Lower-back pain is rampant among Hawai'i adults. Dr. Morris Mitsunaga, chief of orthopedics at The Queen's Medical Center, refers to it as an epidemic.

It can be caused or exacerbated by a sedentary lifestyle, uncomfortable shoes, a sudden twist, turn or bend, improper exercise or simply the natural aging process. Studies have also shown that heightened stress can be a set-up for lower-back pain.
"Framework for the Lower Back: A Six-Step Plan for Treating Lower Back Pain" (Rodale Press), by Dr. Nicholas DiNubile, an orthopedic surgeon whose TV special, "Your Body's Framework," aired on PBS, includes customizable tools for dealing with lower-back pain, including exercise plans and nutritional advice designed to strengthen the muscles, joints and bones.
"It is simply untrue that bed rest is always the best treatment for serious back pain," DiNubile writes. On the contrary, he writes, "An extended immobile period weakens muscles and joints and actually extends the time that pain is felt. We know that most pain will subside on its own if you move about prudently right away and exercise moderately as soon as possible."

"There's no panacea" for lower-back pain, said Dr. Bernard Portner of Portner Orthopedic Rehabilitation Inc. "No one treatment cures everyone, and that includes exercise." That said, after any acute pain or injury is treated, he recommends some form of exercise for rehabilitation.
"If you have poor posture, take up a posturally positive activity such as yoga, tai chi, dance or fencing," Portner said.
One of the forms of exercise he recommends to nearly all his lower-back pain patients is Pilates. "If done reasonably and with caution, (Pilates) is fabulous. Pilates is specifically for core strengthening," Portner said.
People with lower-back pain often say they have "a weak back." What is actually weak is their abdominals, or their core. That's where Pilates comes in. Many Pilates exercises, when done properly, can also improve spinal mobility.
Of course, those experiencing severe persistent pain, especially while at rest, should be seen by a physician immediately. It's also highly recommended that you see your physician before beginning any new exercise program.