I see lots of patients who ask me what exercises to do for back pain. My reply is as formulaic as the exercises are. I generally reply firstly with,
"Will you do them?"because it is my experience both personal and professional that  folks just don't. And therefore I argue to myself why go through a very specific well thought out exercise regime with people who, with the best will in the world, are not going carry them out in any therapeutic fashion.




It is better in my book to get the message over that any exercise is better than none. It may be that the 55 year old slightly cuddly lady whose idea of exercise is to wind her own watch may well respond to the suggestion that a Salsa class can be as helpful as a leotarded aerobics body-pimp session. Or that a brisk walk to the shopping centre is as valuable as getting on the lounge floor and creating work for the Hernia surgeon.


I am always keen to provide pointers to those of my patients who want more information and also are serious about working through a regime of exercise (see the Big 3) but I consider it as helpful as anything physical I do in the consulting room to guide people through the principles of self management of back pain.


There are loads of interesting and (probably) helpful exercise regimes out there from core stability to hyperextensions and none of them demonstrate a body of evidence that says they are exclusively therapeutic. The fact is that activity in whatever guise is generally helpful and whilst there are always caveats (mogul skiing, cage fighting, international rugby) keeping going is demonstrably and evidentially beneficial.