Neurosurgeon on Spinal Health and Exercise: ‘Movement is Important’

Back pain is very common, whether it’s a chronic condition as we age or it hits suddenly after improperly straining one’s self when picking up something heavy. Whatever the cause – arthritis, spinal stenosis (narrowing around the nerve roots), blunt injury or something else that may require surgery — back pain is one of the most common reasons why U.S. adults at middle age or older seek medical care.

But it’s vital that regular exercise be a treatment therapy option once you get clearance from your specialist. There are lifestyle factors that can be modified relating to spinal health, including weight management and staying physical fit by taking part in a range of activities – both aerobics and strength training.

Michael Gomez, M.D., neurosurgeon and director of minimally invasive spinal surgery at Miami Neuroscience Institute.

Patients with NSCLBP -- non-specific chronic low back pain -- should “remain physically active, as long periods of inactivity will adversely affect recovery,” according to a Systematic Review of the Effects of Exercise and Physical Activity on NSCLBP from the National Institutes of Health.  A range of different types of exercise have been explored to treat chronic low back pain, including low-to-moderate intensity aerobic exercise, high intensity aerobic exercise, core stabilization and muscular strength exercises, states the NIH review.

Strengthening core muscles can contribute to improved spine health, better protecting amateur athletes or weekend warriors from lumbar stress fractures or other serious back injuries.

“There’s all this misinformation out there,” explains Michael E. Gomez, M.D., a spinal neurosurgeon and the director of minimally invasive spine surgery at Baptist Health Miami Neuroscience Institute. “I see so many people who have been told they can’t exercise because of back issues or too much weight. There is nothing anywhere that says that if you lift 20 pounds that your back is going to fall apart. Telling people not to exercise is s a disservice.”

As the NIH review puts it: “Physical activity to increase aerobic capacity and muscular strength … is important for patients with chronic back pain  in assisting them to complete activities of daily living.”

Building up to a level of activity that is doable without increasing pain is possible for the vast majority of patients with spinal issues. Most back pain cases have an unknown cause, normally diagnosed after undergoing tests such as X-ray, MRI scan and blood tests. Although, arthritis will likely play a role in spinal health as you get older.

“I don’t tell patients to start doing CrossFit or deadlift 300 pounds, but movement is important because the more you move, the more lean muscle mass you have --  and the more mobility you have in your joints,” said Dr. Gomez, who specializes in spinal surgery, including minimally invasive procedures for degenerative conditions, tumors and spinal deformities.

Regular physical activity provides important health benefits for those with chronic health conditions or disabilities, including people with osteoarthritis, and spinal cord issues, states the U.S. Centers for Disease Control and Prevention (CDC).  The deep muscles of your stomach and low back are the “core” muscles that support and protect your lower back, and help your leg and arm muscles work well.

Both the CDC and the American Heart Association recommend at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. They also recommend moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least two days per week.

Moderate exercise includes any activity that gets the heart beating faster, such as brisk walking. Muscle strengthening includes anything that makes muscles work harder than usual.

“The more core strength you have, the more you ‘bulletproof’ your spine to some degree,” said Dr. Gomez. “If you’re going to have spinal surgery, it’s usually to reduce or eliminate pain and resume an active life. It’s so important to have a certain baseline of physical activity to get started or help you get stronger and healthier.”