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Exercise and Low Back Pain

Studies so far haven't been able to show any specific type of exercise helps patients with back pain. Doctors advise patients to stay active and get back to normal routines as soon as possible.

Some researchers think studies of exercise have lumped all back pain patients together. Everyone is given the same exercises and that's why exercise programs don't seem to be helping. It's possible each patient needs a specific exercise program based on which movements cause pain.

In this study patients were divided into two main groups. The directional preference (DP) group reported pain every time they moved in one direction. This group was further divided based on which direction made the pain better. The second group(no DP) didn't seem to have pain caused by or relieved by a direction of movement.

Three types of exercise were given. Some patients got exercises matching their DP. Others did exercises in the opposite direction of their DP. A third group was given general exercises to include movement in all directions. Everyone in all three groups worked with a physical therapist for three to six visits over a two-week period of time.

The authors report a large number of patients dropped out of the study. One-third of the opposite direction and non-direction groups withdrew because they were no better or they were worse than when they started the program. Overall the rest of the patients in all groups improved. Patients in the matched DP had the best results. Patients who did movements in the opposite (painful) direction had the worst results.

According to the results of this study, patient activity and education are the way to treat low back pain. Instruction in these areas should match the patient's DP for the best results.

References: Audrey Long, BScPT, et al. Does It Matter Which Exercise? In Spine. December 1, 2004. Vol. 29. No. 23. Pp. 2593-2602.

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