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.
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.
Seeking Balance for Back Pain
Perhaps not surprisingly, exercise is also the ounce of prevention that's worth a pound of cure. A report in the January 2016 issue of JAMA Internal Medicine that reviewed 23 studies of nearly 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 an ab workout for a bad back, with the exclusion of strengthening other supporting muscles, could cause an imbalance that just leads to more pain.
Ab Exercises Gentle on Back
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. Performing ab exercises that are gentle on the back can help.
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. The journal recommends including crunches — also known as curl-ups — performed on a Swiss ball, as well as chest press and bridge pose among your ab exercises for lower back pain.
Walking the Plank
One widely agreed-on core exercise for people with back problems, that will also tighten your stomach, is the plank. That's basically maintain the top of a push-up for as long as possible.
According to the American Council on Exercise, the 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 planks as ab exercises for people with lower 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 a 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 a front plank, drop the right arm down to the right forearm, then drop your left arm down to the left forearm, which positions you in an elbow/forearm plank. Hold for three seconds. Return to the starting position by placing first the right hand and then the left hand on the ground and straightening your arms, bringing yourself back to the normal "up" plank position. Repeat for three to five repetitions.
- National Institute of Neurological Disorders and Stroke: Low Back Pain Fact Sheet
- Sports Health: Core Stability Training for Injury Prevention
- American Council on Exercise: 5 Exercises to Flatten Your Stomach and Reduce Low-back Pain
- JAMA Internal Medicine: Prevention of Low Back Pain: A Systematic Review and Meta-Analysis
- MedlinePlus: Back Pain