Staying active when your back is sore

When a back or neck is sore, the natural instinct is to keep still. Public guidance on everyday back pain generally leans the other way, towards keeping up ordinary movement where it is comfortable to do so. This page looks at how people think about activity on sore days and on good days, without prescribing any particular routine.

Why long spells of rest are discouraged

MedlinePlus, in its overview of back pain, notes that most back pain goes away on its own, though it may take a while, and cautions that staying in bed for too long can make it worse. That does not mean pushing through severe pain, and it does not apply to injuries or warning signs that need medical attention. It reflects a broad view that, for the ordinary kind of back ache, gentle everyday movement is usually preferred to lying still.

Everyday movement comes first

For many people, staying active on a sore day simply means carrying on with ordinary life at a gentler pace: getting up and moving around the house, walking to the shops, doing light jobs in short spells, and changing position often rather than sitting or lying for hours. Movement that feels comfortable, or only mildly uncomfortable, is usually the guide. Movement that sharpens the pain, or brings on pain, numbness or tingling in a leg or arm, is a signal to stop and to seek advice.

Pacing

Pacing is a word physical therapists often use for spreading activity out rather than packing it into bursts. On a good day it is tempting to catch up on everything, and on the next day to pay for it. People who pace break big jobs into smaller pieces, alternate heavier and lighter tasks, take short breaks before they are forced to, and build up gradually from what they can manage comfortably now. The same idea underlies the guidance on lifting and carrying and on building up gradually in sport.

Kinds of activity

MedlinePlus's page on exercise and physical fitness describes the main types of exercise:

• Aerobic exercise, such as walking, running or swimming, which raises the breathing and heart rate;
• Strength or resistance training, using weights, resistance bands or your own body weight;
• Balance exercises, which practise steadiness;
• Flexibility exercises, which stretch the muscles.

It also sets out a few simple ideas behind any fitness routine: make activity a habit, build up slowly rather than pushing too hard all at once, mix up the kinds of activity, and keep showing up, even for short sessions. MedlinePlus advises checking with a health care provider before starting, especially if you have trouble moving or balancing, or worry that exercise might not be safe for you.

Activities people often choose

Walking is the most common choice, because it needs no equipment, can be done in short or long spells, and can be stopped at any time. Swimming and other water activities appeal to many people because the water supports the body's weight. Cycling, whether outdoors or on a stationary bike, suits some backs and not others. Gentle classes that focus on movement and body awareness are popular too. What suits one person may not suit another, and a sore back is a good reason to ask a physical therapist or other health care provider which activities make sense for you before starting anything new or strenuous.

The federal guidelines

In the United States, the Office of Disease Prevention and Health Promotion publishes the Physical Activity Guidelines for Americans, which it describes as a flagship resource for health professionals and policymakers based on the latest science. The guidelines set out recommendations for different age groups and are a useful reference for longer-term goals; the right starting point on a sore day is simply what you can do comfortably now.

Fitting activity into the day

Activity does not have to mean exercise sessions. Standing up during phone calls, walking part of a journey, taking the stairs where it feels comfortable, getting off the sofa during advertisements, or a short walk after meals all add movement to days that would otherwise be spent sitting. For people who work at a desk, the regular changes of position described on the desk setup page are part of the same idea.

When to get advice first

It is worth getting advice before increasing activity if your back or neck pain followed an injury, if it is severe or getting worse, if it comes with numbness, tingling or weakness in a limb, or if you have a heart or lung condition, thin bones or a history of falls. The When to see a doctor page lists the signs that need prompt attention.