Why movement is so important for back pain

It is often hard to stay active if you are in pain. Some people are even scared of moving too much. They might be worried that the pain is a sign of a back injury. But that isn't the case when it comes to non-specific back pain, which is usually caused by many different factors. These include weak or tense core muscles, inappropriate physical strain, a problem with the processing of pain in the brain, as well as stress and other types of emotional strain.

Types of exercise that have proven effective include the following:

• Special programs consisting of exercises to strengthen and stabilize the deep abdominal (tummy), back and pelvic muscles, as well as endurance training and exercises to stretch the muscles in the calves, hips and thighs.
• Pilates: A total body workout in which strengthening the deep core muscles is key.
• Tai chi: Originally an Asian martial art, tai chi is now practiced with slow, flowing movements. It can improve your balance and coordination skills, strengthen your muscles, and is said to help you relax your body and mind.
• Yoga: A practice from India that aims to improve your body awareness and health. Yoga typically involves getting into various positions or carrying out certain sequences of movements that aim to promote strength and flexibility, body awareness and a good posture.
• Going on walks: Initial research suggests that going on a walk or brisk walking (Nordic walking) can help relieve back pain if done regularly – for instance, every two days for 30 to 60 minutes.

A doctor or physiotherapist can help you to find a suitable type of exercise that is tailored to your own situation and that you enjoy. People who have medical problems often find it helpful to have a course instructor or trainer with the appropriate experience.

You may need patience to start off with: It can take several weeks for the exercise to have an effect. Your body also needs to get used to the extra movement. That can be tiring and lead to harmless muscle ache, and it sometimes makes the pain worse for a while.

In order for it to help in the long run too, you have to stick to your exercise program. This requires a lot of motivation, and many people find it tough after a while – particularly if they have a very busy job or home life. It is then important to find a way to fit the exercise into your daily routine.

Many people find it easier to exercise regularly if they sign up for a class or exercise together with friends. Some make sure they pack their sports bag before going to work, or increase their motivation by rewarding themselves with a treat afterwards. It is also a good idea to have check-ups with a physiotherapist or doctor to adjust the exercise program if necessary.

If you spend a lot of time sitting in an office, you can be kind to your back by taking regular breaks and moving your body – for instance, by getting up out of your chair, stretching, doing short exercises and going on a walk in your lunch break. Some people find it helpful to wear a fitness tracker watch, or to set reminders on their mobile phone or computer.

Other ways to get more exercise into your daily routine include the following:

• Not using escalators or elevators (lifts), and always taking the stairs instead.
• Regularly getting off one stop before your actual bus or tram stop, and walking the rest of the way.
• Trying to walk or cycle as much as possible.
• Getting up and walking around while you're talking on your phone.

Patient education classes provide you with facts and techniques to help prevent or relieve back pain. There is usually both a theoretical and practical part. The classes typically include modules on the anatomy of the spine and the back, advice on postures and movements that don't put harmful strain on the back, and back-strengthening exercises. These courses are often offered at gyms and physiotherapy practices.

Patient education classes haven't yet been scientifically proven to help people with chronic back pain. Some studies found that they helped a bit, while others did not. There are a lot of different patient education classes, sometimes differing greatly in terms of what they cover and the approaches they use. This might explain why the results of the studies varied so much.