Gym or no Gym for Low Back Pain?

Comment

Comment by Erik Dalton, Ph.D. on November 1, 2009 at 4:34pm

Do any of you teach core stability exercises to your clients with low back pain? Like to hear your take on the core-stability controversy...

Comment by Erik Dalton, Ph.D. on November 1, 2009 at 9:12am

I'm familiar with Cold Laser and have had clients offer favorable reports for certain types of minor chronic pain. Never been personally exposed to it but will probably need it after sitting at this computer all day.

Thx for the heads up on Blue Manna...will give it a try. I've been a big user of various algae products over the years....wonderful stuff.

Comment by Gloria Coppola on October 31, 2009 at 9:58pm

Erik, Are you familiar with the Quantum Cold Laser? My father in law recently purchased one and has been using it on the family. It seems to alleviate pain very nicely . I can get more info, if you or anyone else is interested. Even my dogs hip pain has subsided for a week.

I agree, we need movement of some sort. Which is why I never gave up! I never took pain meds either.
I did use a product called Blue Manna, a derivative of blue green algae by a company called Ancient Sun. It has 2 amino acids, PEA and phycocyanin. Very effective for pain /inflammation. Got many of my clients off Ibuprophen and Alleve, including my mother in law who was on 18-20 IBuprophens daily for pain. OMG!

Keep up the great work!!!

Comment by Erik Dalton, Ph.D. on October 31, 2009 at 1:45pm

Personally, I believe society needs to think about cutting out some of the excessive and sometimes exaggerated language about back pain...particularly in medical journals, the mass media, and health care setttings.

Back pain is rarely described in sober or understated terms such as a "twinge in the lower back," or "tolerably uncomfortable." Instead we hear nouns such as "agony" and "suffering," and adjectives such as "terrible", "unbearable", "crippling",...or... "my back's killing me."

Those of us who write about back pain might do well to heed this quote from the late, great Swedish spinal research pioneer Alf Nachemson, MD, PhD, "Back pain is an overrated discomfort. Patients make too much of it. So do medical professionals. We live in a society that dreams of a pain-free life but that's not going to happen. Back pain is a normal part of living and shouldn't be the focus of life. It shouldn't be disabling but should be thought of as something that will come and go like the common cold without causing permanent damage."

Calming down the back pain rhetoric with our clients helps calm unwarranted fears of impending gloom and looming catastrophe. Noted pain specialist Dennis Turk, PhD, believes that "since fear is a natural consequence of pain, pain-related anxiety and fear may actually accentuate the painful experience in many chronic pain cases". If clients with pain are exposed to fearful situations, they typically respond with either unnecessary worry or escapist behavior to avoid any anticipated harm.

Avoidant behavior can sometimes be useful in the context of acute pain but loses beneficial quality in a chronic pain setting. Reliance on the acute model of pain in chronic pain cases is inappropriate. For example, leading the client to believe that activity might aggravate the initial injury and cause more harm can result in fear of engaging in rehabilitative efforts. This can lead to obsessive mental preoccupation with bodily symptoms and physical deconditioning that only exacerbate the pain...thus causing the client to maintain the disability.

Comment by Erik Dalton on October 28, 2009 at 6:55am

I seriously doubt if the research group used the typical 'weekend-trained' personal trainers we see in most health clubs here in America. Unfortunately, that's what most who join health clubs end up with.

I believe the only point to the study is that whole body resistance training affects a greater range of the body's soft tissues than health club aerobic equipment. This is not a rocket science research project and I think it would be pretty hard to design and control a study that included dozens of different modalities.

Here's how Kell summarizes it:

"The study showed a 60 per cent improvement in pain and function levels for people with chronic backache who took part in a 16-week exercise program of resistance training using dumbbells, barbells and other load-bearing exercise equipment. People who chose aerobic training such as jogging, walking on a treadmill or using an elliptical machine to ease their back pain only experienced a 12 per cent improvement said Robert Kell, professor of exercise physiology at the University of Alberta."

"Any activity that makes you feel better is something you should pursue, but our research indicates that people generally get better pain management results from resistance training. The extra benefits stem from using the whole-body approach required in resistance training, We tried to strengthen the entire body and by doing that, decreased the fatigue people felt throughout the day. The weight-training group were better able to perform their activities of daily living compared to the aerobics group whose training focused more on the lower body, he added." The findings are to be published in early 2009 in the Journal of Strength and Conditioning Research.

Comment by Stephen Jeffrey on October 28, 2009 at 3:30am

As a general statement yes I have to agree the correctly supervised use of the gym in the majority of cases is going to help reduce back pain.
The bug in the system is the quality/consistancy of the supervision and of course the prior assement of the suitability of the individual to undertake said gym work.
When you look around your gym what do you see? gym staff chatting whilst 2 meters away someone is doing thier best to injure themselves ? diabolical techique = potential clients ?
If ever there was a chance for a holistic wellbeing approach surely its at your gym = assesment/treatment/quality personal training? and nutrition and ect ect

Comment by Mike Hinkle on October 28, 2009 at 12:49am

To what degree of pain (mild to ?) was the control group chronic? Was any of the pain caused just from lack of exercise? What were their ages? Would love to see more studies. Sidebar: Love the Back 2 Life Unit, Gloria spoke of, that and the "Eye Port" are two great inventions!

Comment by Erik Dalton, Ph.D. on October 27, 2009 at 7:59pm

Hey Gloria:
Actually, I haven't offered an opinion and really don't have one. Just thought Dr. Kell's findings were interesting. Google him and check out his research on the subject. It seems to be a well-designed and relatively well-controlled study.

Was just wondering how many bodyworkers recommend activity for their low back pain clients/patients.

Many recent studies have debuked the old adage of "bedrest" for the weary back and have instead switched to position of "carry on with your normal everyday activities". However, this is the first legit research I've seen that actually demonstrates that 'gym work' can improve low back pain. Personally, I don't find that weight training does much to improve my low-grade back problem but seems to work well when combined with bodywork, stretching and running.

Comment by Gloria Coppola on October 27, 2009 at 6:41pm

While I would love to agree with you Erik, I have suffered severe low back problems. I used to exericse quite frequently and had a fitness trainor twice a week. Also did yoga and pilates. Once I had my injury, not even yoga helped as I would get 'stuck' in positions and not be able to move, literally would crawl to a wall to help myself. I couldn't claim 3 stairs or get out of bed in the morning w/o severe pain.

How did I heal my back pain? Obviously some "skilled" bodyworkers. Then I purchased a Sleep Number bed which I tell all my clients about. I woke up the next morning and literally jumped up and out of bed. Something that hadn't happened in 3 years.

Then I was able to start walking on level ground w/o pain. Yeah.

I also purchased the Back 2 life machine, developed by a physician. I love it. Gentle on my back, opens the deep abdominals and lower lumbo-sacral region. Doesn't hurt at all. These are some of the things I can tell my clients about and not be out of my scope of practice.