Can exercise really help my lower back pain?

If you have lower back pain from spinal stenosis, one of the last things you want to think about is exercising, but that is just one of the non-surgical treatments your doctor may recommend before determining that you may be among the 5 percent of people who needs surgery.

So the question you may have is how can exercise help?

One of the most common causes of lower back pain is lumbar spinal stenosis, which is a narrowing of the bone channels that surround nerves in the spine. Most commonly, the narrowing occurs in the spinal canal of the backbone that surrounds the nerve bundles that run up and down the backbone. Narrowing also occurs in the foramen, the channel in the individual vertebra through which the nerves branch out to all parts of the body.

Symptoms of lumbar spinal stenosis often include leg pain (sciatica), numbness, low back pain that is often intermittent, or worsens with certain activities or lessens with others.

If your doctor has determined from x-rays, MRI or CT scans that you have spinal stenosis; the problem is that the amount of narrowing shown on imaging does not correlate with the degree of symptoms. Some people have little or no pain with the same degree of stenosis as another person who is experiencing severe pain. Current guidelines for the management of patients with specific low back pain suggest non-surgical intervention as first-line treatment, and exercise is one of those treatments recommended.

In a University of Pittsburgh study published in the Journal of Manipulative Physiological Therapy last year by researchers at a single clinic that specializes in surgery, 54 patients with lumbar spine stenosis underwent 4 months of exercise training, which included stationary bicycling. Patients were evaluated with a standard walking test before and after the training. They found that almost half (26 of 54) of the participants who completed the training felt their lumbar spinal stenosis symptoms improved to such an extent that surgery was not required.

While it was a small single-clinic study that needs to be confirmed by larger multi-center studies, the results suggest that exercise may be an effective treatment for some people with lumbar spinal stenosis.

The study was not designed to determine how exercise improves symptoms from spinal stenosis, however, there has been an abundance of research showing benefits of exercise for improving parts of the body associated with spinal stenosis.

These include:

  • Increased blood flow to the back, which increases availability of nutrients and oxygen and a reduction of toxic metabolites
  • Strengthening muscles that relieve pressure from bones
  • Increased flexibility, which reduces strain from tight muscles that pull and torque the spine
  • Reduces weight that can worsen back pain
  • Increases the release of endorphins that help block pain, and improve mental outlook and reduce stress

At Dr. Michael Gomez the emphasis is on providing a personalized approach to each patient’s needs in partnership with a specialized physical therapy and rehabilitation center as well as connections with the excellent hospitals in the county in a seamless continuum of care.

Our goal is to provide you with the optimal long-term outcome that meets your needs and preferences. Consequently, we are happy to review your MRI and discuss your options and answer all your questions to ensure you get the best treatment for you.

Source: Journal of Manipulative and Physiological Therapeutics