by Mark W. McFarland, DO
The most commonly cited reason for seeking medical care is for lower back pain. In fact, about 80% of us will experience this at some point in our lives. The good news is that a recent study indicates we may be able to avoid this debilitating pain if we simply do one thing…exercise.
As a Spine Specialist, I commonly treat folks who complain of back pain. This pain can be caused by injury, disease, over-use or for reasons we can’t explain. For most of us, the back pain will hit us acutely and cause severe pain for a limited time. Usually, OTC pain relievers, modified activity, muscle relaxers and heating pads will relieve pain in the short term. Physical Therapy can provide long term relief by stretching and strengthening the muscles that support the spine and by teaching appropriate movement and lifting techniques. For more difficult cases, injections, Regenerative Medicine or surgery may be needed.
Thankfully, most of us suffer from back pain that is caused by poor muscle tone and support. I will treat those patients and for a short time, they will exercise and modify their behavior, doing anything to get rid of their back pain. After successful treatment, they soon forget their pain and with it, the good back hygiene they adopted for a short time.
Unfortunately, many of us will have another painful episode within a year, because we tend to fall back into our bad habits and couch-potato lifestyle. Repeated bouts of pain and dysfunction will cause some patients to develop chronic back problems, due to their inactivity and not being able to sustain any type of exercise regimen. So if back pain is difficult to treat and resolve, how can we prevent it from happening in the first place?
The Journal of American Medical Association (JAMA) published a study which finally outlines what works to prevent the development back pain or to combat repeated episodes and what remedies are ineffective. Researchers from the University of Sydney (Australia) compiled 23 studies which comprised more than 30,000 participants with back pain.
To determine prevention success, the participants must have had previous back pain episodes. After using the preventative recommendations, the participants were counted who had not missed work for at least a year due to back pain or who had not reported another bout of back pain.
Methods of prevention were studied for their effectiveness, which included, exercise programs, shoe orthotics, belts providing back support, activity and lifestyle modifications and education programs about back pain prevention. Almost all of these had little to no effect at preventing a recurrence of back pain. Surprisingly, only the exercise programs, with or without education, proved to be successful. Of note, it did not seem to matter what type of exercise was performed, as long as it was done two to three times a week for about two months or longer. The end result was a significantly reduced chance of recurrence of back pain in patients who had a history of these episodes, almost halving the risk. The risk increased again after a year, probably due to the study participants not continuing to exercise.
The takeaway from this is that evidence clearly shows that exercise is the only effective way of preventing back pain recurrence. You don’t have to run a marathon or join an expensive gym. Just get moving. Take a walk with your dog, play tag or dodgeball with your kids or grandchildren, or pick up a golf club and play nine holes. Just do it regularly and several times a week. Your back will reward you with less pain and thank you for your efforts!