When Benjamin Franklin famously said that nothing is certain in life except death and taxes, he should have added back pain to the list. It afflicts about 80 percent of adults at some point in their lives, and it’s the biggest cause of job-related disability.
According to the National Institute of Neurological Disorders, it’s getting worse -- jumping to third place in the ranking of most burdensome conditions in 2010 from sixth place in 25 years earlier.
For most back pain, exercise is widely regarded as the best medicine. The old prescription of bed rest is likely to just make it worse.
Perhaps not surprisingly, exercise is also the ounce of prevention that’s worth a pound of cure. A report in the January 2016 journal JAMA Internal Medicine that reviewed 23 studies of 31,000 people concluded that exercise alone reduced risk of lower back pain by 35 percent. Exercise was also found to lower risk of using sick leave because of lower back pain by 78 percent.
Exercising the abdominal muscles is part, but not all of the equation. Abdominal muscles definitely play an important role in supporting the back. But exercising them to the exclusion of other supporting muscles could cause an imbalance that could just lead to more pain.
Back Pain Comes from Weakness
According to the medical journal Sports Health people with chronic lower back pain have decreased response in a number of muscles, including the transverse abdominis and pelvic floor muscles.
Strengthening the core — the complex of muscles that connect the lumbar spine, pelvic girdle, abdomen and hip joint — protects against future injury and can help resolve weakness that causes pain. It recommends crunches — also known as curl-ups performed on a Swiss ball — as well as chest press and bridge pose for stabilizing the lower back.
“A good rule of thumb for back pain is to do exercises that have you lying on your back, feet on the floor and knees up,” says personal trainer and yoga instructor David Knox, author of Body School: A New Guide to Movement in Daily Life_._
That includes the standard crunch for working the upper abs, single leg lifts for strengthening the hip flexors and variations on crunches such as crossover crunches. “Basically, you’re good with any isometric exercise where the torso doesn’t have to move.”
Walking the Plank
One widely agreed-on remedy for low-back pain that will also tighten your stomach is the plank. That’s basically maintain the top of a sit-up for as long as possible.
According to the American Council on Exercise (ACE), plank has the advantage of requiring very little movement while contracting every layer of abdominal muscles. When done properly, it engages the deep abdominal muscles, as well as the hip, shoulder and upper-back muscles.
ACE recommends these variations on plank to flatten and strengthen the abs and reduce back pain:
- Plank with Hip Flexion/Extension—Beginning in standard plank position, raise the right leg several inches for five seconds, then lift the left leg.
- Plank with Thoracic Spine Rotation— Press the right hand into the ground, rotate both feet and hips to the left while raising the left arm off of the ground. Rotate the left arm down, then repeat the move to the other side, pushing the left hand into the ground and rotating the right arm up.
- Side Plank With Full Extension—First, perform side plank with the elbow directly under the shoulder. Contract the abdominals; squeeze the butt and thighs while pressing both legs together. Hold for 15 to 20 seconds and switch sides.
- Plank-Up—From plank, drop the right arm down to the right forearm, then drop your left arm down to the left forearm; hold for three seconds. Return to the starting position by placing first the right hand and then the left hand on the ground. Repeat for three to five repetitions.
- National Institute of Neurological Disorders and Stroke: Back Pain Fact Sheet
- Science Daily: Exercise Associated With Prevention of Low Back Pain
- Sports Health: Core Stability Training for Injury Prevention
- Body School: A New Guide for Movement in Daily Life, by David Knox
- ACE Fitness: 5 Exercises to Flatten Your Stomach and Reduce Low-back Pain