My doctor keeps telling me to exercise but I'm afraid it will just increase my low back pain. How should I get started?

Moderate to severe and even disabling low back pain often responds favorably to exercise. Studies show that patients can cope with an intensive physical training program. Not only is it safe, but it works!

Other studies have shown that prescribed exercise doesn't cause re-injury or make the symptoms worse in patients who already have back pain. The key idea here is "prescribed" exercise. This means a physical therapist has evaluated your situation and designed a specific program for you.

Such a training program takes into consideration your age, body mass index (BMI), and your general health. Any special risk factors will be further evaluated. Training to restore muscle strength, flexibility, and endurance is started and gradually increased over time.

Recent research also suggests that active physical training might not work for everyone. In a subset of patients, a behavioral or psychological approach works better. With behavioral treatment, patients are taught how to change beliefs and behaviors that are holding the patient back.

For example, many patients start to avoid certain movements and activities for fear that it will cause pain or reinjury. This is called fear-avoidance behavior. Cognitive behavioral therapy helps the patient recognize when this is happening and start to change.

Ask your doctor to recommend a physical therapist who is trained in the treatment of chronic back pain and back care programs. may be of interest to you and your health care provider.