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Is Rest or Movement best for Back Pain?

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Is Rest or Movement best for Back Pain?

When you’re in pain – especially if it’s back pain – your first inclination may be to lay off all activity and rest. But is this really the best thing to do?

When it comes to back pain – my answer is usually “No”.

But I understand why this advice might sound strange or counter-intuitive. It’s scary to move when you’re in pain. And how do you know which exercise is best for your back when it hurts? Plus, advice from the medical community often conflicts with current research. Many people suffering from back pain – especially if it’s an acute injury or episode – are told to rest, ice, and take anti-inflammatories. They are told to limit their movement and activity until their pain goes away. Well science says that 80% of all back problems are mechanical in nature – which means they respond best to movement – even if your back pain is acute.

Let me help you understand.

Mechanical pain occurs when something in your joint (and your spine is made up of a bunch of joints) is restricted in a way that obstructs your normal movement. It’s why back pain is often accompanied by stiffness.

The obstruction can be caused by any structure in your spine. Such as a bulging disc, ligament, or even abnormalities from arthritis.  What the research has found with mechanical pain is that if you move in the right way – usually in a specific direction – you can “release” the obstruction.  When you’re able to move normally again without stiffness – you have less pain.

Therefore, although early movement is good for your back when you’re in pain, it’s critical you pick the right type of movement. Some movements and positions will aggravate your back, especially if it’s acute. Others will accelerate your healing. Generally speaking, gentle movement like walking is considered one of the best things you can do when your back is hurting, along with gentle mobility exercises that are direction-specific. More often than not you’ll want to avoid movements that involve bending forward and any stretches in this direction. If your back pain involves an irritated nerve or bulging disc – forward stretches such as a child’s pose may feel good in the moment. However, they could prolong or possibly worsen your problem.

The only way to know exactly which movement you should do for your particular back pain is to get a proper assessment from a mechanical pain expert. But when it comes to lower back pain, these are the general patterns that we see for movement that is good for your back.

So what about rest? Why is it not advised?

Although most back pain will go away on its own with time – and rest doesn’t necessarily “hurt” you per say – the problem with resting instead of moving is that it can prolong your healing time. This can trick you into thinking your back problem is gone when it’s really not.

Just because your pain is gone – doesn’t mean your problem is gone. If you’ve got an underlying restriction in your spine that’s causing mechanical back pain, it’s possible to be pain free until you move a certain way again that tweaks your back.

Ever “throw your back out” sneezing or getting out of bed in the morning? It’s because you let an underlying mechanical back problem linger. Perhaps every time you hurt your back you rest until the pain goes away. Well, as we just learned, if your back pain happens to be mechanical in nature, and the odds are pretty good that it is – movement – not rest – is what you need to fully the back pain.

If you suffer from chronic back pain, or perhaps you’re acutely injuring your back every few months, there’s a good chance you aren’t moving your back enough or you haven’t yet found the specific type of movement you need.  Talk to an expert who can help you. You may not think it now, but it’s definitely possible to live a life where you’re able to resolve back pain on your own. You can absolutely learn how to control your back pain without medication or surgery – but it requires an active approach – not rest. Back pain is normal, not knowing how to deal with it doesn’t have to be.

Are you experiencing back pain and looking to get answers as to why and how to get out of  pain?

Request to talk to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

 

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. To get a free copy of her Guide to Easing Back Pain and Stiffness – click here.

Tips to Fix Morning Back Pain

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Morning Back Pain? Things you can do.

One of the most common complaints from chronic back pain sufferers is back pain first thing in the morning.

For some folks it rears its ugly head on occasion and appears out of nowhere – as if they’ve thrown their back out. For others it’s like ground-hog-day – they go to bed feeling great but wake up every morning feeling stiff and achy. 

Why does this happen? Shouldn’t your back feel better after a good night’s sleep?

Back pain impacts people in different ways. Both the location of your pain as well as the time of day you feel your worst can be indicators of where your back pain is coming from and what’s going on.

Some of the most common causes of morning back pain include:

  1. Poor sleeping position
  2. A crappy mattress
  3. Bulging discs

Let’s go through each one and talk about tips to help morning back pain.

1. Poor sleeping position

The sleeping position that aggravates you is going to depend on the underlying cause of your back pain. Sometimes sleeping on your back with legs elevated is what makes your back feel worse in the morning – even if it feels amazing while you’re in this position.  For others, sleeping on their stomach is the thing that wreaks havoc on their spine. 

The most back-friendly position is to sleep on your side. Side-sleeping allows you to put your spine in a neutral position – which is where you get in the least amount of trouble.

It’s really challenging to achieve a neutral spine when you’re on your back or stomach.  If it bothers your hips or shoulders to sleep on your side – I recommend placing a pillow under your waist as well as your head – and if needed – also one between your thighs.

2. A Crappy Mattress

Over the course of my career, I’ve probably been asked at least 1000 times what the best mattress is to sleep on. The answer is “it depends”. Your most important concern should be to find a mattress that you feel comfortable on and that gives you the best night’s sleep. This is different for everyone. Some prefer soft and plush, while others prefer firm and supportive.

But here’s the thing – if you don’t have an underlying back problem then the surface you sleep on will be irrelevant. In most cases, I find that when a mattress aggravates your back, it’s a sign that you’ve got a back problem brewing that needs some attention.

