Fat woman lower back pain
June 22, 2020 5:56 AM   Subscribe

Shit happened and I gained 30kg. When I stand up or walk for more than 20 minutes (and I used to be able to walk all day) the back muscles just above my butt scream. I also have a huge front (breasts & belly). Is there anything I can do to ameliorate the back pain while I lose weight? (Extra difficulty: recovery from respiratory disorder that leaves me severely fatigued everyday. )
posted by b33j to Health & Fitness (21 answers total) 41 users marked this as a favorite
Pilates focusing on your core can help strengthen your back and stomach which should help. I like this video. If lying flat on your stomach is uncomfortable for you, instead of swimmers just do another round of bird dogs.
posted by chaiminda at 6:03 AM on June 22 [4 favorites]

IANAD. However, as someone with chronic back pain exactly like you describe, I had a massive lightbulb moment when a very good therapeutic massage/physical therapy provider told me that lower back pain comes from the hips/glutes/piriformis muscle. My weak hamstrings/glutes were forcing my back muscles to carry more than their share of the load, which eventually resulted in my pelvis being tipped slightly forward, which put more strain on my back because my core muscles in the front (abs, obliques etc) couldn’t function properly to carry their portion of the load, either - it was all just my poor, overused, screaming back muscles.

The solution for me was weightlifting specifically targeting my glutes. I was not strong, was not fit, and could barely do bodyweight exercises when I started, but the relief from the back pain came SO FAST once I started to figure out how to use my glutes properly! It felt like a miracle, after over a decade of chiropractic work, massages, doctor’s appointments (where they just prescribed muscle relaxants and waived me out the door) and tons of NSAIDS every day just to be minimally functional.

Squats and lunges (hanging on to a chair or wall, at first) work but were really hard when I first started; I found glute bridges and hip thrusts both easier when I was starting and more effective, anyway.

This is an ongoing maintenance thing for me; my job puts a lot of strain on my back, and when I get lazy about my workouts (like I have been during quarantine), it only takes a couple weeks before my back pain shows back up again. I hope the solution is this easy for you!
posted by wind_up_horse at 6:22 AM on June 22 [30 favorites]

The McKenzie exercises were a life-changer for me, when I was experiencing the same sort of lower back pain. They're easy, require no more than a patch of floor and (sometimes) a pillow, and brought me immediate relief.
posted by DrGail at 6:28 AM on June 22 [14 favorites]

Is it possible for you to see a physical therapist? A physical therapist can figure out precisely what's going on and give you exercises targeted to your needs and abilities. You could have issues with strength, but there could also be problems with muscle tightness. Internet strangers can't tell you what the problem is.
I (obese) used to have episodes of crippling back pain. I worked with a physical therapist, and now doing the exercises and stretches she gave me every day has made my back a non-issue.

If you cannot see a physical therapist, I would look online for exercises for back pain.
posted by FencingGal at 6:29 AM on June 22 [2 favorites]

I came here to recommend #6 from Dr. Gail's list. I had walked into the physiotherapist's clinic in so much pain, and virtually skipped out, the relief was that dramatic. I hope the same thing works as quickly for you. Back pain suuuuuuuuuuuuuuuuuuuucks.
posted by kate4914 at 6:34 AM on June 22

Like DrGail and wind_up_horse, the exercise that brought me tremendous relief for my lower back pain was (and is) the forearm plank exercise.
posted by davcoo at 6:35 AM on June 22 [1 favorite]

I am a fat man and I have found two things help:
  1. Walking, even though it hurts. Doing it regularly will strengthen the muscles that hurt, and they won't hurt as much.
  2. Cable pull-throughs and reverse cable pull-throughs. The latter, specifically, relieve pain almost immediately after I do them, and the more I do them, the less pain I get to begin with. Unfortunately, these are not something you can easily do without some equipment. My gym is closed due to COVID-19 and I haven't been able to do them since February.

posted by kindall at 6:41 AM on June 22

Do you have really good footwear? Sneakers that properly support my high foot arch drastically reduce my back pain when standing or walking for long periods. The reduction in pain with the proper footwear is especially noticeable when I am at a heavier weight.
posted by fourpotatoes at 6:58 AM on June 22

I'm fairly thin, but I had sort of middle-aged creaky lowerback pain until I started weightlifting, specifically deadlifts, a few years back, and since then it has resolved completely. So, targeting the same muscles wind_up_horse suggests, but a slightly different approach. I really can't recommend deadlifts enough -- my subjective experience of walking around the day after I've done a heavy workout in the morning is feeling two inches taller and springy.
posted by LizardBreath at 7:00 AM on June 22 [2 favorites]

I've had a big hanging belly for most of my life and the back pain that goes with it. I've had the most luck with a gentle yoga practice, which ends up doing many of the same movements as the McKenzie exercises above.

