For Chronic Lower Back Pain, Exercise is Therapeutic
Current data suggests that pain affects more Americans than diabetes, heart disease and cancer combined. That means about 100 million Americans suffer with chronic pain. A National Institute of Health Statistics survey indicated that back pain is the most common complaint. Back pain is also the leading cause of disability in Americans under the age of 45. More than 26 million Americans between the ages of 20-64 have frequent back pain and most avoid exercise, fearing more pain. The survey also found that adults with chronic back pain are also four times as likely to experience psychological distress compared to healthy individuals. Considering the size of back packs that students carry to school daily, many may be on track to develop back pain later-in-life.
Current therapies for chronic lower back pain
Some of the more popular ways to treat chronic lower back pain (LBP) include acupuncture, having a chiropractor manipulate your spine, using orthotics or special shoe insoles, back belts, ergonomic interventions, heat and ice, physical therapy and water therapy.
Exercise is often recommended to individuals but there can be significant hesitation because the individual assumes that the exercise will make their back pain worse. A new study suggests that exercise combined with education helps to reduce low-back pain. Insoles, back belts and ergonomic interventions did not help to measurably reduce back pain.
The researchers reviewed medical databases for all randomized trials that involved LBP from inception through November 2014. About 6000 studies, including 23 published reports on 21 separate randomized control studies were included. The total number of participants in the 23 studies combined was 31,112. Throughout the trials, six different lower back pain strategies had been tested: exercise, education, education plus exercise, back belts, shoe insoles and ergonomic programs. Evaluation of success of the therapy was measured by counting the number of sick days due to LBP, and filed reports of specific lower back pain instances.
Data assessment by the study
Exercise by itself measured against control groups did not show marked improvement in pain, or reduction of back pain, in the short term or long term. Similar results were found for education alone, shoe insoles, back belts and ergonomic devices. Results for the trials that tested education plus exercise showed moderate improvement in lower back pain in the short term. The results were not as impressive in the long term and the researchers propose that mostly lack of continued adherence was the reason why pain did not continue to diminish. It can be difficult to remain committed to a demanding program with education and exercise components.
Can we get doctors to prescribe exercise and education?
The lead researcher notes that if a medication or injection offered similar relief for LBP, you’d see an explosion of ads and doctors would be writing enormous numbers of prescriptions. But formal education and exercise combined programs are rarely recommended in prescription format after a patient presents with an episode of LBP. Doctors do need to take the time to discuss this therapeutic option and emphasize its proven therapeutic results to patients, so they recognize the benefits of education plus exercise as a viable treatment option for low back pain. Patients also need to learn to ask for these affordable, accessible and sensible therapy options.
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