Aerobic exercise for managing acute and chronic spine pain.

“I run six-to-eight miles a day, plus weights and aerobics in the lunch hour. I also lie a lot, which keeps me thin.” – Hugh Laurie

One of the mainstays of my practice is a large emphasis and discussion of aerobic exercise in management of acute and chronic spine pain. The benefits of aerobic exercise are numerous, but are often overlooked when it comes to spine pain. These changes on brain function and pain management are important components of establishing basic self-care activities at home.

I don’t feel the need for aerobic exercise to be a part of the supervised physical therapy session, but this should occur outside of the standard physical therapy plan of care. I usually spend a great deal of time on the first visit discussing what this should entail for each individual client.

The benefits for aerobic exercise for spine pain are:
1. Improved multifidus endurance.
2. Improved sleep patterns
3. Enhanced mood states and decreased risk of depression
4. Immediate effects of decreased pain perception
5. Improved circulation to the peripheral nerves
6. Improved nutrition to the spinal disks, especially the parts that do not have a vascular supply.
7. Decreased incidence of low back pain and decreased pain when incidence of low back occurs.
8. Likely will be able to continue working and able to complete normal activities when a patient is aerobically conditioned.

I think there is a common perception that aerobic condition involves someone suffering in a spinning class or sweating like a Richard Simmons in a jump suit back in the 80s. But it doesn’t have to be this way. Aerobic condition can be something as simple as a lively walk around the neighborhood after dinner or during lunch. Or a walk through the park on a Sunday morning with friends and family. It should be something that engages the person as a way to reach other goals, such as being social and enjoying the outdoors.

It also doesn’t have to be nerdy. For those who do not want be constantly checking their heart rate or wearing a heart rate monitor to follow the American College of Sports Medicine Guidelines on Aerobic Exercise, you can move long enough to be able to get your heart rate up for 20 minutes and carry on a conversation. You should do this on a consistent basis for a few, perhaps several weeks.

The bottom line is that my client who can become active during a course of acute spine pain, or who have chronic low back pain, can increase their odds of during well under my care. An aerobic exercise program augments the ability of the manual and specific exercise interventions to improve pain and get them back to living their life.