Is a Weak Core to Blame for Your Back Pain?
Published July 23, 2021
| Written By
SpineNation Editorial Staff
| Medically Reviewed by
Quintin Murray, DC, MS
What is Your Core and Why Does it Need to be Strong?
The core is a term that refers to the group of muscles that connect to the spine and make up the entire trunk of the body. These muscles provide stability for balance and posture, and they support movement throughout the body, including the arms and legs.
“Proximal stability before distal mobility” is a concept that refers to the fact that to maximize the function of our extremities, we must first have strong control of the muscles closest to the center of the body.
When most people hear the term “core,” they think of the abdominals. In fact, there are several major and minor muscles of the core, which are divided into two categories: stabilizers (tonic) and movers (phasic).
Stabilizers—these muscles hold the body in place while movement occurs:
- Transverse abdominis
- Lumbar multifidus
- Pelvic floor muscles
- Diaphragm
- Transverspinalis
- Movers—these muscles cause movement to occur:
- Rectus abdominis
- Internal and external obliques
- Erector spinae
- Latissimus dorsi
- Hip adductors/abductors
A Weak Core and How it Relates to Back Pain
The core is the very center of the body and surrounds the spine. The muscles in this area all work together like a brace to keep the body upright. If one muscle in this region is weak, other muscles compensate. This can lead to overworked, even painful muscles, and can increase the risk of joint injury.
Weak core muscles can also create poor posture, which puts a strain on the surrounding muscles. For instance, the rectus abdominis, aka the abs, is a large muscle at the front of the body that supports posture. If it is weak, it may encourage poor posture that can cause discomfort in the back.
It’s important to note, however, that according to Dr. Patrick Boylan of Logan University, it is not always clear what comes first — back pain/injury that deconditions the core, or muscle weakness that causes back pain or leads to injury.
“Many people with low back pain have less robust core muscles,” says Boylan. “However, it is not known for sure whether this causes back pain or is a result of low back pain.”
Boylan serves as an outpatient clinician at Montgomery Healthcare and as an adjunct professor for Logan’s College of Chiropractic. He continues, “It’s difficult to say that weak core muscles are a direct cause of back pain, although there is certainly an association, and many people will benefit from exercises that engage their core muscles.
Signs of a Weak Core
Identifying weakness in your core is the first step toward getting a body that is stronger and less prone to pain and injury.
“If you find yourself fatiguing quickly during exercises like planks, side planks, or glute bridges, these muscles might not be as strong and robust as they could be,” advises Dr. Boylan.
Some other signs of core weakness are:
- Using your arms to get out of a chair or bed
- Over arched back while standing or walking
- Holding your breath during core exercises
- Poor posture
- Poor balance
Ways to Strengthen the Core
“One thing we know for sure about back pain,” says Boylan, “exercise is helpful.”
The plank, along with its many variations, and glute bridges are two of the top recommended core strengthening exercises, but a gentler approach might be more appropriate for those with back pain who are just starting.
Dr. Stuart McGill, a prominent low-back pain and exercise researcher, developed a group of exercises known as the “Big 3.”
“These are commonly used to strengthen the spine and surrounding muscle without aggravating back pain,” says Boylan.
The Big 3 comprises of:
- The curl-up
- The bird dog
- The side bridge
Once the Big 3 can be performed comfortably, it may be time to move on to more challenging movements.
“Studies have shown that even more global exercises, such as squats, swimming, and walking develop the core muscles as well,” says Boylan. “Any exercise that you enjoy and can do comfortably will help strengthen your core and can help relieve back pain.”
If you’re still not sure about the condition of your core, it might be helpful to seek advice from a medical professional. “Chiropractors and physical therapists can perform different maneuvers to test the strength of these muscles and see if there are areas in which they could improve,” says Boylan.
Updated: September 3, 2021
Disclaimer
Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.
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Contributors and Experts
Dr. Devon Ackroyd serves as an Advance Practice Clinician for Paraquad and a sports clinic clinician for Logan’s Mid Rivers Health Center. He also teachers Physical Rehab 2.
Quintin W. Murray, DC , MS, CCSP, a 2012 Logan College of Chiropractic grad, has been in chiropractic education for nearly eight years.
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