Lower back pain makes sufferers feel like they shouldn't— or can't — move around. That's exactly the wrong approach to getting better for most people. Aerobic exercise is one of the best treatments for an injured back, according to physical therapist Leslie Lawson.
Close to half of lower back pain cases can be linked to a minor accident or even simply strenuous movement. Often, the cause is not known. But exercise nearly always helps.
Lawson, of Cottonwood Hospital Back and Orthopedic, and Dr. Mark Passey, medical director in the pain program at Cottonwood Hospital and a physician at the Intermountain Spine Institute there, will answer questions about chronic back pain Saturday from 10 a.m. to noon during the Deseret Morning News/Intermountain Health Care Hotline.
Chronic back pain is most common in those 20 to 50 years old, most likely because those are very active years, said Lawson.
Most episodes of low back pain get better in a relatively short time. But folks who are looking for a quick fix are likely to find there isn't one. And even after the pain goes away, more than half of those who suffered it will have some sort of recurrence, Lawson said. That's why physical therapists try hard to teach patients ways to improve their body mechanics, as well as how to self-manage back pain so they'll know what to do if it comes back.
But how to treat back pain? There's no simple answer, she said.
"If you go to four different therapists, you might find they have four different treatment approaches," Lawson said. "There really haven't been any good studies done that prove one type of treatment or exercise is more effective than another."
The exception to that is aerobic exercise, which "has really been proven to make a difference and be the most effective," Lawson said. "Increasing aerobic capability increases endurance and the strength of the trunk muscles. Those are what's important in supporting the spine."
People who are fit are 10 times less likely to have lower back pain, compared to those who are less fit. They also have less chance of back pain recurrence, according to Lawson.
An active approach also minimizes the potential of lower back pain to become a chronic disability. And delivering oxygen-rich blood to injured tissue enhances healing.
There are ways to protect your back from injury, starting with maintaining a high level of fitness. Being your ideal body weight helps. Excess weight puts pressure on the spine. In fact, one of the treatments physical therapists use, called "unloading," involves reducing the weight on the spine, either using a machine or a swimming pool to provide some relief.
Smoking is a risk factor for back problems. Job satisfaction is a factor in recovery. One of the best ways to prevent back injury is to maintain good flexibility and use good body mechanics.
The first step with any back pain is a thorough evaluation to determine what movements or positions seem to aggravate or reproduce pain. Examination includes looking at strength, reflexes and sensations. Then a treatment plan can be drawn up. Lawson said listening to the patient is probably the key component of effective assessment.
No one plan works for back pain. It must be tailored to the individual.
Besides surgeries and medications, tools such as electric stimulation and ultrasound may be used, usually for acute pain. Physical therapists also teach "stabilization," showing the patient how to hold the lumbar spine and pelvis in a neutral position by tightening the deeper abdominal and back muscles and holding them, then working to strengthen those muscles.