Exercise and Low Back Pain
As well as manipulation, all the recent clinical guidelines being promoted today for treatment of low back strains and sprains emphasize exercise, early and often. The concept of resting a sore lumbar spine is deeply entrenched both in the minds of the public as well as in medical circles and it is this notion that is frustrating the adoption of these new clinical guidelines. Study after study has shown that the recovery of one's low back condition is absolutely inversely proportional to the time spent resting. "Get up and get moving" that is the new mantra for low back pain sufferers!
However, as good and as necessary as exercise is, it alone will not heal an ailing low back. A recent study in Europe proved this, again. This study was published in the journal Spine earlier this year (2003:28(6), pp. 525-532). What the authors did was take a group of 50 very chronic low back patients who had been off work from 2-6 months. These 50 people were divided into 2 groups. One received exercise only while the other group received manipulation and exercise. The exercise only group got sixteen 45-minute sessions over eight weeks. Patient improvement was measured before the exercise sessions began and at four weeks, six months and one year after the sessions ended.
Patients in the manual-therapy group received mobilization and what we call high-velocity, low-amplitude manipulation from trained medical people and physiotherapists. This form of treatment is exactly what chiropractors do and we call it adjusting the spine. Along with these manipulations this group also performed general exercises for the trunk, spine and legs.
Results? Guess what? Both groups showed significant improvements. However, the group that was adjusted experienced much greater improvements than the exercise group in all areas of improvement (pain, functional status, etc.) at every stage in the follow-up. The average reduction in pain was double for these lucky patients, compared to exercise patients. As well, when the study ended, the manual-therapy group was significantly more likely to have returned to work (67%, vs. 27% for the exercise group).
The biggest plus - and this really gets the attention of health insurance people - one year later, the exercise-only patients were over three times more likely to still be off work than the ones who actually had something done to them.
These results are spectacular even with the manipulations of ill-trained amateurs. That's how powerful these spinal treatments
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