If you suffer from low back pain then consider yourself part of a very large group of individuals. Statistics suggest that about 80 percent of people will experience a bout of acute back pain during their lifetime. Unfortunately back pain also has a relatively high rate of recurrence. So 75 percent of those individuals will have repeated bouts of back pain. A new study suggests that beginning and maintaining the right exercise program could help you to avoid recurrence of back pain.
What are the most common causes of low back pain?
- Sports injuries
- Shoveling snow or performing some other heavy or challenging task
- “Bad luck”
- Unknown cause or etiology
A typical acute attack of back pain can last for a week and then will usually resolve. Many people will however experience recurrences of this back pain, often within a year of the first acute attack. When that happens, repeatedly, the result can be feelings of debilitation, a general sense of a serious setback, often identified as a spiral of decline. The typical response to back pain is to restrict movement and become sedentary, spending lots of time on the couch or even in bed. The individual may find they can’t comfortably return to activities of daily life, or return to whatever level of fitness they enjoyed before this debilitating cycle began. The inactivity can actually result in more pain with movement, nudging the cycle of pain and inactivity further. Treating and preventing back pain Obviously the cycle described above makes it clear that prevention of further occurrences of back pain, after a first acute attack, is an important goal. There have been few studies that have examined what does work (or doesn’t) when it comes to preventing recurrent back pain. Typical therapeutic and preventive approaches that have been studied include: lifestyle change education, shoe orthotics, back belts, massage, various exercise programs and exercise programs combined with education on how to avoid instigating back pain. To be considered “successful” a treatment had to stave off back pain for a year or more, or limit lost workdays due to back pain.
New study assess efficacy of exercise alone or with educationResearchers combed through over 6000 studies that assessed back pain prevention, and they identified 23 studies that they thought were viable, based on methodology. The 23 studies looked at almost 30,000 participants with back pain, and evaluated the most popular techniques used to prevent back pain. The reviews of the 23 studies were a bit disappointing. Success as defined above was somewhat limited for many of the approaches. Education by itself did not prevent back pain. Back belts and orthotics in shoes also did little to prevent a recurrence of back pain within a year. On the positive side, exercise programs, with or without education proved to be quite respectable when it came to preventing back pain.Exercise alone was good, but exercise plus education was effective 43 percent of the time in preventing a recurrence of back pain. Did the type of exercise matter, when it came to preventing a recurrence of back pain?
The researchers found that the type of exercise did not matter. In some cases, the training involved core and back strengthening exercises, while in other studies aerobic conditioning coupled with balance and strength programs was the formula. Some of the studies involved two or three sessions of exercise a week for a couple of months, while other studies involved longer commitments to exercise. Some of the studies included education, while some did not.
What was noted was that the protective benefits seem to disappear at or after a year, probably because most people abandoned their commitment to the exercise or combined education and exercise. So there are no real long term studies on the impact of exercise, or exercise plus education to prevent back pain.
Applying the findings to your chronic back pain cycle **It’s clear that fearing exercise because you think it may bring on more pain may seem intuitive.Based on this new research the science seems to suggest quite strongly that exercise may actually be your best friend. You should consider asking your doctor for a referral to a physical therapist so you can assess the best exercise practices for limiting a recurrence of back pain. Also consider that tune ups or periodic return visits to an exercise specialist would likely be beneficial. Those return visits could help with motivation, and also help to fine tune or refine any exercise modalities so they provide an optimal prevention payoff. Changing your routine a bit or increasing challenge may also help to prevent recurrences.
The biggest roadblock that needs to be overcome is fear of more pain if you exercise. If you do commit to an exercise program then the other limiting factor is staying committed. According to this research, exercise may be your best option to prevent a chronic cycle of lower back pain.
Journal of the American Physical Therapy Association
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