Can strength training combat chronic back pain?


As of September 2017, new Sweat Science columns are being published at Check out my bestselling new book on the science of endurance, ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance, published in February 2018 with a foreword by Malcolm Gladwell.

- Alex Hutchinson (@sweatscience)


This week’s Jockology column takes a look at some rather surprising research from the University of Alberta on back pain and lifting weights:

The question

My lower back is killing me. What can I do about it at the gym?

The answer

It’s the classic moving-day injury: You’re hoisting a dresser or grabbing one end of a sofa, then – bam! – you throw out your back.

So it may come as a surprise to hear that a promising solution for chronic lower-back pain, according to a series of recent studies from the University of Alberta, is lifting weights. A whole-body strengthening program dramatically outperforms aerobic exercise for those whose nagging back pain lingers for many months, the researchers say. And the more you lift, the better. [read on…]

There’s always a risk in reporting on research like this that it will get taken out of context. I should emphasize here this research applies to chronic (i.e. not immediately after you throw your back out) and non-specific (i.e. not related to a specific disc or muscle problem) back pain. And it’s not advocated strengthening the lower back itself — it’s strengthening other areas of the body, like the arms and legs, to take some load off the back.

For that matter, even that diagnosis remains controversial:

This one-size-fits-all approach has limitations, though, according to Stuart McGill, a professor of spine biomechanics at the University of Waterloo .

“There’s actually no such thing as non-specific back pain,” he says. “It just means you haven’t had an adequate assessment.”

Still, the results of the studies are interesting — and very much worth thinking about, in my opinion. They’re just not for everybody with back pain.

6 Replies to “Can strength training combat chronic back pain?”

  1. Late to the party, but my back was out. Heh. My back is always out. It’s been fused with metal brackets and screws into a grade 11 spondylolisthesis. Shortly after surgery I was left alone in the bathroom, where I fell, ripping the bone fusion (attendant to the metal fusion). My back healed unrepaired, in the uncorrected position. The surgeon left town. Pardon what you may think is a tangent but really not, because this is a warning to your readers: do not believe a surgeon who says all you need is X surgery and you’ll have your life back. Do not tell me your surgeon is better than mine. Mine was head of orthopedic surgery in my city’s huge medical school attached to the fourth largest university in Canada. Do believe your active-rehabilitation physiotherapist though, who tells you you are going to have to work hard, every day of your life, but if you do, your outcome will be better than a surgery.

    And yes, a recliner of any brand is absolutely instrumental for back pain management and recovery. I’ve logged thousands of hours and many a night in mine when I could not lay down. For me, being in a supported flexion position frequently and regularly is mandatory. If I forget my back puts me there. I have to do it about four times a one-kilometre walk (that’s me crouching on the trail hugging my knees) and after every half hour or so of standing for whatever reason. Yes, this is a disability although the insurance cos and our universal health care system will not call it that, because I do not have a wheelchair or a scooter, or (contraindicated for back) use a cane. A structural back problem is a life-long pain and posture coping and management effort.

    My advice to back pain sufferers: go out and get whatever kind of recliner you can afford. I’m saving for my third, and I think it’ll be Laz-y Boy’s snazzy lime green leather number.

    To my question re back exercises. For the first exercise shown in the Globe and Mail version of your article, how can I duplicate this at home where I use free weights?

  2. I think my question got lost in my preamble.

    “For the first exercise shown in the Globe and Mail version of your article, how can I duplicate this at home where I use free weights?”

  3. Hi Riv: Really sorry to hear about your back problems, which sound extremely challenging. You’re asking about the leg press, which focuses on your quadriceps. Two very good free-weight (or even body weight) exercises that will strengthen your legs, including your quadriceps, are squats and lunges. It’s essential that you use good form for these, and I’d recommend starting with no weight before trying to do them while holding weights.

    More generally, I’d like to emphasize that there’s nothing particularly magic about the exercises shown in the article. They’re standard parts of a whole-body strengthening program. What Robert Kell’s research suggested was not that these exercises in particular will “cure” back pain, but rather that being strong throughout the body will help you perform everyday tasks without straining your back, which will ultimately reduce back pain. So feel free to use whatever facilities you have available to strengthen your upper and lower body (ensuring, of course, that you’re not aggravating your back), without worrying too much about which exact exercises you’re doing.

  4. i am reading all these articles with great interest. i too have had major back issues – 3 surgeries, 2 fusions. it’s really a life choice. my back is going to hurt regardless, sometimes more, sometimes less. but i can tell you that regular exercise is, to me, extremely important not only for strengthening and stretching purposes but for mental health also. my first surgeon told me never to run – worst thing a person could ever do. my second surgeon told me to get out there. it took a year to get my head around that but then i started. i had always walked but then i picked it up. i started to walk/run at very slow pace. running at a natural pace was far easier than the speed walking i was requiring to maintain my level of fitness. the running gait was much easier on my body. i forgot to mention too, that i am 50 yrs old. in my entire life i never ran more than a couple of k. i did 5k, then 6 or 7, then 8 and now have done 12. and i plan to keep going. i combine this with regular core conditioning and maintain an ongoing relationship with my dr and physio. to sit at home and let the pain win is not an option. i encourage anyone dealing with a similar situation to start a regular programe (obviously under dr approval) and regain that feeling of accomplishment while strengthening your body. you won’t regret it. at least i haven’t.

  5. That’s really great to hear, Jackie. Obviously a tough situation, but really fantastic to hear how you’ve (more than) coped with the help of exercise.

Comments are closed.