Regular Physical Exercise for Prevention and Treatment of Low Back Pain: A Systematic Review
Introduction: Low back pain is one among the main health problems during life time with a high prevalence, which causes functional loss and reduced productivity. Low back pain specifically affects the lumbar region of the spine. The pain is usually related with mostly muscle tension, and often limits our range of movement. Low back pain (LBP) is a common problem involving the muscles, nerves, and bones of the back. Objective: The purposes of this review study are to describe about low back pain and to examine the most recommended exercise for prevention and management of low back pain, to review scientific evidence on the effect of physical exercise on low back pain and to review the risk factors which lead to develop low back pain. Methods: The review of related literature search strategy were used the terms in relation with LBP and exercise, exercise prescription for LBP, exercise testing for LBP, recommended exercise for LBP, the effect of exercise on back pain and etc. A search was conducted in the following databases: online research databases, web of knowledge, and science direct, sport discus, Google scholar and from other relevant citations. Results: Based on LBP analysis and outcome functions, can be categorized as acute (<6 wk), sub-acute (6-12 wk), and chronic. Risk factors associated with low-back pain include age greater than 34 years, degenerative diseases such as arthritis or osteoporosis, a family or personal history of back pain or trauma, a sedentary lifestyle, low job satisfaction, and low socioeconomic status, excess body weight, psychological stress or depression and physically hard work. Common symptoms of LBP: pain that is dull or achy, contained to the low back, stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet, muscle spasms and tightness in the low back, pelvis, and hips, pain that worsens after prolonged sitting or standing, difficulty standing up straight, walking, or going from standing to sitting and pain that worsens with bending, lifting, standing or walking. Regular exercise particularly endurance and stretching exercises such as walking, biking, and swimming, has the good evidence of efficacy among exercise regimen, whether for whom with acute, sub-acute, or chronic low back pain. Generally, to reduce and manage LBP following low-impact endurance, strength and stretching regular exercises are advised.
Regular Physical Exercise for Prevention and Treatment of Low Back Pain: A Systematic Review, American Journal of Sports Science.
Vol. 8, No. 3,
2020, pp. 73-80.
Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet. 2012; 379 (9814): 482-91.
Van Tulder M, Becker A, Bekkering T, et al. (2006). European guidelines for the management of acute nonspecific low back pain in primary care. EurSpineJ. 15 (Suppl2): s169-91.
Almoallim H, Alwafi S, Albazli K, Alotaibi M, Bazuhair T. (2014). A simple approach of low back pain. Intern J Clin Med. 5: 1087-98.
Finestone AS, Raveh A, Mirovsky Y, Lahad A, Milgrom C. (2009). Orthopaedists’ and family practitioners’ knowledge of simple low back pain management. Spine (PhilaPa1976). 34 (15): 1600-3.
Freeman MD, Wood ham MA, Woodham AW. (2010) The role of the lumbar multi fidusin chronic low back pain: review. PMR. 2 (2): 142-6.
Koes BW, van Tulder M, Lin CW, Macedo LG, McAuley J, Maher C (2010). "An updated overview of clinical guidelines for the management of non-specific low back pain in primary care". European Spine Journal. 19 (12): 2075-94. doi: 10.1007/s00586-010-1502-y.PMID20602122.
Hoy D, Bain C, Williams G, et al. (June 2012). "A systematic review of the global prevalence of low back pain". Arthritis Rheum. 64 (6): 2028-37. doi: 10.1002/art.34347.PMID22231424.
Casazza, BA (2012). "Diagnosis and treatment of acute low back pain". American Family Physician. 85 (4): 343-50. PMID 22335313.
Manusov EG (2012). "Evaluation and diagnosis of low back pain". Prim. Care. 39 (3): 471-9. doi: 10.1016/j.pop.2012.06.003. PMID 22958556.
Salzberg L (2012). "The physiology of low back pain". Prim. Care. 39 (3): 487-98. doi: 10.1016/j.pop.2012.06.014.PMID22958558.
Menezes Costa Lda, C; Maher, CG; Hancock, MJ; McAuley, JH; Herbert, RD; Costa, LO (2012). "The prognosis of acute and persistent low-back pain: a meta-analysis". Canadian Medical Association Journal. 184 (11): E613-24. doi: 10.1503/cmaj.111271.PMC3414626.PMID22586331.
Deyo, RA; Mirza, SK; Turner, JA; Martin, BI (2009). "Over treating Chronic Back Pain: Time to Back Off?". Journal of the American Board of Family Medicine: JABFM. 22 (1): 62-8. doi: 10.3122/jabfm.2009.01.080102.PMC2729142.PMID19124635.
Chou R, Qaseem A, Snow V, et al (2007). Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 147: 478-91.
Delitto A, George SZ, Van Dillen LR, et al. (2012) Low back pain. J Orthop Sports PhysTher. 42 (4): A1-57.
University of Michigan Health System (2010). Acute Low Back Pain. Ann Arbor (MI): University of Michigan Health System; p. 16.
Work Loss Data Institute (2013). Low Back-Lumbar and Thoracic (Acute and Chronic). Encinitas (CA): Work Loss Data Institute.
