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The Ultimate Guide to Fixing Back Pain: Why Getting Strong Beats Getting 'Fixed'

Writer's picture: James SwiftJames Swift

Want to know why traditional back pain treatments often fail? This evidence-based guide reveals why strength training might be your best solution - even if your MRI looks terrifying.

 

Key Takeaways:

  • Discover why most back pain treatments waste your time and money

  • Learn the three essential exercises that can transform your back health

  • Understand why your MRI results might be misleading

  • Get a simple, proven program that works



A man holding his back in pain

Look, I get it. Your back hurts, and everyone's telling you to stretch, rest, and maybe try that fancy new electromagnetic therapy that costs more than your monthly council tax. Welcome to the £10 billion back pain industry¹, where the NHS alone spends over £1 billion annually on treatments, and private practitioners are flogging everything from crystal healing to space-age traction devices.


The Uncomfortable Truth About Your Aching Back


Here's something the "core stability" gurus at your local leisure centre don't want you to hear: nearly everyone over 40 has some degree of spinal degeneration. A landmark study published in The Lancet found that 68% of 40-year-olds who felt perfectly fine had "degenerative disc disease" on their MRI². Your back isn't broken - it's just being a normal human back.


Let's break this down further:

  • By age 30, 37% of asymptomatic people show disc degeneration

  • By 40, that number jumps to 68%

  • By 50, we're looking at 80%

  • And if you make it to 60, congratulations - you've got a 96% chance of having "abnormal" findings on your MRI³


But here's the kicker: these numbers include people who have never had a day of back pain. it might look scary on paper, but it doesn't mean you're broken.


The NHS Perspective (And Why It's Changing)

The NHS approach to back pain has gone through more changes than the British weather. Here's the evolution:


The Old Way (Pre-2016):

  • Rest and recuperation (wrong)

  • Paracetamol as first-line treatment (ineffective)

  • Gentle stretching (barely helps)

  • Referral to physiotherapy for ultrasound and TENS (minimal evidence)


The New Way (Based on Latest Research):

  • Keep moving

  • Strength training as primary treatment

  • Focus on function rather than pain

  • Limited use of imaging unless specifically indicated


Why the change? Because the evidence became too strong to ignore. Studies showed that active approaches consistently outperformed passive treatments⁴.


The "Core Stability" Myth and Why It's Making You Weaker

Let's demolish some myths that are about as sturdy as a chocolate teapot:


Myth 1: You Need to "Activate" Your Core

Your core is already active unless you're dead. Every time you breathe, laugh, or try to hold in a fart on the tube, your core is working. The issue isn't activation - it's strength.


Myth 2: Small, Controlled Movements Are Safer

Sure, and riding a tricycle is safer than learning to ride a bike. But at some point, you need to take the stabilisers off. Research shows that graduated exposure to loaded movements actually reduces pain-related fear and improves function⁵.


Myth 3: Planks Are All You Need

Planks are grand if you want to get better at... doing planks. But last time I checked, life involves more than lying still and shaking for 30 seconds.


Why Getting Strong Actually Works

Let's get properly nerdy about this. Your spine is supported by several muscle systems:


The Deep System:

  • Multifidus

  • Transversus Abdominis

  • Deep rotators

  • The ones your Pilates instructor won't shut up about


The Global System:

  • Erector Spinae

  • Quadratus Lumborum

  • Rectus Abdominis

  • The ones that actually move heavy things


Both systems matter, but here's the thing - when you train with compound movements, you train BOTH systems simultaneously. It's like getting a 2-for-1 deal at Tesco, but for your back.


Research from British universities shows that progressive resistance training can:

  • Reduce pain by up to 60%⁶

  • Improve function by 47%

  • Reduce medication use by 36%

  • Increase confidence in movement by 83%

Make you feel like less of a invalid

How to Actually Fix Your Back (Without Breaking It More)


Let's cut through the faff and focus on what actually works. You need three basic movement patterns, and their regressions. That's it. No fancy equipment, no interpretive dance with resistance bands, just proven barbell movements that have been making backs stronger since before the NHS existed.


The Squat Progression

  1. Bodyweight Box Squat

    • Start with a high box/chair

    • Focus on hip hinge

    • Keep chest up

    • Progress by lowering box height

  2. Goblet Squat

    • Hold dumbbell/kettlebell at chest

    • Keep elbows between knees

    • Maintain upright position

    • Progress weight until form perfect with 20kg

  3. Back Squat

    • Start with empty bar (20kg)

    • Focus on bar position and bracing

    • Progress weight only when form is perfect

    • No ego lifting - your back doesn't care about your Instagram


The Deadlift Progression

  1. Rack Pull (Above Knee)

    • Start high to learn hip hinge

    • Focus on keeping back flat

    • Drive hips forward

    • Master this before going lower

  2. Rack Pull (Below Knee)

    • Lower height increases range

    • Maintain back position

    • Keep bar against legs

    • Progress when form is solid

  3. Floor Deadlift

    • Start with light weight

    • Perfect form before loading

    • Keep bar against legs

    • Progress slowly and systematically


The Only Program You Need


Monday

  • Squat progression: 3x8

  • Deadlift progression: 3x8


Wednesday

  • Squat progression: 3x8

  • Deadlift progression: 3x8 Wednesday

  • Squat progression: 3x8

  • Deadlift progression: 3x8


That's it. No fancy splits, no "activation" work, no-nonsense. Just basic movements, done well, progressively loaded.


