Don't Worry, We've Got Your Back!
“Is your pain preventing you from living your life to the fullest? Don’t worry, we’ve got your BACK!”
Anju Jassal, Physiotherapy Practicum Student
Do you or someone you know, suffer from chronic non-specific low back pain (CNSLBP)? You are not alone.
CNSLBP is one of the most common musculoskeletal conditions in the adult population, which is known to cause persistent pain and in turn lead to physical inactivity and disability (Santos et al., 2019). CNSLBP is also a worldwide health problem, defined as low back pain (LBP) that lasts longer than 6 weeks and presents without evidence of a specific disease or spine pathology (Wewege et al., 2018). According to Santos et al., 39% of the population will present with LBP at some point in their life and is linked to be one of the main reasons people miss work (2019). If this is so prevalent in our population, there has to be something out there that helps, right?
What does the research say?
Based on studies which have explored low back pain, exercise is shown to be beneficial in increasing physical activity tolerance, physical fitness, strength, health-related quality of life, and pain tolerance (Ronai and Sorace, 2013). As you may have discovered, there are so many ways to exercise and achieve the goals listed above, and the amount of information on the handy dandy world wide web, can be overwhelming. So, now you might be wondering what interventions for CNSLP are recommended in the most recent research?
According to a systematic review and meta-analysis by Wewege et al. “exercise significantly reduced pain intensity” (2018). This meta-analysis specifically compared progressive aerobic training (PAT) and progressive resistance training (PRT) to determine the role they play in reducing pain and disability, while improving quality of life. Both of these interventions demonstrated significant reductions in pain and disability in adults with CNSLBP, although the findings concluded that neither was superior.
In regard to PRT, the most benefit was seen with moderate to high intensity (60% to > 70% 1 RM) interventions (resistance machines and free-weights), which were conducted 2 + 1 non-consecutive days per week for an average of 11 + 3 weeks (Wewege et al, 2018). Whereas, PAT interventions (treadmill walking, jogging, or elliptical machine) which were conducted 3+ times per week with a mean program duration of 10 + 4 weeks, were based on the patient’s baseline assessment and progressed with either an increase in intensity or time.
Another article, by Santos et al., also discussed the effect of aerobic on pain and disability on patients with CNSLBP (2019). It shared valuable information from a systematic review from 2015, which stated aerobic exercises decrease pain, increase fitness, and improve psychological functioning. This was in addition to a 2016 review, which concluded that aerobic exercise in combination with other forms of therapy (flexibility, strength, and stabilization) is beneficial for patients with CNSLBP. In this particular article, they focused on looking for studies that included aerobic exercise which was between 15 – 60 minutes in duration with an intensity of 60 – 90% of the maximum heart rate. Overall, these findings were consistent with previous studies, which suggest aerobic training can be implemented to help reduce pain in patients suffering from CNSLBP.
So, now you’re probably wondering what this means to you?
Well, based on the most current research, both PAT and PRT, have shown to be beneficial for CNSLBP. With that being said, there are many ways to implement the right program into your daily life, and this is where a physiotherapist can help. Physiotherapy can help identify which program will best suite your needs and help you on the road to recovery, in a safe and effective way. A physiotherapist can conduct a thorough assessment to address your main concerns and determine a baseline for your program. They are dedicated to working closely with you to answer any questions you may have and to progress your program accordingly. Physiotherapist are trained to design exercise programs that aide you back to your optimal health and function.
References
Ronai, P., & Sorace, P. (2013). Chronic Nonspecific Low Back Pain and Exercise. Strength and Conditioning Journal, 35(1), 29-32 doi 10.1519/SSC.0b013e3182822bb1
Wewege, M. A., Booth, J., & Parmenter, B.J. (2018). Aerobic vs. resistance exercise for chronic non-specific low back pain: A systematic review and meta-analysis. Journal of Back and Musculoskeletal Rehabilitation 31 (2018) 889–899 doi 10.3233/BMR-170920
Santos, I. D., Lunardi, A. C., Bastos de Oliveira, N. T., Oliveria de Almeida, M., & Oliveria Pena Costa, L.
(2019). Effects of aerobic exercise on pain and disability in patients with non-specific chronic low back pain: a systematic review protocol. Systematic Reviews: 8:101 doi.org/10.1186/s13643-019-1019-3