Thursday, May 13, 2010

Exercise and the Prevention of Low Back Pain


ChiroACCESS Article

Many occupations in modern society require prolonged sitting which has been shown to be a risk factor for low back pain. There are numerous studies that suggest that exercise can play an important role in preventing occupational and non-occupational low back pain. An innovative approach was published this month (April 2010) in The Spine Journal that used an office chair exercise that is performed while seated. The exercise, described in the article by Jerome Fryer, D.C., provides a brief decompression of the lumbar spine by moving forward on the chair seat, placing the hands on the seat of the chair, pressing downward with the arms to take pressure off the lumbar spine, and arching the back and shoulders backward at the same time. This decompression maneuver held for 5 seconds followed by 3 seconds of reloading (sitting normally) and was repeated 4 times. Sequential MRI demonstrated a marked increase in vertical height of the lumbar spine using this decompression strategy. The authors concluded that “Seated upright MRI and stadiometry, as performed in this study, appear to be feasible methods for detecting compressive and decompressive spinal changes associated with normal sitting and, alternately, seated unloading exercises. Larger studies are encouraged to determine normative values of our study measurements and to determine if morphological changes induced by seated unloading predict treatment response and/or reductions in the incidence of sitting-related LBP.”

A January 2010 Cochrane review concluded that “There is moderate quality evidence that post-treatment exercise programs can prevent recurrences of back pain but conflicting evidence was found for treatment exercise”. There have been many studies published this past decade that support the value of exercise in primary, secondary as well as tertiary prevention of low back pain. These studies have been conducted with multiple age groups and multiple settings including sports venues and the workplace.

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