Cardio Conditioning for Back Pain

Proper exercise is critical to alleviating low back pain and keeping it from coming back.

Exercises for core support and spine limbering are well-established modalities in the war on back pain.  But what about the specific effects of cardiovascular conditioning on the low back?

Can low back pain sufferers help themselves by hitting the treadmill or elliptical machine, or by simply going out for a walk?

What does the research say?

The research on this issue isn’t totally clear.

One reason is that many research studies have tested the effects of exercise in general for low back pain, without teasing apart the various effects of aerobic conditioning, strengthening, limbering, balance and proprioceptive training, etc.

For instance, two researchers in Canada studied the effect of an exercise program on low back pain.  The exercise program included aerobic conditioning, but it also included exercises that focused on other fitness components (flexibility, strength).  People in the exercise group fared far better than those who didn’t exercise.  But the research can’t tell use which specific aspects of exercise were important.

Other research projects have tried to zero in on the specific benefits of cardio conditioning – with mixed results.

For instance, two researchers in Thailand found that low back patients on a cardio exercise program improved more than those who didn’t exercise.

Meanwhile,  other researchers who studied the same issue concluded that patients engaged in aerobic exercise improved their mood but not their pain levels.  (Not that there’s anything wrong with that.)

Then there’s yet another opinion.   This article favors strength training over aerobics for back pain.

The Bottom Line?  Is Cardio Training Good for Helping with Lower Back Pain?

Why split hairs? You need to be more fit anyway.  Just do it. Don’t ignore the other aspects of exercise, but include cardiovascular fitness exercises as part of your weekly routine.

What About Running for Back Pain?

Does running compress the low back discs and make back pain worse?  Can you get lower back pain from running?

These are good questions.  I’ll give you three answers, and you can pick the one that make sense to you.

  1. Yes – running does compress the low back discs.  Instead of running, choose another aerobic exercise, such as an elliptical machine.  Even walking can be good.  To make walking more challenging, try walking uphill or climbing stairs.
  2. The effects of running depend on the way you run.  Wearing decent running shoes and running on a compliant surface make a big difference to the amount of low back impact when you’re running. Another factor making a big difference is whether you land on your heel when you’re running or whether you’re a fore-foot lander.  Stay tuned for an upcoming blog post that deals with this issue.
  3. Answer #3 is my personal observation which may not prove to be of any value when subject to more scrutiny.  But it occurs to me that the discs of the low back only get nourishment and can only get rid of waste products by passive diffusion.  The discs need repetitive cycles of loading and unloading to squeeze fluids in and out.  The fluid turnover speeds disc metabolism for healing and regeneration.  That’s a positive boost you give yourself when you run.

SUMMARY:  If you enjoy running, and you have back pain, try a brief run on a compliant surface and see how it feels for you, not only while you’re running, but for a day or two after.  If it seems benign to you, gradually increase your distance.  You can also retrain yourself to be a forefoot planter.

On the other hand, if running doesn’t feel right for your low back, switch to walking, an elliptical machine, stationery bike, or another path to improved fitness.

Of greatest importance: don’t use back pain as an excuse to be a couch potato.  That’s a losing proposition.

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About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website, askdrlavine.com, provides more information about his approach. Please contact him at drlavine@yourbodyofknowledge.com or at 212-400-9663.
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