Avoid Complete Rest

This is just one anecdote, but it aligns with extensive research. With over a decade of clinical practice and 20 years in training, I can personally vouch for the effectiveness of graded activity over a wait-and-see strategy for treating back pain or other musculoskeletal issues.

Studies show that most cases of lower back pain see significant improvement within the first three months after onset. A recent 2024 study in the Canadian Medical Association Journal found that acute pain (lasting less than six weeks) typically shows a 30-point improvement on a 100-point scale within six weeks. Meanwhile, subacute pain (lasting 6 to 12 weeks) averages a 34-point improvement. Conversely, chronic pain (lasting longer than three months) shows only an 8-point improvement after 12 weeks and 16 points after a year.

The treatment method can often be self-care, akin to what my friend practiced. He utilized the graded activity approach mentioned earlier.

Graded Activity Defined

Graded activity is a rehabilitation strategy that involves progressively increasing physical activity levels based on one’s capabilities and tolerance. While some discomfort is acceptable, it's crucial not to push through levels that could result in injury or delay recovery.

Pain as a Warning System

Initially, after experiencing a back injury, focus on activities like bench presses and brisk walking. Gradually, you can progress to specific leg and back exercises such as seated knee extensions and lat pulldowns. Instead of jumping right into full deadlifts and squats, start with lighter rack pulls and box squats or leg presses, incrementally increasing the range of motion and weight.

Is Back Pain Common?

I recently shared a post on LinkedIn related to this topic:

"Don’t treat pain as if it’s a temporary diet."

Immediate treatment of pain enhances recovery prospects, but care should continue beyond the initial pain relief. Whether pain subsides through self-treatment or physical therapy, ongoing body care is essential. Unfortunately, many people approach rehabilitation like a diet—once they reach their target, they revert to old habits.

For instance, someone might lose weight by reducing caloric intake, but if they return to their previous eating patterns, the weight will likely come back. This principle applies to rehabilitation as well. Without adjustments to exercise, sleep, or dietary habits, pain is more likely to return.

This is a significant reason why 69% of individuals who recover from lower back pain experience another episode within a year. Addressing both symptoms and underlying causes is crucial. While pain and injury can’t be completely avoided, the risk can be significantly minimized.

Some of my colleagues concurred with this perspective, though not universally. One clinician noted the importance of distinguishing between what is 'normal' and what is 'common.'

This is a valid point. Does 'normal' equate to 'healthy,' or does it simply indicate a frequent occurrence?

At any moment, about 8% of the global population experiences back pain, with 39% of individuals in the U.S. encountering it within a single year. It’s likely that you have already experienced or will face back pain at some point in your life.

Should we merely accept the prevalence of back pain as normal? No. We should recognize it as common and acknowledge that various life stressors elevate the likelihood of experiencing back pain.

Factors Contributing to Back Pain

Here’s a list of elements that heighten susceptibility to back pain: sleep deprivation, poor nutrition, obesity, stress, inactivity, diabetes, and smoking.

Consider the life events that lead to sleep deficiency (e.g., parenthood), stress (e.g., work), poor diet (e.g., financial issues), and inactivity (e.g., lack of time).

To minimize the risk of low back pain, we should aim to reduce these factors and enhance our body's resilience through exercise.

If you’re facing low back pain, know that it can be managed through a gradual increase in activity. If you require assistance, consult a physical therapist soon after the pain begins. But don’t stop your efforts when the pain subsides.

Injury Prevention is a Long-Term Commitment

Following physical activity guidelines, ensuring 7+ hours of quality sleep each night, and maintaining a healthy diet all contribute significantly to treating and preventing low back pain.

Practical Steps for Recovering from Low Back Pain

The example shared illustrates a general overview of recovering from low back pain. Now, let’s delve into specific actions you can take.

The timeline for recovery largely depends on your symptoms. Most episodes of low back pain resolve within several weeks. The best course of action is to stay active. This doesn’t mean pushing through pain with a "no pain, no gain" mentality, but rather, listening to your body and gradually increasing your physical activity.

Certain activities may be best avoided, particularly heavy lifting, but there isn't a universal threshold. For some, 20 pounds may be too much, while others may manage 120 pounds without issue.

Consider modifying your lifting technique by widening your stance, kneeling, or squatting deeper. In the gym, focus on smaller ranges of motion.

Utilize rack pulls instead of deadlifts, box squats or leg presses instead of full squats, and hamstring curls instead of stiff-legged deadlifts. Discover an exercise routine that allows you to train effectively without worsening your pain.

You might not feel pain during your workout but notice discomfort the following day. That’s acceptable; it doesn’t mean you’ve caused additional harm. Your body is simply signaling that you should slow down.

If pain becomes a significant distraction, using ice or heat packs for 15-20 minutes can provide relief. Other temporary solutions include TENS units, foam rolling, gentle stretching, and massage. However, none of these approaches are long-term fixes.

Your body isn’t misaligned, fascia isn’t stuck, and you don’t have trigger points that require release. The theories surrounding posture, fascia, and alignment have been extensively debunked in research. Nevertheless, these treatments may still offer some temporary relief.

The short-term alleviation allows you to sleep, stay physically active, and divert your focus from pain. These actions are essential for recovery. Instead of searching for a miraculous cure, concentrate on fundamental practices.