If you've never done these kinds of exercises, I'd recommend getting someone to show you proper form first. I used to go to a yoga class, then figured I could do it myself at home. The first time I did yoga at home I caused some massive muscle spasm and was out of commission for a few days. Also, something I try to remember even if I'm just doing some random stretches at my desk - always combine forward and back bends in equal measure.
posted by cabingirl at 7:08 AM on June 22

This Yoga with Adriene video feels really good when I have lower back pain.
posted by sallybrown at 7:15 AM on June 22 [3 favorites]

I've just been dealing with a flareup of lower back pain. What helps me is a combination of walking and exercises for core and hips that my physical therapist prescribed. The most important exercises are:

side lying leg lifts
glute bridges
quadruped opposite arm/leg raises

There are a series of increasingly difficult versions of most of these exercises, especially if you have resistance bands. Technique is important. If you can't see a physical therapist, look at online videos for form.

Disclaimer: I am not a medical doctor, and this is not medical advice, just my own experience.
posted by brianogilvie at 7:28 AM on June 22

I could have written this question! I struggle with lower back pain so much, and the responses here are motivating me to get back to doing my exercises to try to improve things.

When I've gone in for a few sessions of physical therapy, they've had me do:
standing hip flexor stretch
abdominal brace with marching
glute bridges
standing hip abduction (with resistance band sometimes)
"dead bug" type exercises like this
posted by beandip at 9:17 AM on June 22 [2 favorites]

Ooh, I'm pretty much on the same page as everyone else -- lower back stuff is cured by strengthening your abs and your glutes, and increasing flexibility in your hamstrings. Background: I was very, very fat with a lot of back pain and am now a little fat with occasional back pain. Go to physical therapy if you have access - they are usually genius at starting you off with simple moves that barely qualify as "exercise" but which will target the muscles you need to strengthen.
posted by BlahLaLa at 10:12 AM on June 22

In my case, exercises alone were not sufficient for my body to improve. Hands-on physical therapy was the key that unlocked improved posture and muscle tone, and decreased pain. Feel free to email me if you'd like more info.
posted by dancing leaves at 10:19 AM on June 22

massive lightbulb moment when a very good therapeutic massage/physical therapy provider told me that lower back pain comes from the hips/glutes/piriformis muscle.

Ditto. Just occasionally stopping to stretch my upper legs (hamstrings) does wonders.
posted by Tell Me No Lies at 10:23 AM on June 22

I am recovering from the same exact kind of issues - in my case, as a result of pregnancy my weight increased 20%, my core muscles became incredibly weak, and I'm now carrying around a squirming 15-lb creature for hours a day, giving me crazy back pain. The solution is definitely as people have said above: strengthening core muscles and glutes, and relaxing hip flexors and piriformis. Also, physical therapy! They will give you the same exercises as above but in a plan that is specifically for you and easier to follow.
posted by epanalepsis at 11:12 AM on June 22

You've gotten lots of good advice about strengthening, stretching and physiotherapy so far, but there's one more potential issue you might consider.

A lot of us find out around our 40s or later that we have developed some degree of lumbar stenosis, where cruft accumulates in the spinal canal and leaves less space for the spinal cord, causing some degree of pain. Exercises and physiotherapy can certainly help, but what made mine get better was paying conscious attention to my posture to avoid any kind of swayback posture. Standing tall(er), engaging my abs, and keeping my butt tucked in as I walk has now become second nature. I used to have to limit my walking to 30 minutes or less, but I have been able to walk for 1-2 hours or more at a stretch for the last year or so even after slacking off my exercises. Posture changes alone made a big difference.

When you do choose exercises, avoid those that cause you to extend (sway your back) because this narrows the spinal canal further and makes things worse. Choose exercises that put your spine into flexion (curling your back like a startled cat). This site shows both types of exercises. You'll probably find that the recommended exercises are the ones that will diminish your pain right away.

A good source on all kinds of back issues is McGill's Back Mechanic. See also my earlier answer from a time just before improvements from postural changes kicked in.
posted by maudlin at 11:14 AM on June 22 [1 favorite]

In addition to all of the great advice already given, I’d like to add this YT video 10 Best Lower Back Stretches from Dr. Jo. They are very similar to warm-up exercises I did in PT.
posted by dorkydancer at 1:41 PM on June 22

As you're in Australia, you might be able to get subsidised physio visits with a GPMP / TCA through your GP.
posted by quercus23 at 9:27 PM on June 22

I don't know if diclofenac gel can be had without a prescription in Australia, but it's just gone over-the-counter here in the US (brand name: Voltaren). It really helps my wife when she has acute lower back pain. It's a topical NSAID.
posted by kindall at 7:16 AM on June 23

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