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Stretching the Value of Exercise in Treating Back Pain
[[img=/_includes/images/blog/Spine_Pain.jpg]]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.

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I suffer from back pain. My doctor gave me some pain killers and muscle relaxant. These medications assuage the pain slightly but my doctor advised me to practice proper posture in order to avoid suffering from the pain in the future. I don't have the pain now but if I bend my body in the wrong way or if I sit with improper posture, the pain would come suddenly and I would become almost immobilized with pain. I wouldn't be able to straighten my body and each movement I make will be so painful. All I can do is just lie in my bed in a fetus-like position.
I have chronic lower back pain. It is sure a pain to deal with. I also use muscle relaxants to help myself feel better, but they wear off quickly. Thank you for posting this to help us all feel better about our back pain. I hope these exercises help me.
I've fallen out of the habit with my back exercises, but I really need to start doing them again. I have permanent spinal injuries that cause back pain, and I can't walk or stand for long periods of time. I did notice that I had less trouble when I was diligent about my back exercises though.
Stretching does seem to help when I get an episode of back pain. I also use prescribed muscle relaxants when the pain is bad. Those, together with the stretching exercises soon help to put things right. Years ago, the advice was to rest a bad back, but these days, they seem to advocate movement. The problem is, sometimes movement seems just about impossible. When that happens, I do find I get some pain relief from deep breathing exercises and relaxation techniques.
This is a great post to have come across with good information and other sites to go onto. I was in a bad car accident in 2005 and suffered from two slipped disk and herniated disk in my lower back. I do not have constant back pain but I do get back pain when I am standing on my feet for too long or even once in a while it will start to hurt and nothing helps It will just be a continued pain that does not go away. Right after my accident I was seeing a chiropracter but it wasn't helping me too much and then my insurance ran out so I wasn't able to afford it anymore anyway. I have seen a few doctors and it seems like all they want to do is jack you up on pain medication wich most times I obviuously accept and take but it really does not help. Inflamation medications have helped more then anythng else but guess what when the meds run out the pain is back sometimes worse then before I started taking the pills :(. I love to find new ways/methods other then pain medication to help me.
I noticed my chronic back pain isn't as bad as it usually is after losing a little weight. I have disc issues too and pinched nerves. I can't afford health insurance so I do the best I can on my own. Stretching helps and laying flat on my back for a few minutes at a time. Standing straight up and than slowly bending down and holding one pound weights while I'm almost touching my toes for a few minutes also helps. Even when I take Motrin or Tylenol the pain doesn't go away. If it's a really bad back day. I'll use those menthol pads they sell in the pharmacy or a tiny bit of Ben Gay.
Strengthening the core muscles can help alleviate back pain. The core muscles support the spine, weak muscles are weak support. For instance, the PVA muscles wrap around the spine and protect it. Strong glutes will act as a buffer and take pressure off the lower back.
I fell down a couple of steps, years ago on one knee and injured my back, neck and knees, eventually developing osteoarthritis. When my backs starts to hurt from standing too long, the pain is relieved, if I do bending back and forward exercises of my back. I had started using Omega-3 Fish Oil, to lower my cholestrol, as recommended by a friend. As a result, I found it also helped with inflammation and reduced the back pain. A great surprise.
I always wondered why my lower back would often throb. It would be painful in my buttocks area and I could not understand why. I had to have a CT scan done to check for kidney stones. When the results came back, the radiologist said that I had no kidney stones but I did have severe facet disease. It was discovered by accident. At the time, I did not know what that meant because I had never heard of it before. I read that doctors will do surgery to help people with facet disease. I would much rather help the condition by stretching and strengthening exercises. The information presented here is valuable information.

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