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Classifying Your Low Back Pain Before You Choose Exercise


Should you do yoga to help with your low back pain? Maybe. But maybe not.



Low back pain is the leading cause of physical disability world-wide and the number one reason individuals come in to Thrive Fitness to see our kinesiologists. Active rehab has been shown to be helpful in reducing low back pain particularly when it accompanies other methods such as hands on manual therapy, stress management and proper ergonomics.



A common challenge in treating these issues is determining what type of low back pain an individual is dealing with. One research paper refers to this process as:


“Classifying a low back pain patient into a pertinent sub-group to guide initial interventions.”


In other words, placing a patient into the right category so you know how to approach their exercise rehab. At Thrive Fitness, we recently began using a system to classify individuals suffering from low back pain developed by two research groups: the STOPS trial (Specific Treatment of Problems of the Spine) and the Treatment Based Classification System.


The research placed individuals suffering from low back pain into four main categories, each with their own unique type of intervention. In doing so, patients enjoyed far better health outcomes then those who received more generic methods of low back pain management. Here is a brief overview of the four categories.


Manipulation / Mobilization

This category focuses the initial treatment on spinal manipulation and mobilization. This is needed when a part of the spine isn’t moving very well and ends up causing problems. It is best treated by a qualified manual therapist (such as a chiropractor, osteopath or physiotherapist) as movement-based exercises often do not provide much pain relief for someone in this category.


Direction Specific Exercise

This category focuses the initial treatment on using specific exercises to move the spine in a particular direction for numerous repetitions. This group of individuals may have some type of a disc injury and respond well by seeing their pain ease after performing the exercises. One example would be 25 reps of cobra press ups for someone suffering from a herniated disc.


Spinal Stabilization

With this category, the initial treatment focuses on stabilization and motor control exercises. This is helpful for someone who does not have any major underlying issues and may just experiencing back pain from a lack stability, strength or lack of exposure to healthy movement stress.


Persistent Pain

For those managing persistent low back pain, this approach focuses on patient education. Sometimes the presence of chronic pain can lead to changes in the nervous system and a hyper vigilance surrounding sensations of mild discomfort, so called “proper” form and loading of the spine. One key for these individuals is to help alleviate the fear and resistance by graded exposure to movement and stress.


So what does this all mean? Two things: before you choose which exercises to do for your low back pain, it is vitally important to (a) make sure you don’t have anything more serious causing your pain, such as a fracture or infection and (b) make sure you are doing the right exercises for you. Your back will thank you for it!

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