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Physical activity is central to achieving better back health. Engaging in some forms of physical activity may increase the risk of low back pain (LBP), but in general a physically active lifestyle seems to be protective for LBP.1 The only known effective prevention method is exercise alone or exercise with education.2 Most guidelines for acute LBP focus on advice to increase physical activity. For persistent LBP, most effective treatments have physical activity at their core, either where it is the main component (eg, aerobic exercise) or where there is greater use of psychological principles (eg, graded exposure).
In our view, the potential value of physical activity for back health is not being realised. We address four key issues.
1. Preoccupation with the right physical activity could be holding us back
While many clinicians confidently preach the benefits of physical activity for general health, this confidence seems to be replaced with a pause or panic when advising a patient who has …