Maintaining physical activity is essential in the management of chronic back pain (low back pain). However, efficacy does not appear to be the same in all patients. Who benefits the most?
Chronic low back pain refers to pain in the lower back (lumbar vertebrae) that lasts for more than three months without any medical cause being identified (such as a broken or herniated disc). The impact on daily life – private, social and professional – can be considerable and this for at least two reasons: pain and functional limitation.
Pain and functional limitations
With back pain, the “natural” tendency is to rest, and at the very least to reduce your activities. It’s a bad idea. Immobility may be necessary during the acute phase, which lasts a few days. But then it is essential to try to resume a normal life, to move. Scores of studies support this recommendation, but with one uncertainty: which patients benefit most or least from exercise?
A Canadian team (Dalhousie University) undertook the task to provide some answers. To do this, the team analyzed and cross-referenced the results of some thirty high-quality clinical trials carried out around the world. Two main criteria were targeted: pain and functional limitations.
First point and confirmation: compared to a sedentary lifestyle and “basic” care, physical exercise helps reduce pain (- 10% on average) and even more functional limitation (- 23%, with a rapid benefit). The best results are obtained among people who do not face high physical demands at work, those whose body mass index (BMI) is not more than 30 (in other words, not obese) and among patients who take pain relievers to relieve their back pain.
Pursue an active life
As the International Journal of Medicine (JIM) explains in substance, “if physical exercise is essential for good recovery, it appears, and it is logical, that over-straining the lumbar area is harmful, like that may be the case in trades requiring the carrying of heavy loads or with a lot of repetitive movements straining the back, or for people who are very overweight ”.
As for painkillers, their medium and long-term effectiveness on low back pain has not been demonstrated at all, on the contrary. However, if this meta-analysis is to be believed, these drugs may make it easier to stick to an exercise program. What should be remembered is that the pursuit of an active life, supplemented by regular and adapted physical activity (cycling, swimming, walking, etc.), is one of the keys to overcoming the limitations associated with exercise.
