Care for patients with low back pain (LBP) has evolved over the years. Many changes have occurred. Most of these changes are the direct result of research and scientific investigation.
Back schools were very popular in the 1970s. Postural training and patient education were the main focus of this treatment. Patients learned about their own anatomy and how the back works. Various ways to lift properly and safely were also part of the back school concept.
By the end of the 1980s, the role of physical deconditioning was recognized. Back care programs changed to include functional restoration programs (FRPs).
FRPs were based on the idea that deconditioning develops as a result of inactivity from LBP. The FRP was designed to improve spinal flexibility and muscle strength. There was also an aerobic component to improve endurance and reduce depression and anxiety. Psychologic and occupational counseling were also included.
In the 1990s, the focus of back care has shifted again. Ergonomics became the new direction of treatment. Ergonomics refers to designing tasks and work areas to maximize efficiency and work quality for workers. The idea of improving ergonomics has also impacted sports and leisure activities.
Today scientists are sorting through all of the components of back care. They are looking for what works for each individual patient. Some may need endurance training while others need strengthening. If testing shows good strength, endurance, and flexibility, then the patient may need more of a psychologic approach.
Throughout all the years, one thing is clear. Exercise reduces pain and improves mood. It’s not clear just yet if one type of exercise is better than another. It appears that patients benefit no matter what type of exercise is followed.