Treating Back Pain By Stretching The Value Of Exercise

2010-04-30 |
Back Pain Prevention With Exercise

The construction of the human spine is impressive when we consider the combination of strength and flexibility that exist simultaneously in the design of the spine. Our spines, with all 33 stacked vertebrae, manage to support our upper bodies while allowing us freedom of motion and providing protection to the ever-so-delicate spinal cord. Yet, unless we are experiencing back pain, we rarely think about our spines.

When we do have back pain, however, we think about it a lot. With very few exceptions, each of us has either experienced back pain directly or observed the discomfort and suffering in our friends and family members. Back pain is so common that 80% of us will experience it within our lifetime. Low back pain, in particular, is estimated, by the World Health Organization (WHO), to be a problem for 42% of the world’s population.

That said, there are two ways in which we experience back pain. The first is the sudden sharp pain that results from making a motion we should not have. The second, and more problematic, is the chronic pain of strained back muscles or something pinched or compressed around the spine itself. Such chronic pain may have started as a result of that sudden, sharp pain.

Chronic pain is never good for the body and can have considerable effects on quality of life. In particular, such pain is tied to both depression and insomnia. At the same time, chronic back pain was found in the UK to be the second leading cause of absence from work for those involved in manual labor. Consequently, it is also responsible for many trips to the doctor’s office.

Unfortunately, however, research shows that too many treatments offered by doctors are ineffective in eliminating the causes of back pain or the pain itself. In a survey by the University of North Carolina, researchers found that 61% of patients were on pain killers and 31% were on muscle relaxants. Yet, on average, each patient had made 21 visits to roughly 3 health care providers each year to try to cope with the pain.

Also important was that the same survey pointed out that less than 50% of patients had a prescription for exercise and only 3 in 10 had seen a physical therapist for the problem.

Until recently, this under prescription of exercise for back pain would have been considered a failing by many doctors and organizations in preventing unnecessary surgeries.

Researchers at The George Institute for International Health had found that supervised training by a physical therapist in motor control exercise was effective in reducing pain. By training patients to gain better control and use specific muscles in the stomach area and lower back when performing specific activities, the researchers believed patients were able to minimize or avoid pain while improving their mobility.

In another review published in the Journal of the American Academy of Orthopaedic Surgeons, the authors claimed that core muscle training of the muscles in the lower back and stomach area significantly reduced the pain experienced by those with disc-related pain. Similarly, research at the University of Montreal found that certain exercise done on a machine specifically intended to increase back muscle strength while reducing use of the hip muscles were also important in reducing pain.

Yet further evidence of the value of specific exercises for reducing pain came from a study carried out at West Virginia University. There, researchers found that a specific form of Yoga, called Iyengar Yoga, was able to reduce pain in patients. A key focus of these exercises is posture control that involves the use of the muscles in the stomach area and lower back. The studies found that after 6 months of twice-weekly 90-minute Yoga sessions, patients experienced significantly less pain.

Unfortunately, all of these studies shared one thing in common in that they were not based on the rigid double-blind placebo-based trial used to ensure treatment effectiveness and remove interpretations by those involved in the study. In short, the results were strongly affected by patient interpretation of how valuable the treatment is.

When The George Institute for International Health executed a subsequent study that met these more stringent criteria, they found that patients were experiencing the placebo effect and that the exercises provided no measurable reduction in pain. Though this is but one study, the fact that it met the stringent treatment testing rules makes it likely that exercise is not a reasonable treatment for reducing back pain.

For those who advocate exercise as an effective treatment for back pain, this finding is bad news. It is also bad news for patients looking to avoid prolonged use of medications or the risks of back surgery. When pain is not even managed by medication, surgery is often recommended as treatment. In the US alone, some 1 million people receive spinal surgery annually for back problems so at a cost of $86 billion, or 9% of US health spending alone, it is also bad for health care systems worldwide.

With health care costs rising and back pain contributing so much to these costs, significantly more research into the causes of back pain is needed. The combination of the human and dollar costs of back pain are something we cannot afford so we need to spend more time thinking about our spines.

As a side note, should you suffer from back pain, it is important to remember that recovery can take a while. Roughly 1 in 3 sufferers will take up to 9 months to recover and after 1 year, only 40% of people will have recovered. This is important to keep in mind for those that might feel tempted to switch from one form of treatment to another too quickly.

If you suffer from chronic back pain, please share your experiences with others in the health forums.

Related Links

http://www.statistics.gov.uk/articles/labour_market_trends/sick_absence_Apr05.pdf
http://ca.wiley.com/WileyCDA/PressRelease/pressReleaseId-59677.html
http://www.lww.com/newscenter/articledisplay/?newscenter_id=541
http://ptjournal.apta.org/cgi/content/abstract/89/1/9
http://www.newswise.com/articles/avoiding-surgery-for-low-back-pain
http://www.nouvelles.umontreal.ca/udem-news/news/20100419-exercise-therapy-for-low-back-pain.html
http://www.ncbi.nlm.nih.gov/pubmed/19701112
http://www.bmj.com/cgi/content/abstract/339/oct06_2/b3829
http://www.ncbi.nlm.nih.gov/pubmed/19892856
http://www2.cochrane.org/reviews/en/ab000335.html
http://www.thegeorgeinstitute.org.au/shadomx/apps/fms/fmsdownload.cfm?file_uuid=6DF0EA97-B1FD-1319-9DEB-6169B989CA1A&siteName=iih

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Category: Disease Prevention, General Health, Medical Treatment, Symptom Information

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