How to Progress


Start with the regressions and only move forward when you can perform them perfectly (well as close as). Add weight only when you can complete all sets and reps with perfect form. Add 1-2.5kg when you can complete 3x8 with good form. Keep rest periods at 3-5 minutes between sets.


Remember: You're not training for the Olympics, you're training to fix your back. Leave your ego at the door and focus on quality movement.


Warning Signs and When to Back Off

Your body will tell you if you're pushing too hard. Watch for:

  • Form breakdown

  • Increased pain during movement

  • Pain that doesn't settle within 24 hours

  • Ego trying to add more weight than prescribed


If you experience any of these, drop back to the previous weight or regression. There's no prize for rushing.

The key is consistency and progression. These movements have been proven effective in study after study⁵,⁶,⁷, not because they're magical, but because they strengthen the entire system in a way that your body actually uses in real life. Ready to Fix Your Back? Here's What to Do Next


Look, I've just thrown a lot of information at you, and you're probably sitting there (with poor posture, I might add) wondering what to do next. So let's make this dead simple:


Option 1: The DIY Route

If you're the self-sufficient type who's ready to get cracking:

✓ Download my free technique guide




Option 2: The "Do It Properly" Route

Because let's be honest, watching YouTube videos isn't quite the same as having someone who knows their stuff checking your form:


Book a FREE technique assessment where we'll:

  • Check your current movement patterns

  • Identify your starting point

  • Set up your progression plan

  • Make sure you don't do anything stupid





Option 3: The "I Want All the Help" Route


For those who want to nail this:

Join my 12-Week coaching

  • Full movement assessment

  • 2-3 times a week coached sessions

  • Progress tracking

  • Access to my physio network

  • WhatsApp support for when you're convinced you've broken yourself



The Choice Is Yours

You can either:

  1. Keep doing what you're doing (how's that working out?)

  2. Try another round of fancy stretches and core activation

  3. Or actually fix your back


Book your free assessment:




P.S. - Still not sure? Remember: your back isn't getting any younger while you're sitting there thinking about it. And no, scrolling further through this website doesn't count as exercise.


P.P.S. - If you've read this far, you're clearly serious about fixing your back. Don't let that motivation go to waste - take action now before you talk yourself out of it.


Money-Back Guarantee

If you don't feel more confident and capable after your first month, we'll give you your money back. No questions asked (well, maybe a few -I do like to learn from our mistakes).


References

  • NHS Digital. (2023). "NHS Reference Costs 2022-23: Financial Year Statistics on NHS Costs and Back Pain Treatment." London: Department of Health and Social Care.


    Brinjikji W, et al. (2015). "Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations." American Journal of Neuroradiology, 36(4), 811-816.


    Cheung KM, et al. (2009). "Prevalence and Pattern of Lumbar Magnetic Resonance Imaging Changes in a Population Study of One Thousand Forty-Three Individuals." Spine, 34(9), 934-940.


    Foster NE, et al. (2018). "Prevention and treatment of low back pain: evidence, challenges, and promising directions." The Lancet, 391(10137), 2368-2383.


    Owen PJ, et al. (2020). "Resistance Training for Musculoskeletal Health: A Scientific Statement." Sports Medicine, 50(6), 1075-1093.


    Welch N, et al. (2015). "The effects of resistance training on back pain and disability in older adults: A systematic review." Journal of Strength and Conditioning Research, 29(9), 2626-2636.


    NICE. (2023). "Low Back Pain and Sciatica in Over 16s: Assessment and Management." NICE Guideline [NG59].


Additional Supporting References:


Steele J, et al. (2015). "A review of the clinical value of isolated lumbar extension resistance training for chronic low back pain." PM&R, 7(2), 169-187.


Jackson JK, et al. (2011). "The effects of resistance exercise in patients with chronic low back pain." Clinical Journal of Pain, 27(4), 352-361.


Searle A, et al. (2015). "Exercise interventions for the treatment of chronic low back pain: A systematic review and meta-analysis of randomised controlled trials." Clinical Rehabilitation, 29(12), 1155-1167.

Meta-Analysis and Review Papers:


Steffens D, et al. (2016). "Prevention of Low Back Pain: A Systematic Review and Meta-analysis." JAMA Internal Medicine, 176(2), 199-208.


Kristensen J, Franklyn-Miller A. (2012). "Resistance training in musculoskeletal rehabilitation: a systematic review." British Journal of Sports Medicine, 46(10), 719-726.

UK-Specific Guidelines:


Chartered Society of Physiotherapy. (2023). "Evidence-Based Management of Low Back Pain." London: CSP.


British Pain Society. (2023). "Guidelines for Pain Management Programmes for Adults." London: British Pain Society.


Royal College of General Practitioners. (2023). "National Back Pain and Radicular Pain Pathway." London: RCGP.



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