disc or possible fracture due to trauma or potential underlying disease, exercises aren’t even on the radar, advanced imaging is!

Only once the acute situation has been contained/stabilized and the inflammatory cascade of chemicals is being addressed should very light exercises be considered. I may wait days to weeks to recommend them and, the exercises must be as SPECIFIC as possible to the individual, not a “cookbook” approach.

The most effective regimens I have developed incorporate stretching and strengthening based upon the individual’s height, weight, age, occupation, history of injuries and surgeries. Samples of the exercises I often prescribe are on my website,

Most exercises given to facilitate a rapid recovery can be continued throughout life to keep the situation from becoming chronic.

Back pain is considered “chronic” after three months duration with no significant reduction in pain. Before a person with chronic back pain undergoes a strengthening or stretching program, I first want to evaluate them for spinal function. If joints in the spine of the pelvis are not mechanically efficient, exercise will aggravate the situation by pulling tendons, ligaments, and muscles against joints that won’t/don’t move. By the same token, many cases demonstrating spinal mobility problems will improve when the surrounding connective tissues are stretched and or strengthened.

Speaking of connective tissues, the most overlooked facet of managing back pain is the constituent connective tissue in us all, fascia. Just under our surface is the thin layer I often refer to as “Saran Wrap.” Deeper layers are thicker yet still resilient. If you’ve ever seen a string of sausages linked together you can correlate that image to muscles being wrapped individually inside you but connected in the string. For example, the fascia on the bottom of the foot is connected to the calf in the back of the leg, which is connected to the hamstring on the back of the thigh, which is connected to the glutes in your pelvis and the muscles that run alongside your spine all the way to your neck, over your head and attached to the skull just above your eyebrow! WOW, one single sheet of connective tissue from the base of your foot to your eyebrow! Consequently, whenever possible I design stretches that activate a whole string of fascia overlying various muscles. You can see an example of this on an activity I labeled, “Deep Front Line” on my website videos.

In closing, any time you feel more pain after exercises, stop and ask for help. It could be you are not ready for that exercise or, your technique needs tweaking.

The MOST FREQUENT mistake I see is someone chasing pain with exercise directed to the area that hurts. In the absence of direct trauma, the painful area is typically a compensation. Often pain on the left is triggered by dysfunction on the right or above or below, so don’t be surprised if I tell you to attend to an area seemingly remote to where you feel your pain. I’ve fixed many neck by releasing fascial restrictions established in the feet from injuries long, long ago!

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I hope this was helpful and thanks for reading!