Steady sleep and movement can make sore days easier

A steady sleep schedule may ease next-day soreness

Back soreness can wake you during the night. Poor sleep can also make you feel more tender. Keep your bedtime and wake time fairly steady.

Use any sleep position that feels supported. A side sleeper may place a pillow between the knees. A back sleeper may put one under the knees.

Judge your sleep across several nights, not just one. Note your sleep, activity, and soreness the next day. Tell a provider about loud snoring, gasping, or deep daytime sleepiness.

Spreading chores across the week can prevent worse soreness

A better morning can tempt you to finish every chore. Your back may feel much worse the next day. Split a long job into smaller parts instead.

Choose an amount you can manage on an average day. You might take several short walks instead of one long walk. Don't add more until your soreness stays familiar.

Hot weather can affect the time and place for activity. Indoor pickleball at Rio Vista may feel easier during summer heat. Don't use all your energy before the drive home.

Useful movement prepares you for a task you miss

Walking can help you spend more time on your feet. Strength work can help with stairs and lifting. Gentle bending can prepare you for yard work.

Pick one task you'd like to do again. Break golf, driving, or housework into shorter parts. You'll see progress when that task becomes easier.

Familiar mild soreness during practice can be safe when it settles soon. Stop if numbness spreads or your leg grows weaker. Those changes need a medical check.

Sources

1. The RESTORE trial randomised 492 people with chronic disabling low back pain across 20 primary-care physiotherapy clinics to usual care, cognitive functional therapy, or cognitive functional therapy with movement-sensor biofeedback. Both therapy arms produced a 4.6-point improvement on the 24-point Roland Morris Disability Questionnaire versus usual care at 13 weeks, with similar effect sizes still present at 52 weeks and substantially lower societal costs. Adding the sensor added nothing.

   Kent P, Haines T, O'Sullivan P, et al. — Cognitive functional therapy with or without movement sensor biofeedback versus usual care for chronic, disabling low back pain (RESTORE): a randomised, controlled, three-arm, parallel group, phase 3, clinical trial.. The Lancet, 2023. DOI: 10.1016/S0140-6736(23)00441-5.

2. A network meta-analysis of 97 randomised trials and 13,136 participants found psychological interventions for chronic low back pain work best when delivered ALONGSIDE physiotherapy care rather than instead of it: cognitive behavioural therapy and pain education with physiotherapy produced clinically important improvements in physical function, and behavioural therapy with physiotherapy was the only combination that maintained clinically important pain reduction to mid-term follow-up.

   Ho EK, Chen L, Simic M, et al. — Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis.. BMJ, 2022. DOI: 10.1136/bmj-2021-067718.

3. A Cochrane review of 41 trials and 6,858 people with chronic low back pain of more than a year's duration found multidisciplinary biopsychosocial rehabilitation reduced pain and disability compared with usual care, and nearly doubled the odds of being at work a year later compared with physical treatment alone (OR 1.87). Two trials comparing it with surgery found little difference in outcomes and MORE adverse events with surgery.

   Kamper SJ, Apeldoorn AT, Chiarotto A, et al. — Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis.. BMJ, 2015. DOI: 10.1136/bmj.h444.

4. The Cochrane review of exercise therapy for chronic low back pain pooled 249 trials and found moderate-certainty evidence of a clinically important 15.2-point pain reduction (0-100 scale) versus no treatment, usual care or placebo. The effect on functional limitations was 6.8 points, which did NOT meet the review's own threshold for a minimal clinically important difference, and adverse effects were mostly minor muscle soreness.

   Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW — Exercise therapy for chronic low back pain.. Cochrane Database of Systematic Reviews, 2021. DOI: 10.1002/14651858.CD009790.pub2.

5. The Cochrane review of acupuncture for chronic non-specific low back pain included 33 studies and 8,270 participants. Against SHAM acupuncture the pain difference was 9.22 points on a 0-100 scale - below the review's 15-point clinical threshold - and back-specific function was no better than sham. Against no treatment acupuncture produced a clinically important 20.32-point pain reduction. The gap between those two comparisons is the size of the ritual effect.

   Mu J, Furlan AD, Lam WY, et al. — Acupuncture for chronic nonspecific low back pain.. Cochrane Database of Systematic Reviews, 2020. DOI: 10.1002/14651858.CD013814.