A common response to low back pain is to become less active and to stop using the muscles in the back. It’s natural to want to avoid the pain that may come with movement, but not using back muscles can lead to more problems. The muscles quickly lose strength and start to tire easily–hardly a recipe for a healthy back. Exercise therapy can help. But what benefits can patients expect from exercise therapy, and is one kind better than another?
This study was the first of a three-part series to examine the effects of exercise therapy on low back pain. In particular, these authors wanted to know whether different exercise therapy programs would improve back muscle strength and endurance for patients with ongoing low back pain.
Participants included 148 patients who had been having pain off and on for an average of 11 years. More than half of them were women. The average age was 45.
Patients were placed in one of three treatment groups. The first group had one-on-one physical therapy treatments. They did strength exercises and learned about healthy ways to move. The second set of patients met in groups of two or three and used special training devices to improve back strength. The third group of patients met with a dozen others in an aerobics and stretching class, which included exercises for the trunk and legs. For all groups, treatment took place twice a week for three months.
Patients in each group did a series of physical tests before and after treatment to see whether their physical performance had changed. After treatment, patients in all of the groups showed better trunk strength (bending forward, stretching back and to the side, and twisting). They were better able to use their back muscles in trunk-bending exercises, suggesting improved strength. Patients’ back muscles also showed better endurance, though the authors suggest these improvements had more to do with patient motivation and pain tolerance than real physical changes in the muscles.
The specific type of treatment patients got didn’t seem to affect their physical performance, with one exception. Patients in the group that used special training devices did better on tests of trunk strength. This could be because they had practiced similar exercises during the treatments.
The authors conclude that exercise therapy encourages patients to use their back muscles again, with positive physical results. From this study, it doesn’t seem to matter what kind of exercise therapy patients do, as long as they follow through with it.