Lower back pain is one of the most common musculoskeletal complaints among
adults, affecting up to 80% of individuals at some point in their lives. This often-
debilitating condition can range from mild discomfort to excruciating pain, and
can greatly impact an individuals ability to engage in daily activities and physical
exercise. That being said, with proper understanding and management,
individuals can safely return to the gym and resume their usual fitness routines. In
this blog, we will discuss the causes of lower back pain, how to appropriately train
around pain, and provide tips for returning to the gym after experiencing lower
back pain.

CAUSES OF LOWER BACK PAIN

Whilst lower back pain can is often associated with things like poor posture,
muscle injury, herniated discs, and age-related degenerative disc disease, in
reality the specific causes off back pain can be increasingly complex and
multifaceted. Outside of structural issues (like an injury or specific pathology), one
common reason active or sporty individuals can experience back pain is a lack of
adequate recovery in their routine (i.e. lack of sleep, poor nutrition, dehydration,
overtraining etc). Stress can also play a prominent role in back pain, with evidence
suggesting periods of high stress can correlate to periods of higher pain. Equally
though, we must acknowledge that sometimes ‘things just hurt’ and that even the
most well-thought-out prehab plan cannot 100% bulletproof us from injury.

TRAINING IN PAIN

It is important to note that while training with lower back pain is very possible, it
should be encouraged with caution and under the guidance of a qualified
professional. This is because specific pathologies may often be exacerbated by
specific movements. For example, if an individual presented with a facet joint
problem (where they often exhibit extension-based intolerances), immediately
programming them multiple sets of back extensions and deadlifts may be
inappropriate. Equally, programming a heap of lumbar flexion exercises to
someone with an acute disc herniation could cause further issues (as well as a lot
of pain) and potentially delay the healing process. With proper guided
management however many individuals can continue to train safely and maintain
a decent training effect that will drive adaptation whilst their back pain improves
with time.

RETURNING TO THE GYM

When returning to the gym either during or after a bout lower back pain, it is
important to start slowly and gradually increase the intensity of your workouts
over time. Rushing back into your normal routine can lead to further injury and
prolong the recovery process. Some people may benefit from working with a
personal trainer who can develop a customized exercise plan that takes into
account your specific needs and limitations. At Pro Health Physio NE, we work
alongside some fantastic coaches at Pioneer Performance, so would recommend
them 100%!

It is also important to listen to your body and pay attention to any pain or
discomfort. Although discomfort is often a normal part of the rehab process, if
you experience any sharp pain or discomfort during exercise (5/10), pull back
and seek the advice of a healthcare professional. More often than not though,
temporarily modifying your routine slightly is all that is required. This may include
reducing the weight or intensity of your exercises, altering the range of
movement or switching to low-impact activities. Equally, taking a temporary
break from that specific painful exercise and swapping it for a less painful
alternative can be helpful on some occasions. The painful exercise can then be
gradually reintroduced once your pain has subsided.

Let’s say an individual gets pain during a deadlift… it’s an 8/10 pain and is a clear
non-starter. Modifying the range of motion (by raising the starting point on some
blocks) and lowering the weight may be all that is needed to continue. Pain may
now be a much more tolerable 3/10, as opposed to an 8/10. We have now
managed to a) keep a hinge movement in our program, b) reap the rewards from
training the associated musculature and c) keep our sanity! We need to take into
account the potential negative psychological implications of just ‘stopping
exercise’, so the priority at the start should often be ‘how can we keep this person
going’ rather than ‘we need to stop’.

RECOVERY AND MANAGEMENT
Recovery from lower back pain takes time and it is important to be patient and
consistent with whatever treatment plan you may choose. In addition to
modifying our exercise routines, several other complimentary treatment
modalities exist including medication, manual therapy, and physiotherapy.

– Medication can help to alleviate pain and reduce inflammation, but it
should be used under the guidance of a healthcare professional. Common
medications used to treat lower back pain include nonsteroidal anti-
inflammatory drugs (NSAIDs), acetaminophen, and muscle relaxants.

– Manual therapy, which includes modalities such as soft tissue massage or
chiropractic techniques, can also often be beneficial for individuals with
lower back pain (especially in the acute stages). These therapies help to
promote relaxation, reduce muscle tension, and improve range of motion.
It is important however to work with a qualified healthcare professional
when seeking out manual therapy, as improper techniques can regularly
exacerbate your pain.

– Physiotherapy is a key and valuable component of the treatment of lower
back pain. A physiotherapist can work with you to develop a customized
treatment plan that addresses your specific needs and limitations.
Treatment may include exercises to improve strength and flexibility, as well
as manual therapy and education on proper technique and body
mechanics.

At Pro Health Physio NE, our physiotherapists are experts in the treatment of
lower back pain. We use a variety of techniques and modalities to help our
patients recover, including manual therapy, therapeutic exercise, and education
on pain science and training around pain. Our goal is to help our patients return
to their normal activities as quickly and safely as possible. Whether you are a
‘weekend warrior’ or elite level performance athlete, we pride ourselves on being
able to create the perfect bespoke rehab plan to get you back doing what you
love.

Find this interesting and what to know more?

Alex Turvill
I am just an email away – alex@prohealthphysione.com