Puentedura EJ, Louw A. (2012) A neuroscience approach to managing athletes with low back pain. Phys Ther Sport; 13 (3): 123-33.
Louw A, Diener I, Butler DS, Puentedura EJ. (2011) The effect to neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 92 (12): 2041-56.
Moseley GL. (2004). Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomized controlled trial. Pain. 108 (1-2): 192-8.
Samanta J, Kendall J, Samanta A. (2003). 10-minuteconsultation: chronic low back pain. BMJ. 326 (7388): 535.
Thomas D. Fahey, Paul M. Insel and Walton T. Roth(2011). FIT&WELL: Core Concepts and Labs in Physical Fitness and Wellness, 9th ed., McGraw-Hill, New York.
Airaksinen O, Brox JI, Cedraschi C, et al. (2006). European guidelines for the management of chronic nonspecific low back pain. EurSpineJ. 15 (Suppl2): S192-300.
Toward Optimized Practice. (2011).Guideline for the Evidence-Informed Primary Care Management of Low Back Pain. Edmonton, Alberta (Canada): Toward Optimized Practice; 2011. p. 21.
Simmonds MJ, Goubert L, Moseley GL, Verbunt JA. (2006). Moving with pain. In: Flor H, Kalso E, Dostrovsky JO (2006). Proceedings of the11th World Congress on Pain, Sydney, Australia, August 21-26, 2005. Seattle (WA): IASP Press; p. 799-811.
Hasenbring MI, Hallner D, Klasen B, Streitlein-Böhme I, Willburger R, Rusche H. (2012). Pain-related avoidance versus endurance in primary care patients with sub-acute back pain: psychological characteristics and out come at a 6-month follow-up. Pain. 153 (1): 211-7.
Ratter J, Radlinger L, Lucas C. (2014). Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review. J Physiother. 2014; 60 (3): 144-50.
Hasenbring M, Hallner D, Rusu A. (2009). Fear-avoidance-and endurance-related responses to pain: Development and validation of the Avoidance-Endurance Questionnaire (AEQ). Eur J Pain; 13 (6): 620-8.
Verbunt JA, Smeets RJ, Wittink HM. (2010). Cause or effect? Deconditioning and chronic low back pain. Pain. 149 (3): 428-30.
Hodselmans A, Dijkstra P, Geertzen J, vander Schans C. (2008). Exercise capacity in non-specific chronic low back pain patients: a lean body mass-based A strand bicycle test; reliability, validity and feasibility. J OccupRehabil. 18 (3): 282-9.
Smeets R, van Geel K, Verbunt J. (2009). Is the fear avoidance model associated with the reduced level of aerobic fitness in patients with chronic low back pain? Arch Phys Med Rehabil; 90 (1): 109-17.
Smeets R, Wittink H, Hidding A, Knottnerus J. (2006). Do patients with chronic low back pain have a lower level of aerobic fitness than healthy controls? Is pain, disability, fear of injury, working status, or level of leisure time activity associated with the difference in aerobic fitness level? Spine. 31 (1): 90-7.
Fortin M, Macedo L. (2013). Multifidus and para spinal muscle group cross-sectional areas of patients with low back pain and control patients: a systematic review with a focus on blinding. PhysTher. 93 (7): 873-88.
Hides J, Stanton W, Mendis M, Sexton M. (2011). The relationship of transverses abdomen is and lumbar multifidus clinical muscle tests in patients with chronic low back pain. ManTher. 16: 573-7.
Davarian S, Maroufi N, Ebrahimi I, Farahmand F, Parnianpour M. (2012). Trunk muscles strength and endurance in chronic low back pain patients with and without clinical instability. J Back MusculoskeletRehabil; 25 (2): 123-9.
McGregor AH, Hukins D. (2009). Lower limb involvement in spinal function and low back pain. J Back Musculoskelet Rehabil. 22 (4): 219-22.
Hegmann KT. Low back disorders. (2011). In: Hegmann KT, editor. Occupational Medicine Practice Guidelines. Evaluation and Management of Common Health Problems and Functional Recovery in Workers. 3rded. Elk Grove Village (IL): American College of Occupational and Environmental Medicine; p. 333-796.
Bouwmeester W, van Enst A, van Tulder M. (2009). Quality of low back pain guidelines improved. Spine. 34 (23): 2562-7.
Majewski-Schrage T, Evans TA, Ragan B. (2014). Development of a core-stability model: a Delphi approach. J Sport Rehabil. 23 (2): 95-106.
Marshall PW, Desai I, Robbins DW. (2011). Core stability exercises in individuals with and without chronic nonspecific low back pain. J Strength Cond Res. 25 (12): 3404-11.
McGill SM, Karpowicz A (2009). Exercises for spine stabilization: motion/motor patterns, stability progressions, and clinical technique. Arch Phys Med Rehabil. 2009; 90 (1): 118-26.
Rainville J, Childs L A, Peña EB, et al. Quantification of walking ability in subjects with neurogenic claudication from lumbar spinal stenosis-a comparative study. Spine J. 2012; 12 (2): 101-9.
Sullivan M, Shoaf L, Riddle D. The relationship of lumbar flexion to disability in patients with low back pain. Phys Ther. 2000; 80 (3): 240-50.