Low Back Pain: Is Strengthening The Core All A Myth

Low back pain is becoming increasingly common especially with the current climate of WFH (work from home) set ups. Combine this with the recent eight-week hiatus from resistance training or physical activity and low back injuuries are easily increasing or worsening over time. For those with experience of low back pain (or even those that have had a family member suffer), you’ve probably all heard the word “core” being thrown around. It is common knowledge that it’s a key factor in low back pain. Numerous health practitioners claim that if you have back pain, “it’s because their core is weak” but how much does this really play a role in low back pain?

Prior treatment of low back injuries has often had physiotherapists instructing patients to “pre-brace” their core before beginning a painful movement. For example, they may be sitting and asked to “tighten their core” as they stand, hoping that this might relieve their symptoms. In reality, it just makes people move really awkwardly, really stiffened and almost more tense than they already were. So, if this approach is not working then why have physiotherapists hung onto this for so long?

When we are in pain, we tend to become somewhat more anxious with our day to day activities and movements. The ultimate fear is of aggravating or re-injuring ourselves. This often causes you to tense your core/back and entire body in hopes of protecting yourselves. Yet this contraction overall only increases compression to the spine, elevates heart rate and stress levels thus heightening the pain response. With these systemic effects occurring, it’s no wonder some then struggle to become physically active and mobile to help reduce their low back pain.

So, if you have given the above approach a go for low back pain and it has not worked for you then here is an alternative:

• Deep breathing exercises: Try completing 8-10 deep breaths where you focus on expanding your ribs as much as possible without your shoulders elevating. Exhale fully and feel how your muscles subsequently relax. Try completing 3-4 sets of these throughout the day and include in part of your daily routine.
• Integrate your deep breathing functionally. For example, if moving from sitting to standing is what has been particularly painful for your injury, try your full inhale in sitting and as you exhale, move to standing.
• Mobility is still absolutely a key factor in improving back pain so try to continue with low impact, low intensity activity where possible while keeping in mind the above points.
• Try to pin-point key stressors in your life that could be aggravating your pain. These could be physical, emotional, or mental factors that add to stress and anxiety, ultimately aggravating your pain response.

Recently, the benefits of breathing exercises have been progressively utilized to not only improve pain but to control your heart rate and anxiety. Only by reducing the stress and tension in the body, can someone then begin to move more freely and begin other forms of treatment. To be perfectly clear, this is not disregarding the importance of the core. General strengthening around the low back and core still has a role in the treatment of low back injuries, however, strengthening of the “core” does not have a miraculous effect on pain itself.

Deep breathing is a relatively new and oh so simple technique that most will not consider possible to improve pain but if nothing else has worked then why not, right?

If you are struggling to reduce your low back pain and have tried strengthening your core, get in touch with one of our highly trained physiotherapists to help get your pain under control and to keep you moving.