What Doctors Say About Back Pain and How to Treat it With Exercise

This article is not meant to diagnose or provide medical advice—that responsibility lies with physicians. The author is not a licensed medical professional.

Are you sitting down? You probably are because people today spend significantly more time seated compared to previous generations. An average American today sits around 13 hours per day, perhaps more. And, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), back pain is one of our society’s most common medical problems.

Lots of people experience back injury—to varying degrees—but there are definitely ways to reduce your risk. Especially for those in today’s work culture. Laura E. Pempkowski, PT, DPT in Cambridge, Massachusetts, works with an overwhelming number of biotech and computer science professionals. “The sedentary postures that accompany many of these jobs is a main contributor to injury and prevents back health and wellness,” says Pempkowski. “Unfortunately, the evolution of our culture in science and computer technology is too fast for the evolution of human beings.”

“We know that the pressure in the discs between the discs and spine vertebrae is greatest when you are sitting,” says Nicholas Goyeneche, M.D., who specializes in orthopedics and sports medicine. “This means the pressure is hefty compared to say, standing or laying down.”

But, great news! There are all kinds of ways to counteract the man-made evils of our time.
David McCormick, M.D., MPH, PGY-2 outlines it simply: maintain a healthy weight and exercise consistently. “Regular exercise helps strengthen muscles—which support your back—and when you use muscles, they always ‘pull’ on the bones that they are attached to.” This pulling effect helps to strengthen bones.

Studies reported by NIAMS show that low-impact aerobic exercise is good for the disks that cushion the vertebrae and the individual spinal bones. Here are a few:

Barre Class

These classes combine floor work with small, isometric movements using the ballet barre and the participant’s body weight. The focus here is on the core, seat, arms and thighs. Nationwide popular franchises include Pure Barre, Barre Method and Barre3.

It is important to squeeze your seat. “Societies and cultures—both ancient and modern—that incorporate squatting force people to utilize their glutes in the way that they were designed: to extend the hip from a flexed starting position,” explains Pempkowski. Glute muscles provide a sturdy base and core for the body to function. “Sadly, when people use their lumbar back para-spinal/extensor muscles to stand erect they are overworking these string muscles,” she says.

However, if you’re prone to lower back pain, barre might not be right for you. Maintaining a neutral spine is key to protecting your lower back when doing workouts like barre and pilates. Tell your instructor you’re concerned about your back and ask for extra attention in maintaining a neutral pelvis (AKA barre tuck).

Yoga

Yoga asanas (postures) revolve around strong core muscles in the abdomen and back. Because these postures are coupled with breathing, the practice—when done safely and in the right form—is great for your lower back. In addition to your core, stretching hip flexors are a key for back health longevity.

“Sitting causes tightness to develop in the hip flexors … particularly when we sit with legs crossed at the thighs or when sitting with the low back arched away from the back of the chair,” says Pempkowski.

You can begin with these five poses from coach Julie Rader of BreakingMuscle.com.

Swimming

Pool time is excellent because it is a low-impact exercise that is also a form of active stretching. Unlike yoga and barre, swimming is the easiest on the rest of your body, requiring little to nothing from your other joints. It tones the tops of your glutes, your core and beyond. The buoyancy of the water is another added perk of this exercise that can be modified if you’ve already experienced an injury depending on your specific needs.

Do I Need to See a Doctor?

The level and duration of pain are key for knowing if you need to see a specialist. Physicians like Dr. Goyeneche stress the importance of a physical examination and family/patient history to rule out a neurological issue. As a nod toward being aware of the financial crisis of health care, many doctors are cutting down on the use of MRIs because they are expensive and unnecessary for all patients and employing conservative treatment like physical therapy or a targeted spinal injection.

Dr. Goyeneche also suggests investing in a good chair. He notes that “there are more exercises than there used to be … the key is doing things correctly.”

Not all back pain is created equal. Regardless of what happens with the Affordable Care Act under the Trump Administration, surgery for a herniated disc has historically always fallen under the category of “elective surgery” (Read: not covered by most insurance policies). But one that is most likely “medically necessary” (Read: gray area).

For something like a herniated disc, surgery for uninsured individuals runs between $10-$20 thousand. With insurance, the copay amounts to about $2,000. (Of course this is with the caveat that you met your deductible requirement and have already paid enough into your plan for that fiscal year).

Disclaimer: Please consult a physician or physical therapist or other expert before beginning an exercise program.

Andrea Blumenstein is a writer based out of New Orleans who loves cooking, fitness, books, all types of glitter and looks forward to opportunities to cuddle with her best friend’s cat.