Turn your back on pain: how to alleviate soreness and stiffness that can halt your workouts

Muscle & Fitness/Hers, July, 2003 by Amy Sutton

you eat right, work out regularly and get plenty of rest. In short, you're devoted to a healthy lifestyle designed to keep your body in top shape. So why does your back still hurt? Caroline Weynerowski, a graphic designer from Montreal, had the same problem. Despite hitting the gym six days a week for cardio and weight training, she couldn't alleviate the soreness and stiffness in her lower back. A sedentary desk job and a hard fall conspired to keep her in pain.

This situation isn't unique. According to the American Academy of Orthopaedic Surgeons (AAOS), four out of five adults will experience low-back pain at some time during their lives, and many women miss work (and workouts) because of low-back pain each year.

What's going on back there? The back is a complex structure, consisting of bones called lumbar vertebrae, which are held together with ligaments and muscles and surrounded by nerves, joints, and disks. When you consider your back's anatomy--and the fact that it stabilizes and connects your chest and arms to your pelvis and legs--it's no wonder that back pain is a source of suffering for so many women.

Back Pain Blues

Generally, back pain falls into two categories: acute pain and chronic pain. Acute pain is intense and comes on suddenly, often after performing a motion improperly or too quickly. Chronic pain occurs repeatedly and is often aggravated by everyday demands on the back, such as carrying heavy purses, overflowing grocery bags and squirming children.

Lifestyle factors play a major role in the development of back pain. Overweight women, smokers and those with sedentary or stress-filled lives risk decreasing the strength and elasticity of the muscles, bones and ligaments in the back, thus increasing the risk of injury. Other contributors to back pain include:

* Fashion (such as high heels and tight clothes)

* Pregnancy and child care

* Breast size

* Menstruation

Getting older can also be a pain in the back. "Most low-back pain is from the aging process in the disks," says Mark Foster, PhD, MD, a Pittsburgh orthopedic surgeon and author of Backache: Putting It Behind You (Rutledge Books Inc., 2001). "The disks dry out throughout life and they do not remain stiff and stabilize the vertebrae during motions of the body or normal activities." The result? Pain and friction in the lower back. Aging may also lead to osteoporosis, a disease that causes brittle bones and increases the risk of bone fractures in the back.

Another common cause of back pain is a protruding or "slipped" disk, a painful condition that occurs when a disk between the vertebrae becomes cracked and ruptures.

Pain Prevention Pointers

When your low back is screaming, it's tempting to skip your workouts until the pain subsides. But experts say that's a mistake. "Bed rest has often been a treatment for low-back pain, but the fact is, it is terribly destructive to muscles," says Jerome McAndrews, DC, a chiropractor and spokesman for the American Chiropractic Association.

Instead of avoiding exercise, talk to your health-care provider or trainer about modifying your activities. For example, if you regularly experience low-back pain but you still want to attend your group fitness class, talk to the instructor. He or she should suggest specific modifications that can help you avoid pain, says Lisa Taylor, a certified personal trainer in San Diego.

Taylor also suggests avoiding back-taxing moves such as deadlifts, deep squats and lunges, as well as step aerobics and cardio kickboxing. And don't forget to use proper form for each exercise. If you don't currently work with a trainer, consider signing up for a few consulting sessions to make sure your form is perfect.

To prevent pain, some experts recommend core training, such as Pilates. Pilates teaches you to stabilize the spine and pelvis, which can prevent back injuries and increase strength and flexibility. But beware of favoring certain muscle groups over others. "A lot of women will concentrate on lower-body exercises and overexercise their abdominals," says Joe Franco, an ACE- and ACSM-certified personal trainer from Warminster, Pennsylvania. "They may go so far as to train their abs every day, but by overtraining abdominals, you can have a tendency toward imbalance and back problems."

By taking steps to prevent pain, you can get your normal workouts back on track. Just remember not to push yourself too hard or you could end up exacerbating the problem.

Treatment Options

If back pain doesn't respond to home treatment and gentler workouts, you may have to seek the advice of a professional. Most cases of low-back pain are not serious and treatment is simple, according to the AAOS. For periodic bouts of pain, apply ice and heat to the injured area. Your doctor may recommend an over-the-counter anti-inflammatory drug, such as acetaminophen or ibuprofen. For regular or severe pain, see an orthopedist, a specialist in the treatment of spinal disorders. Physical therapy eventually may be prescribed to increase flexibility and strengthen weakened muscles.