Patients always write to us asking what type of spine exercises will cure their chronic back pain. This is a loaded question, since the answer is virtually always “none”, despite the prevalence of back exercises being used almost universally to treat all manner of structural dorsopathy concerns.
Exercise is fantastic for health maintenance and we are outspoken advocates of an active lifestyle. However, we are also realists and have seen very few success stories in which back pain cures can be definitively attributed to any type of exercise program. Far more often, we see symptomatic relief provided, yet no cure enacted, or a worsening of symptoms due to escalated physicality.
The exceptions to this rule include pain that is generated by muscular deficiencies and imbalances, as well as some forms of pain caused by general physical deficits.
Using exercise as a treatment for most correctly diagnosed spinal structural conditions seems illogical, but these methods of care are continuously recommended, regardless.
This essay takes an in-depth look at many of the lesser known aspects of exercise therapy, when used to treat anatomically-induced pain syndromes in the back and neck.
Almost any motion will exercise the spine to some degree, since the back is involved in nearly every movement we make and virtually every activity we participate in. The mere act of standing, or even sitting upright, exercises the back muscles and spinal structures, as the postural muscles get very few chances to rest. Therefore, the more reasonable question should be, "What types of activities do not exercise the spine?" This would be a far shorter list to compile.
Virtually any physical activity will exercise the back, be it walking, swimming, yoga, tai chi, running or doing dedicated calisthenics and back stretches.
Patients exercise all day long, just by living normal lives and doing the usual things people do moment to moment. We do not see these activities providing any relief for most patients, nor do we see evidence that specially-prescribed exercises, such as those used during physical therapy, do anything at all to resolve the structural issues which are cited for causing the wide range of back and neck pain conditions.
However, in a majority of scenarios, regardless of the diagnosis, exercise does indeed provide a temporary respite from pain. How and why this occurs is a matter of great controversy in the modern medical system.
Despite the fact that exercise does nothing to undo spinal injury or degenerative changes in the vertebral column, many patients feel much better when moving about than they do when standing or sitting still. Actually, many patients report the ability to do very strenuous exercise, despite the complete inability to do some very basic and easy physical tasks, like sitting or tying their shoes.
It does not take a genius to see that these reports are completely illogical from a structural point of view, but they exist in voluminous numbers, nonetheless. In fact, my own back pain condition mirrors this very pattern.
There is one universal logical explanation for the most basic problem with the back pain diagnostic process. Structural spinal issues, such as herniated discs and osteoarthritic changes, should not respond positively to exercise therapy; yet many do.
Therefore, it is safe to assume that the diagnosis of the structural condition, as being causative for pain, is probably incorrect. This is the truth of the matter in the vast majority of diagnosed patients, regardless of the theorized source of symptoms. This truth also explains why so many back pain treatments fail abysmally, as they are directed at a mistakenly identified condition.
When exercise creates increased levels of pain, given a structural diagnosis, the likelihood of that diagnosis being valid increases.
For example, facet syndrome is diagnosed in the lower back. Logic would dictate that movement of the diagnosed levels of the backbone should induce pain. If exercise does exacerbate the condition, the diagnosis might be correct. However, if movement makes the area feel better, then the structural changes might not be the true cause of symptoms.
So if exercise does provide a soothing effect, what can be the reason?
There are many theories that may apply and none are universally accepted. However, we will detail one that seems the most logical. Most exercises work to temporarily resolve symptoms due to one simple truth: They increase regional circulation of blood. This process provides nutrients and oxygen to the region and also helps to metabolize waste products in the cells.
Since exercise relieves pain, one can assume that the true source of the symptoms might be ischemia or waste chemical accumulation. Lactic acid buildup in cells can cause soreness, but is rarely associated with acute or severe pain, forget about any type of neurological expression, such as paresthesia or numbness. Therefore, this potential cause of symptoms seems unlikely in the vast majority of patients.
However, regional cellular oxygen deprivation can indeed cause extreme pain, as well as neurological dysfunction that can explain virtually all back and neck pain expressions. Increasing the oxygen supply, through improved circulation, will temporarily stave off the symptoms. Unfortunately, once the exercise ends, the circulatory rate returns to a lower level and the pain returns.
Regardless of the exercises used, there are some facts that are indisputable:
Exercise will not undo degenerative disc disease, heal a herniated disc or take away years of spinal osteoarthritis buildup. However, exercise will increase regional oxygenation of tissues, counteracting the horrific effects of oxygen deprivation back pain. This statement actually makes sense and has proven itself to be the case in countless patients who have applied non-medical therapies, such as knowledge therapy, to fully end their pain.
The bottom line comes down to this: If you are reading this essay looking for some specific forms of spinal exercises, then we are sorry to have taken your time. Instead, we highly recommend you visit our back exercises resource section to get a detailed look at the best fitness activities for spinal health. But, if you are here to actually find a cure for your pain, instead of temporary relief, this article might just put you on the right path towards full symptomatic resolution.
Remember, it is your job to question everything, when treatment fails to bring about a cure. Question your diagnosis. Question your treatments. Question this very article. Do your own research and discover the truth for yourself.
Only harm can come from accepting everything without question, since this mistake is statistically proven to result in the worst possible outcomes when treating back or neck pain long-term. Just ask any of the hundreds-of-thousands of patients who have cited this fact on the back pain surveys that they have completed and sent to us.