That being said – for those that do suffer from generalized, chronic back pain – a firmer, more supportive mattress is going to be your best bet.

3. Bulging Discs

This is the most common reason I see for morning back pain.

Your vertebral disc has three primary functions:

  1. Absorb shock
  2. Help hold the vertebrae of your spine together
  3. Contribute to the mobility in your spine

The interesting thing about vertebral discs is that they are made up primarily of water.

Over the course of a normal day – and over the course of life – your discs will compress and decrease their water content. At night, your disc literally re-hydrates and can gain up to 17-25 mm of height. While this may be beneficial to someone who’s arthritis is to blame for their back pain, it is not beneficial for someone suffering from a bulging disc.

Remember when I mentioned that your disc is partially responsible for mobility in your spine? When you have a building disc – that bulge restricts your mobility. If it fills up with fluid overnight – you’re going to wake up feeling a lot more restricted and in a lot more pain.

Unfortunately, there is no quick fix I can reveal for you on this one. The best advice I can give you is that if you’re waking up every morning in a lot of pain and you’re afraid to move – there’s a good chance you’re suffering from bulging discs, and you should see someone who can help you with this.

If you’re waking up every morning with back pain…

then hopefully this information helps you have a better understanding as to why it might be happening. Although a crappy mattress could be the reason, I caution you not to default to that. More often than not, there’s an underlying problem in your back that needs to be addressed.

But the good news is that 80% of the time there is a natural, movement-based solution that can address your back pain successfully without relying on pills or procedures.

Are you experiencing back pain and looking to get help without pills or procedures?

Request to talk to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. To get a free copy of her Guide to Easing Back Pain and Stiffness – click here.

 

 

Why Strengthening Your Core Could Be Hurting Your Back

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As you probably already know, we specialize in back pain and core strengthening via Pilates…

So why on earth then – would we be writing about how strengthening your core could actually be hurting your back instead of helping?

One of the number one reasons people come to see us is because they want to strengthen their core – in hopes that it will put an end to their back pain.

But here’s the thing about core strengthening and back pain…

In most cases, it will make you feel better and possibly even take away your pain. But there are many times when going to core strengthening first is not right for your back, and can actually make it worse.

The biggest misconception I see when it comes to getting rid of back pain is that if the pain is gone – the problem is gone.

NOT TRUE!

And this is where people can get in trouble. If they try to strengthen their core too soon, back pain will come back with a vengeance.

Here are a few ways to tell if strengthening your core could be hurting your back instead of helping…

 

1. You feel stiffer after workouts.

As I mentioned previously, the absence of back pain does not mean you have addressed the root cause of your back problem. This is especially true if you’re prone to “throwing your back out” year after year.

One of the precursors to a full-blown back pain episode is stiffness.

If you find that your spine feels more stiff after your core strengthening routine, it could be a sign that you are aggravating your back instead of helping it. It’s only a matter of time before you wake up one morning stuck in pain and unable to move.

In our office, whenever we transition our clients from back pain treatment to our Pilates program, we teach them how to self-assess and check their spines.

This allows them to know if the core strengthening being done in Pilates is starting to aggravate them for some reason. If their self-assessment reveals a stiffening back, they know how to correct this before it turns into pain, allowing them to quickly get back to strengthening without skipping a beat.

2. Your neck hurts

I’ve spoken about this before, but increased neck pain or tension during or after core workouts is typically a sign that you’re not activating your core properly.

If you’re trying to work your core to recover from back pain, this could be a big problem for you. It’s only a matter of time before your back pain returns.

When you don’t know how to activate your core properly, you aren’t able to properly control pressure and tension in your abdomen. And you likely have difficulty controlling and coordinating your breath. When this happens, you can end up with unwanted pressure in your lower back every time you work those abdominals. This will eventually result in back pain.

This is one of those cases where core strengthening could be the right thing for your back, but you just aren’t doing it at a level that is appropriate for you.

Learning how to activate and build your core strength the right way is important all of the time – but it’s critical when you’re recovering from back pain.

3. Your hamstrings are sore and achy

A good core strengthening program targets more than just your abs. You should be strengthening your hips, glutes, and hamstrings as well.

While it’s normal to have some soreness after a good workout, when it comes to back pain, it’s important that you know the difference between muscle soreness and pain caused by nerve irritation.

Where you feel your pain and how it behaves is one of your best clues.

Let’s say that after a good Pilates session you notice soreness in both of your thighs and hamstrings the next day. This is typically considered “good” soreness. It’s symmetrical, feels better when you stretch, and likely subsides in 2-3 days. The more you work out, the less this soreness seems to occur.

But let’s say you feel an ache or a pull-down only one of your hamstrings after a Pilates class. You stretch and it doesn’t help. It possibly even aggravates your leg. You rest, the pain goes away, but then comes right back after your next workout.

This could be a sign that your core strengthening routine is causing irritation to a nerve in your spine.

If you don’t address the irritation, your leg won’t feel any better and your back will start to hurt as well.

Plus, if you feel pain or soreness anywhere in your body after a workout, it’s important that you learn to recognize the difference between good and bad pain so that you can correct problems before they happen.

Looking for ways to safely strengthen your core?

Our At Home Pilates 101 Get [Your] Back to Health program might be perfect for you, to apply and learn more CLICK HERE! We’d love to have you start your Pilates journey with us.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. To get a free copy of her Guide to Easing Back Pain and Stiffness – click here.