Importance of Exercise for Chronic Low Back Pain

Exercise and Chronic Back Pain

“When compared with other therapeutic approaches, exercise demonstrates positive results by itself and in combination with other treatment options” (Dreisenger, 2014)

 

 

 

Chronic back pain is one of the most common and expensive medical conditions, that is estimated to cost 100 billion dollars per year in the United States alone. Low back pain is a very common injury and form of disability amongst adults. It is the fifth most common reason for physician visits, and will affect approximately 60-80% of adults throughout their lifetime. Pain that occurs for greater than three months is considered to be chronic. Back pain can be either specific or non-specific:

Specific back pain is caused by another condition such as; herniated disk, fracture, osteoporosis, inflammation, arthritis etc.

Non-specific back pain cannot be linked with a direct cause

A theme across studies in the management acute, subacute, and chronic back pain have provided recommendations for more, rather than less, activity in recovery. 

“When compared with other therapeutic approaches, exercise demonstrates positive results by itself and in combination with other treatment options” (Dreisenger, 2014)


Exercise to combat the fear of moving

 This image shows the cycle of fear avoidance behaviors

This image shows the cycle of fear avoidance behaviors

An old school way of thinking when it comes to back pain was to rest and medicate. We now know that the opposite is true. A lack of movement can lead to fear of movement, which causes less movement throughout the day, detraining of muscles and more pain.

Exercise also plays a role to decrease fear - avoidance behaviour. Fear avoidance behaviour is when fear of pain prevents an injured person from moving. Not moving, and disuse further contributes to disability from having chronic pain and prolongs recovery. Exercising in a supervised environment helps people with back pain become less fearful of moving as well as learn what movements are safe to do an won’t cause pain. The image above demonstrates the cycle of fear avoidance behaviours. 

One group of researchers analyzed a group of studies investigating if exercise was effective in the management of chronic low back pain and found that 100% of studies they analyzed showed positive results for exercise helping improve chronic low back pain (Liddle, Baxter, Gracey, 2003).

The Bottom Line: When it comes to low back pain, the best option is to stay moving


What type of exercise is good?

  1. Flexibility and Mobility Exercises
  2. General Strengthening Exercises
  3. Core Strengthening Exercises

Core exercises play an important role in the management of chronic low back pain. Core exercises involve strengthening the abdominal muscles and the lumbar spine to help improve stabilization of the lumbar spine. There are four general types of core exercises that can be done:

Balance exercises - in standing, sitting, or on unstable surfaces
Stabilization - holding your body in place ( including: planks, side planks, bird dogs etc. ) Motor Control exercises - learning how to activate and control core muscles
Segmental stabilization - activation of the deep core muscles

In the Journal of Physical Therapy Science one study found that all four kinds of core exercises were helpful in the treatment of low back pain, but particular focus should be on training the deep core muscles (Chang, Lin, Lae, 2015).

Why see a physiotherapist for chronic low back pain?

A physiotherapist can help identify and address muscular weakness that could contribute to chronic low back pain. A physiotherapist or kinesiologist can help develop an exercise program and keep you accountable and on track. Supervised exercise groups were found to have greater compliance to exercise and positive long term results in comparison to people who did exercise at home.

Supervised exercise allows the therapist to give feedback, correct form, and change or modify the exercise program as the client progresses. Individualized 1 on 1 sessions and exercise based treatment is at the heart of everything we do at WestcoastSCI. If you or a family member experiences chronic low back pain, book an appointment below! We would love to help.  


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References

I. Khan, R. Hargunani et al. “The lumbar high-intensity zone: 20 years on.” Clinical Radiology, 6 June 2014, 551-558