Now that you know about the importance of the hip in all things related to exercise, let’s talk about recurring lower back pain.
Lower back pain (LBP) is a common clinical presentation in primary care visits each year. Results are generally positive for those with acute LBP in the first year, however, recurrences in the next 12 mos are very common with statistics ranging from 24-87%. In the December 2013 issue of the journal of Physical Therapy a Cochrane review of the literature was performed to explore the evidence and effectiveness of physical therapy exercise in prevention LBP recurrence. The Cochrane library is a respected source of reliable evidence related to health care. The review looked at 13 articles reporting on 9 trials related to this topic. Exercise programs were divided into two interventions. One, those that were defined as ‘treatment for a current episode of back pain with the aim to prevent new episodes’ and two, ‘interventions that were provided to patients after their regular treatment had been finished with the aim to prevent recurrences of back pain’. In the second group additional exercises were given when the patients episode had fully recovered and they were back to work.
The review found moderate evidence to support that post treatment exercises (group 2) were more effective than the control group (no exercise) with recurrent risk halved (risk ratio=.5, 95% confidence interval=.3-.7) in the 2 yrs following the episode (22 of 67 exercise patients had recurrence vs 41 of 63 in the control group) . In contrast exercises delivered during the initial treatment were found to not be effective (113 of 174 with initial treatment vs 124 of 174 in the control group). What is important here is that as a patient progresses through his/her program, exercise and treatment techniques must be changed to increase effectiveness as the body can perform greater movement/activity.
Alpine’s SpineCare program is a 3 step process of identifying the biomechanical cause(s) of dysfunction, implementing treatment, and finally focusing on exercises needed to prevent recurrence. We feel that our job is best done when we see you back out on the trails or at the ski hill vs. a return to our office.
You don’t have to live with lower back pain! Talk to us about developing an exercise program to help you get back to life.
Reference: LEAP (Linking Evidence and Practice) Macedo et al. Exercise for the Prevention of Recurrences of Nonspecific Low Back Pain. Physical Therapy 2013;93: 1587-1591