People with back pain often shy away from movement. Getting in the water may help, experts say

Aidan O'Leary, 77, has suffered with back pain brought on by a hip replacement, but says he's found great relief by staying active at his local swimming pool. 

"Everything moves when I swim. It's not like walking or using a gym machine or anything," O'Leary told The Current. "In the water, everything moves, every muscle moves."

"I feel so free in the water, I feel weightless."

O'Leary, who lives in Toronto, was an avid cyclist before he broke his hip in a fall two years ago. He's replaced cycling with swimming three times a week and said it "very much" helps to alleviate the pain.

Statistics Canada has estimated that four out of five Canadians will experience back pain at some point in their lives, with the World Health Organization (WHO) recognizing it as the leading cause of disability globally.

But Shawn Beaudette, an associate professor of kinesiology, says that many people who experience back pain can develop kinesiophobia — the fear of specific movements that may have contributed to their injury — and avoid the physical activity that would help with healing.

In a 2022 paper published in Frontiers in Behavioural Neuroscience, researchers in Quebec noted that kinesiophobia affects between 51 and 72 per cent of patients with chronic pain. The researchers wrote that in contrast to other phobias, "people with kinesiophobia believe that avoiding movement is an appropriate response, resulting in deleterious behaviors and decreased overall functional ability."

Beaudette said these fears are also fuelled by a "kind of rhetoric ... [that] our spines are fragile, they're susceptible to injury" — but he argues that moving your body in different and varied ways is key to avoiding repeated stress that can lead to pain. That means getting out for a walk if you work a sedentary job, or mixing in breaks if your work is more manual.

"Your spine is meant to move … but we need to think about the types of movement that we're doing with our spine," said Beaudette, who specializes in the biomechanics of the spine at Brock University in St. Catharines, Ont.

"Any type of movement in moderation and diversity is good."

Swimming or water-based exercise would be "an excellent fit" to achieve that greater diversity of movement, in an environment that could reduce that fear, he said.

"I think getting somebody into the water, getting them away from kind of more traditional, weight-bearing exercises will help to provide a nice challenge to some of the trunk muscles … in a less risky type of environment," he said.

Health Canada cites low back pain as a form of chronic pain, a broad category that includes pain coinciding with an underlying disease or issue, such as pain from cancer treatment or surgery. It also includes pain that has no identifiable cause, or pain that persists after an injury has healed. Health Canada projects that as many as nine million Canadians may be living with chronic pain by 2030. 

The WHO reports that 619 million people experienced lower back pain in 2020 — a 60 per cent increase from 1990.