Interesting Finding About Back Pain
December 3rd, 2005 by.
An interesting finding with respect to back pain. Many therapists prescribe specific exercises for patients with chronic low back pain. In a study of almost 700 patients comparing back-specific exercises with general recreational exercise such as walking or sports, investigators found that back exercises were associated with worse pain and general recreation with a better outcome. As one commenter noted, this was an observational study, and it might be possible that there is a selection bias — that people with worse disease choose to do back-specific exercises. However, the size and makeup of the study is strongly suggestive of the possiblity that back exercises worsen back pain and general activity makes it better.
Article:
Hurwitz, EL et al. Effects of recreational physical activity and back exercises on low back pain and psychological distress. Findings from the UCLA low back pain study. Am J Public Health 2005 oct 95:1817-1824.
Posted in General Medicine | 5 Comments »
December 4th, 2005 at 10:05 am
Ever read about the McKenzie Method for back pain? They seem to advocate the “wrong” exercises — things conventional medical wisdom say you should NOT be doing.
http://www.spine-health.com/topics/conserv/mckenzie/mck01.html
December 4th, 2005 at 1:11 pm
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Interesting. However, in light of this study, it would be interesting to see if it really is better than general exercise. I am skeptical.
December 4th, 2005 at 2:15 pm
I wonder. If the primary cause of the pain is squashed discs or pinched nerve thingies, then should not one seek to ease the pressure on those thingies in some fashion or other? Puff the disks back up, where possible? Add to that conventional exercise to strengthen the usual muscles, of course. There is some advocacy for the Pilates or the Core training as well, tucked in there — strengthening those inner muscles.
Haven’t really read up on it much — this is the Spousal Unit’s thang. He’s got some serious back issues that he’s trying to resolve and has found a great deal of relief using McKenzie’s techniques, along with a back inversion table and a “chi” machine to help stimulate internal fluid flow.
December 4th, 2005 at 3:33 pm
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Well, as you know, chronic back pain is not something I have to treat. However, in my reading on the subject, I’m not such a big fan of the “squashed disk” explanation for chronic low-grade back pain.
Certainly, bulging disks can put pressure on nerve roots and cause pain, particularly radicular pain. But that’s a different kind of paoin. However, if one looks at MRIs of people without any symptoms at all, a significant portion of them *also* have such disk abnormalities. Thus, if you take a group of people in pain, and a group of people not in pain, both will have bulging disks.
There are a lot of different reasons for chronic low back pain, and the therapies need to attack the specific cause for the specific individual. A person with nerve impingement is very different than one with osteoporosis, or arthritis, or fracture, etc.
January 9th, 2009 at 10:36 am
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