Q: I suffer from severe backache. I was told that exercise can help control back pain. But I am afraid that exercising might aggravate my problem. Please advise.

RP, Patna

Back pain is often caused by weakness in the spinal and trunk muscles, so the recovering strength is crucial. Exercises to improve core stability and abdominal muscles help to ease soreness. For acute pain and spinal manipulation, physiotherapy is effective. People who are physically conditioned are less likely to injure their backs during work or daily activities than the average lot.

Therefore, the benefit of exercise for your lower back depends on three key principles. First, you must attain satisfactory aerobic fitness. Second, you should focus part of your workout on the muscle groups that support your back. Third, you must avoid exercises that cause excessive stress to your back.

The ideal aerobic exercise involves the movement of the large muscle groups of your body (arms and legs) in a smooth, cyclical fashion. Recommended exercises include swimming, walking, cycling and using a ski-machine or elliptical exerciser. You should achieve the appropriate heart rate for 30 minutes at least three times per week. Of course, you should consult your family physician and review your aerobic programme before getting started. He/she can give you the appropriate target for your heart rate during aerobic exercise.

It is always optimal to approach your aerobic goals slowly, especially if you have not worked out recently. Part of your workout should stretch and strengthen the muscles of your lower back, abdomen, pelvis and thighs. Flexibility in these areas will greatly decrease the chance of further injury to the back. By strengthening these muscle groups, the body’s weight distribution and posture may be improved, resulting in less stress on the lower back. It is best to perform these exercises after a good warm-up, such as your aerobic routine. Ask your health club trainer or physical therapist for instructions on specific stretching and strengthening exercises for these areas.

While the merits of good conditioning cannot be overstated, the wrong type of exercises can actually worsen your lower back problem. Activities that cause excessive stress on the back such as lifting heavy weights, squatting and climbing are not advised. In addition, high impact exercises such as running, jumping and step aerobics can aggravate the condition. When walking, wear well-cushioned shoes with good arch supports and use a treadmill or a track made for athletics. Cycling on a recumbent stationary bike can relieve stress on the back. Exercise works in 80 per cent of the cases, but if the pain persists, then one must seek medical assistance.