Some of the best medicine for back pain might not actually be medicine. Finding relief can often be as simple as making time for more walks, for example.
"Just like every other part of the body, the spine naturally degenerates over time," explains Dr. Sean Barber, a spinal neurosurgeon at Houston Methodist. "And one thing we know is that a sedentary lifestyle can really accelerate this, increasing the risk of back pain."
Estimates suggest that around 80% of people will experience at least one significant episode of back pain in their lifetime, making this particular consequence of inactivity one we should all take seriously.
But for as common as back pain is, there's good news: It's never too late to get active, and even light exercise can help you achieve back pain relief.
Understanding the causes of back pain
Your spine is more than a stack of bones running down your back. It's also a complex network of disks, nerves, muscles and ligaments that supports your body as you sit, stand, walk, bend and twist.
"When thinking about the spine, people often forget about their back muscles, but they play as important a role as any of the other parts," says Dr. Barber. "Weak back muscles cause instability in the spine."
This can make degeneration and wear and tear more likely and lead to a variety of painful musculoskeletal problems, ranging from strains and sprains to herniated disks, facet joint damage, pinched nerves and more. (Related: 8 Causes of Lower Back Pain)
"Back pain can also be nonspecific, meaning we don't exactly understand what's causing it," adds Dr. Barber. "But even in these cases it's likely still due to an underlying lifestyle behavior that could be improved upon, like not being active enough."
Factors directly linked to an increased chance of experiencing back pain include:
- Living a sedentary lifestyle
- Being overweight
- Smoking
Dr. Barber notes that other factors and underlying issues can lead to back pain, but these are much less common.
"The vast majority of people with back problems are experiencing musculoskeletal pain," says Dr. Barber. "Fortunately, this type of pain can often be addressed with exercise."
Exercise for back pain: How it helps
Many studies show that physical activity can relieve back pain, though Dr. Barber points out that the reason it helps isn't entirely clear.
"The theory is that exercise strengthens the back muscles supporting the spine, keeping it stable and functioning normally as you go about your day," Dr. Barber offers. "But the completely honest truth is that no one really understands the exact mechanism."
What is known is that it doesn't take a lot of exercise to get rid of back pain.
"People often think this takes some intense workout plan, but it really doesn't," adds Dr. Barber. "From all of the evidence we have, it doesn't seem to matter exactly what exercise you do — even just walking or doing light exercise around the house can help."
(Related: What Matters Most on a Walk — Steps? Speed? Mileage?)
The more often you get moving, the better. But don't set a goal that becomes so overwhelming you won't (or can't) get it done. The best exercise routine for you is the one you'll do consistently. Talk to your doctor before beginning a new exercise routine if you're unsure where to start.
"If you have bad back pain, don't go out there and immediately start training for a 10K — because you're probably going to make things worse," Dr. Barber adds. "Avoid any activities that exacerbate your pain or cause it to flare up but do try to work in a little bit of something at least once a week."
Treatment may be required if lower back pain won't go away
Physical activity can play an important role in back pain relief, but don't put off seeking care for pain that lingers.
Signs it's time to see your doctor about back pain include if it's:
- Lasted more than a week
- Not responded to over-the-counter anti-inflammatory medications
- Accompanied by pain, weakness or numbness down your leg or arm
- A frequently recurrent problem
- Keeping you from being physically active
- Interfering with your job or life at home
When you visit your doctor, you'll be asked questions about your pain. You may also need to undergo some tests to determine the cause and next steps. Back pain treatments range from physical therapy to muscle relaxants, medications and steroid injections to even back surgery in some cases.
"Physical therapy is one of the mainstays of the nonsurgical options for treating back pain," says Dr. Barber. "Many people think they don't need it, since they've already tried exercises and stretches for back pain on their own at home, but a physical therapist has a whole repertoire of skills and tools at their disposal to help with chronic back pain."
Not only can physical therapists pinpoint weak muscle groups and recommend specific back exercises targeting those areas, but they also offer massage, dry needling and other nonsurgical treatment options.
"We typically do physical therapy for six weeks before deciding whether more extensive treatment, such as surgery, might be needed," says Dr. Barber. "But the vast majority of patients see benefit from either exercising themselves at home or following the exercise guidance of a physical therapist."
