Back pain and exercise

Many people with back pain have been told that they can move “within the limits of pain“. What does this mean? The idea is to encourage people to move even when they are in pain. It is an important tip – but can it also cause problems?

Back pain is a problem that comes back several times a year for many people. Let’s imagine that the back pain started when a person picked something up from the floor. As they lifted it, they bent down towards the floor and felt a sharp pain in their back. Ouch, there goes my back!!

Let’s say that two years have now passed since that lift, and the back pain has come back many times since. When the back pain started two years ago, the doctor told the person to move within the limits of pain. They have followed the advice and gone running and to dance classes.

They have avoided bending forward completely, because they are afraid that their back might “go” again. Even the thought of bending forward feels unpleasant, and the painful episode immediately creeps into their mind.

What is the problem with this advice?

I often notice that the meaning and purpose of the advice has not been explained when it was given. The advice is not meant to be followed for the rest of your life. The back – and back pain too – likes movement and exercise, so it would be best to start moving the back quickly, right in the acute phase. The sooner you start moving, the sooner the pain starts to ease. And yes, in this example that includes bending forward, which is where it all started.

The advice to move within the limits of pain often remains unclear to clients. They are often left wondering what it actually means and what exactly they should and may do.

That advice is not meant for the rest of your life

Movement for back pain

Bending the back forward is a natural and safe direction of movement for the back. Even if the back pain started when you bent down, it does not mean that you can never again or should never lift anything from the floor by bending over. When the advice is given, the client should also be shown the exercises for getting the back moving, and how and with which exercises to progress step by step to the next stage.

I always give my clients with back pain easy and slightly more challenging exercises. One person needs the easiest exercises, while with another we can jump straight to slightly more challenging ones. The client gets a “toolbox” for moving the back and knows how to progress with it. In fact, we also have research evidence that it is fine to feel tolerable pain during the exercises. This is important, because back pain often starts when lifting. I have written about the same topic in another article that might interest you >> Annamari got rid of her back pain.

If you live in the Helsinki area, you can book an appointment online here. My clinic is in Metsälä at Läkkisepäntie 11.

Best wishes, Jerry
osteopath, personal trainer