Studies show that low back pain (LBP) patients often expect pain even before doing an activity. This anticipation of pain can negatively impact physical performance. In this study researchers looked at the effect of intense exercise on expected back pain. Previous studies show exercise reduces the intensity of back pain. It's not clear how or why this happens. Maybe exercise alters anticipated pain. Or perhaps exercise just reduces the pain that comes with physical activity.
Seventy LBP patients were treated by physical therapists at three spine rehab programs. All three centers used the same exercise program. Patients attended therapy in groups of up to eight people. Sessions lasted two hours, three times a week for six weeks. At discharge patients were given a home exercise program.
The authors report that most of the patients in this study expected pain before doing the tests of back function. Then back pain occurred during the test. Patients who expected pain the most had the worst results on the test.
This response changed after spine rehab. Patients expected less pain and had less pain with testing. Therapists think anticipated pain can be altered by exercise that improves back function. Patients did better on tests with direct feedback, such as the number of pounds lifted or pressed. Future back rehab programs may want to keep this in mind when planning specific exercises.
This study gives proof that intense exercise may change pain that is expected before doing physical activities in people with chronic LBP. People in this study also had less pain as a result of doing activities.
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