Back Pain

This guide is for educational purposes only, and should not be used as a substitute for professional medical advice, diagnosis, or treatment. The guidance here is general, and you should always listen to the advice of your personal healthcare provider.

Back pain is one of the most common—and concerning—aches you can experience. It can make you feel fragile and nervous about all movement, worried that you might "slip a disc" or "make it worse."

Here is the most important message you will read today: Your back is not fragile. It is a strong, robust structure that is designed for movement. It is anti-fragile.

In almost all cases, finding a way to keep moving is the best and fastest way to get better. This guide is your plan to do that safely and confidently.

Before you read on, watch this video. It is the 5 most important messages that we want everyone with back pain to understand:

"But What About My Scan?" (Disc Bulges & 'Degeneration')

The vast majority of back pain (well over 90%) is called "non-specific." This simply means there isn't one single "broken" part or serious issue causing the pain.

Many people are sent for X-rays or MRIs, which often come back with frightening-sounding terms like:

• Disc bulge / protrusion
• Disc degeneration
• Annular fissure
• Facet joint degeneration
• Disc space narrowing
• Spondylolisthesis

Here is a crucial fact: These findings are common, normal parts of ageing (like wrinkles on the inside!). They are found nearly as often in people with NO back pain as in people with back pain.

These scan results do not predict your pain or your ability to get better. They do not mean you are damaged.

No matter what the scan says, you can and likely will get better.

A Helpful Analogy: The Common Cold

It can be useful to think of an episode of non-specific back pain like catching a common cold:

• Almost everyone gets it at some point, and (like a cold) it can come back from time to time.
• It can feel awful and be very disruptive, but it's very rarely a sign of anything serious.
• It almost always gets better on its own with a bit of time.
• The best strategy is to find simple ways to manage the symptoms (like gentle movement) and patiently let your body recover.

Your Game Plan: Keep Moving (Hurt Doesn't Equal Harm)

The good news is that most back pain resolves on its own. Our job is to help it along by staying active and confident.

Resting in bed is the last thing we want to do. The most important thing is to find a way to stay active, which is why we highly encourage you to keep going with your workouts as best you can.

You don't necessarily need to add special "core exercises" or "back exercises" to get better, although these can sometimes help. Research shows that all kinds of exercise are helpful for back pain, including the strength, cardio and balance workouts you're already doing in your program.

When your back is sore, it's sensitive. Some movements might feel uncomfortable, but it's important to remember this vital concept:

"Hurt doesn't equal harm"

Pain and discomfort when you move does not mean you are doing damage. It just means your back is sensitised, and you need to find a level of movement that feels manageable.

Your 3-Step Modification Toolkit

Our goal is to find a level of exercise that feels "tolerable."

This is a key word for us. It does not mean "100% pain-free." A bit of discomfort (think 2-3 out of 10 pain) is often fine. "Tolerable" means you feel in control, and the exercise doesn't cause significant pain or leave you worse off later that day or the next morning.

Here are the 3 main ways to modify any exercise to make it feel tolerable:

1. Reduce the Weight: This is the simplest fix. Just lower the weight a bit. It make take some trial and error to find a weight level that feels tolerable.
2. Reduce the Range of Motion: Don't go as deep in your squat or deadlift (or whatever exercise you find most challenging). A smaller movement is still building strength!
3. Substitute the Exercise: Swap the problem exercise for a similar one that feels better (e.g. swapping a deadlift for a glute bridge).

Deadlifts can be the most challenging exercises with a sore back. For a deep dive on adjusting these, see our modification guide:

Link: How to Modify Deadlift Movements

What if an exercise just isn't working for you today? It is okay to skip it. Complete the rest of the workout as best you can. Be proud that you showed up and did what you could. Try re-introducing that exercise after a week or two.

When to See a Professional

While most back pain is not serious, there are a few "red flags" that mean you should get an in-person assessment from your local doctor or physio:

• Recent trauma (like a significant fall)
• Constant, severe pain that doesn't change with rest or movement
• Pain that is progressively getting worse
• Pain radiating down your leg
• Pins and needles or numbness in your legs or feet
• Any change in your bowel or bladder function (e.g., loss of control, difficulty urinating, numbness in the "saddle" region). This is a medical emergency.

The Takeaway: Your Back Is Anti-Fragile

Back pain is a challenge, but it's one you can overcome. It's a signal to modify your approach slightly, not a stop sign.

Remember the key principles:

• Your back is strong and designed for movement.
• "Hurt doesn't equal harm." Find your level of tolerable.
• Use your 3-Step Modification Toolkit.
• Always aim to "do something rather than nothing."

Want to Learn More?

If you're still feeling unsure, we have a few other videos about back pain which you might find helpful and encouraging:

1. Lifting is safe, even when you have back pain. This video discusses that idea, and shows you a clear deadlift progression guide, starting with the easiest possible version of a "deadlift" for someone with a painful back - https://youtu.be/k9vvy7WbaeU
2. The truth about posture and back pain. This videos discusses why posture is not as important as you might have thought, and gives some practical tips on how to sit and move more comfortably - https://youtu.be/dM1-J8giuwM
3. Four exercises for a stronger back. If you want to add some extra back strengthening exercise into your routine, here are 4 exercises you can try. You could do these exercises a couple of times per week, ideally on days you aren't doing your regular strength workouts - https://youtu.be/dHACFqGE_30