Home' Trinidad and Tobago Guardian : January 30th 2016 Contents A24
body & soul
Guardian www.guardian.co.tt Saturday, January 30, 2016
YOUR DAILY HEALTH
News and advice
Lower back pain is an almost universal if unwel-
come experience. About 80 per cent of those of us
in the Western world can expect to suffer from dis-
ruptive lower back pain at some point in our lives.
But if we begin and stick with the right type of
exercise programme, we might avoid a recurrence,
according to a comprehensive new scientific review
of back pain prevention.
Lower back pain develops for many reasons, includ-
ing lifestyle, genetics, ergonomics, sports injuries,
shoveling or just bad luck. Most often, in fact, the
underlying cause is unknown.
By most estimates about 75 per cent of people
who have had one debilitating episode of lower back
pain will have another within a year.
These repeated bouts can set off what doctors and
researchers call a "spiral of decline," in which someone
takes to his or her couch because of the pain; this
inactivity weakens muscles and joints; the person s
now-feebler back and core become less able to sustain
the same level of activity as before and succumb
when he or she tries to return to normal life, leading
to more pain and more inactivity; and the spiral
accelerates. This scenario obviously makes preventing
back pain extremely desirable.
But until now, few studies have systematically
examined what really works against repeated back
pain and what doesn t.
So for the new review, which was published in
JAMA Internal Medi-
cine, researchers affili-
ated with the George
Institute for Global
Health at the University
of Sydney in Australia
and other institutions
set out to gather and
analyse as many rele-
vant studies as possi-
ble.The researchers set-
tled on 23 that they felt
to be methodologically robust. These studies had
examined, in total, more than 30,000 participants
with back pain. The prevention techniques under
review included education about lifestyle changes,
shoe orthotics, back belts, various types of exercise
programmes and exercise programmes that also
included some type of education about back-pain
For the purposes of the review, a successful pre-
vention programme was one that had kept someone
from reporting another bout of back pain within a
year or longer or that had staved off lost work time
due to back problems.
Such success, as it turned out, was discouragingly
limited. Educational efforts by themselves showed
essentially zero ability to prevent a recurrence of back
pain, the researchers found. Back belts and orthotics
likewise were almost completely ineffective, leaving
people who employed either of those methods very
prone to experiencing more back pain within a year.
But exercise programmes, either with or without
additional educational elements, proved to be potent
preventatives, the researchers found.
In fact, "the size of the protective effect" from
exercise "was quite large," said Chris Maher, a professor
at the George Institute, who oversaw the new review.
"Exercise combined with education reduced the risk
of an episode of low back pain in the next year by
45 per cent. In other words, it almost halved the
Interestingly, the type of exercise programme didn t
matter. In some of the experiments that Dr Maher
and his colleagues reviewed, the regimens focused
solely on strengthening the core and back muscles.
In others, the training was more
general, combining aerobic con-
ditioning with strength and bal-
ance training. Most asked par-
ticipants to complete two or
three supervised sessions every
week, typically for about two
months, although some lasted
A few included education pro-
grammes as well.
The end result was that if
someone with a history of back
pain exercised in a regular way,
he or she was considerably less
likely to be felled by more back
pain within a year.
However, the protective effects
typically wore off after that, with
recurrences rising after 12
months, probably because many
of the people who d been
involved in the studies stopped
exercising, Dr Maher said, and
their back problems returned.
The end result was
that if someone
with a history of
back pain exercised
in a regular way, he
or she was
likely to be felled by
more back pain
within a year.
Back exercises and stretches
can help lower back pain.
To prevent back pain, exercise works
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