"When can I get back to normal activity?", this is a question that we are sure is frequently asked of many therapists. Low back pain and the accompanying neurological pain to the leg can occur intermittently. Its intensity can range from mild irritation to severe and debilitating pain that can completely disrupt your daily life.
As strange as it may sound, and as much as your body may tell you that it doesn't want to move, exercise and physical activity are extremely important and key to the healing process and overall recovery.
Of course, we are aware that every person is different and experiences the moments when low back pain is exacerbated differently. Pain can vary widely. For some, even normal walking is extremely difficult. An important point in the recovery process is to be able to incorporate safe movements, which can be gradually built upon, so that the person can successfully return to their normal routine. For that portion of patients who are active exercisers, it is especially important to be guided on how to gently increase the exertion so that they can safely return to their previous exercise regimen.
However, let's give some examples of what indicators we use to assess whether a person is ready to return to more habitual daily movements (and therefore can incorporate more strenuous rehabilitation exercises). An important indicator that tells us that things are going well is whether or not the patient can walk with a normal gait. What we mean by normal gait, the stride length is large enough and the weight is transferred evenly on both legs (no limp).
The ability to walk normally (but let's note that we say normally, not without any lack of discomfort) is an important stage of recovery that we as therapists look for. This means that the spine is sufficiently stabilized by the abdominal musculature and the nerves in the lower extremity are not severely inflamed and can tolerate the mild stretching that will occur when incorporating afterload.
If normal gait is lacking, then efforts should be directed towards gradually restoring mobility in the low back and lower limbs, along with activating and gradually strengthening the abdominal and back muscles to provide stabilisation. At these times, it is a good idea to limit your sitting by incorporating more frequent standing and gentle movement (walking, some light exercise you can do at work, etc.), but don't rush to overexert yourself yet (as you did before the pain exacerbation), at least not yet.
It is important to remember that everyone's recovery will proceed differently and may take a different amount of time. Recovery and return to normal activity should be completely tailored to the symptoms you are experiencing at that time. The most important thing is to listen to your body, how it is reacting, if there is any irritation, instability or other sensation, this will give you an indication of what strain you can tolerate and pain will be an indicator to stop.
When can I get back to exercise and workout after I have had lower back and leg pain:
Here we can give you a rule to follow: if during a movement the pain intensifies and starts spreading down the legs, this is an indication that you should stop the movement. If the opposite happens and the pain becomes centralised, that is, it contracts and returns towards the spine (even if that pain increases slightly), then continue with that movement, it has a good effect.
With good treatment, exacerbated low back pain can go away in about two weeks. Conditions where there is more significant pain may take longer (4-6 weeks or longer. The important thing is to stick to your recovery plan and not try to get ahead of treatment.
