Low back pain is extremely common. It is one of the main reason for patients to visit a doctor. Most of us will experience episodes of low back pain at some point in our lives. Luckily, most of the time these episodes will last a few days and then the pain goes away. Unfortunately, these episodes tend to recur, and sometimes persist. Most patients that have an episode of low back pain severe enough to limit their activities will suffer at least another episode within a year. Too many times, patients, on their own or following advice from their physician will limit their physical activities after these episodes of low back pain. This can lead to weakness of joints, ligaments, and muscles and, possibly, a vicious cycle of pain and inactivity that will create the conditions for more frequent and more severe episodes in the future.
In twenty years of treating patients with low back pain I have learned that disuse and inactivity, along with poor posture, poor nutrition, and high levels of stress are major contributors to chronic low back pain. The way a patient lives his/her life is as important as any finding on the lumbar spine MRI in explaining chronic low back pain. This view is supported (at least in part) by a new comprehensive review of the medical literature that has found a simple method to prevent recurrence of low back pain episodes: regular exercise.
The authors of this review looked at more than 6,000 studies of back pain prevention, and found 23 studies of high quality. These studies included more than 30,000 patients with low back pain. They looked at different factors studied in the prevention of episodes of low back pain. They found that education, shoe inserts, or back belts, by themselves, had little impact in preventing episodes of low back pain. But, an exercise program, either with or without additional educational elements, was found to have quite a large effect in preventing episodes of low back pain. Exercise combined with education reduced the risk of low back pain within the next year by almost half (45% reduction). Also, the type of exercise didn’t seem to matter. The end result was that if someone with a history of back pain exercised in a regular way, he/she was considerably less likely to develop more episodes of back pain within a year.
So, if you suffer from back pain, consider starting a regular exercise program. Even a simple walking program will do. As previously discussed in this blog, this other recent study had found that a simple walking program was effective in improving functional abilities among patients with chronic low back pain. I would also add: to eat healthy (watch out for those complex carbohydrates, saturated fats, and preservatives), take care of your posture, avoid sitting for many hours in a day, and find out waya wlaking program will do. Even as to manage your stress (meditation, hobbies, pets, etc). Certainly, try these methods before considering any invasive intervention or surgery for your spine.
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