My lower back is killing me. What can I do about it at the gym?
It's the classic moving-day injury: You're hoisting a dresser or grabbing one end of a sofa, then - bam! - you throw out your back.
So it may come as a surprise to hear that a promising solution for chronic lower-back pain, according to a series of recent studies from the University of Alberta, is lifting weights. A whole-body strengthening program dramatically outperforms aerobic exercise for those whose nagging back pain lingers for many months, the researchers say. And the more you lift, the better.
By some estimates, two-thirds of adults will suffer from lower-back pain at some point in their lives. Many sufferers are diagnosed with "non-specific" back pain, which means their doctor hasn't been able to identify a specific physical problem such as a slipped disc or muscle imbalance as the cause.
There's no shortage of solutions, from bed rest and acupuncture to spinal manipulation and radiofrequency denervation, but none have emerged as reliable cure-alls.
Earlier studies have established that not lifting anything neither cures nor prevents this type of back pain. In fact, it can trigger a downward spiral where inactivity makes you weaker, which worsens your back pain and causes you to become even less active, says Robert Kell, a professor at the University of Alberta's Augustana Campus.
"People with back pain have a hard time getting through the day, because they … are no longer able to maintain their spinal stability," he says. "If you can increase their strength and endurance, they can complete their normal activities without losing their posture."
Since each person's "non-specific" back pain may stem from a slightly different combination of weakness and imbalance, Dr. Kell uses a 16-week program that targets muscle groups throughout the body. In two studies published in the Journal of Strength & Conditioning Research, he observed more than 25-per-cent improvement in measures of pain, disability and quality of life compared with controls and to subjects doing aerobic exercise.
A third study, whose results were first presented at the American College of Sports Medicine annual meeting last year, divided 240 volunteers into groups who lifted weights between zero and four times a week. Those lifting four days a week reported decreased pain by 28 per cent, compared with 18 per cent for three days a week and 14 per cent for two days a week. (Non-exercising controls decreased pain by 2 per cent.)
"If you can make time to do a little bit, like 20 minutes twice a week, it will help. If you can do more, it gets better," Dr. Kell says.
This one-size-fits-all approach has limitations, though, according to Stuart McGill, a professor of spine biomechanics at the University of Waterloo .
"There's actually no such thing as non-specific back pain," he says. "It just means you haven't had an adequate assessment."
People with back pain caused by weakness in one of the muscles targeted by Dr. Kell's program will indeed see improvement. But the blanket "non-specific" diagnosis also includes people with other sources of back pain, whose condition could worsen if they lifted weights.
The most prudent course of action, Dr. McGill says, is to find a clinician who is able to diagnose the root cause of your back pain and determine the appropriate treatment.
Certainly, you shouldn't persist with any exercise that causes pain or discomfort. With that caveat, a whole-body strengthening program still seems like an excellent recommendation. Whether or not it cures your back, you'll be healthier as a result.
Alex Hutchinson blogs about
research on exercise at www.sweatscience.com.