I am having ongoing problems with my low back. My medical doctor and my chiropractor have both suggested exercise as a way to break through the pain-spasm cycle that I'm in. I tried it for a little while, but it didn't seem to help. What should I do next?
Patients' belief systems have a lot to do with how they respond (or don't respond) to treatment. If you think your pain is an indication that there's something wrong or that anything that makes it hurt is actually damaging your spine, then exercise and activity won't seem helpful to you.

Exercise has been shown over and over to be beneficial for patients with chronic low back pain. But sticking with a program every day is essential. Patients who believe movement and activity will only make things worse have a more difficult time carrying out a regular schedule of exercise.

In some cases, general activity may not address your specific needs. At this point in your rehab, you may need a particular type of exercise program. This could be core training, motor control training, or some other specific program to change your movement patterns. A physical therapist can help identify what this may be for you. Once you've gotten past the first roadblock, it should be smooth sailing for you. Knowing that your back pain is not a fracture, tumor, infection, or inflammatory process is very helpful.

Ongoing pain in the case of a nonorganic, noninflammatory cause of low back pain suggests that pain beliefs are present that are hindering your progress. If consistently carrying out your prescribed exercise program doesn't help, you may need the skills of a counselor or cognitive behavioral specialist.

Together, you, your counselor, and your physical therapist can help you identify and change the way you think in order to change how you respond to your pain. Breaking the links between beliefs about pain, physiologic damage and physical harm, and exercise can change your pain levels and functional ability.