Alleviating lower back pain(1): it's not so much the programme, more the activity itself

Most physiotherapists and doctors are now aware that exercise is important for rehabilitation of lower back pain symptoms. However, the research has not studied what kind of programme produces the best results (see also SIB 3, page 6). This study (Mannion et al, (1999). 'What programme is best for the lower back?' Spine, 24(23), pp2435-2448) looked at 148 lower back pain patients and split them into three groups: active physiotherapy, muscle conditioning and low-impact aerobics. Each subject performed their treatment/exercise twice a week for 12 weeks. At the end of the training period, pain and lumbar mobility tests were evaluated.

Surprisingly, the researchers found that all three groups improved to the same degree in terms of pain relief, pain frequency and ability to perform daily tasks. In addition, these effects were well maintained for up to nine months after the training programme had ended.

This suggests that for chronic lower back pain patients, it is inactivity that is the problem.

Alleviating lower back pain (2): spinal flexibility is not a priority

Spinal muscle flexibility is considered important for preventing and treating lower back pain. This new study (Kuukkanen and Malkia (2000). :'Does exercise therapy improve back mobility?' Physiotherapy Research International, 5(1), pp. 46-61) investigated the impact of therapeutic exercise on chronic lower back pain and spinal flexibility in patients with mild problems. 86 patients were included in the study and were divided into three groups: intensive training, home training and control. The training programme lasted for three months and tests were performed at the beginning and end of the training period, as well as three and nine months after the end of the programme to determine its long- term effects.

The results of this study showed that in this group of lower back patients with mild symptoms, spinal flexibility and pain were not related. The programme did improve flexibility, and these improvements did last long term in erector spinae but not in hamstrings.