Preventing Chronic Low Back Pain

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Finding relief from chronic low back pain can be a challenge! While many patients can be treated non-operatively, some patients undergo spine surgery. What if it was possible to prevent some types of low back pain? Undoubtedly, if you could prevent low back pain, you would!Man holding his low back with a pained expressionPreventing low back pain is something doctors and researchers have been exploring. Preventing low back pain is something doctors and researchers have been exploring. One study, published in the American College of Sports Medicine's journal, Medicine and Science in Sports and Exercise, explains how a lumbar extension exercise program is effective in preventing low back pain.

Back Rehab History
From the 19th century up to today, the goal has remained the same; return the patient to a normal functional level. Strengthening exercise may have been part of physical therapy, but not in general conditioning. Soon the idea of exercising an isolated muscle group against a resistive force was developed. In the 1940's, PRE or Progressive Resistance Exercise was introduced. The principles of PRE treated back pain, weak muscles, degenerative joint disease, and low back strains. Further developments progressed including creating equipment and machines to build strength, endurance and flexibility.

Pelvic stabilization was recognized as important to accurately measure the strength of the lumbar extensor muscles. These muscles attach to the back of the spine to keep the body upright and assist in movement such as when standing or lifting. The problem was that exercise equipment and machines designed to strengthen these muscles were ineffective in keeping the pelvis stable (fixed). The MedX Lumbar Extension machine is different as it effectively stabilizes the pelvis and isolates the lumbar muscles.

Spinal Rehab Today
Some spine rehabilitation programs use the MedX machines to help patients return to a normal functional level. Research shows how lumbar extension exercise using progressive resistance increases strength and reduces low back pain. The benefits are long-lasting and include greater muscle strength, increased bone density, endurance, and flexibility. Studies reveal that patients who strengthen their low back muscles "show promise" to reduce future back injuries.

Featured Journal Article
Carpenter DM, Nelson BW. Low Back Strengthening for the Prevention and Treatment of Low Back Pain. Medicine and Science in Sports and Exercise. Vol. 31, No. 1, 1999.

Updated on: 11/14/17
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Gerard Malanga, MD
This is a very interesting article as it demonstrates that strengthening core muscles with a specific device can be helpful in the prevention of low back pain episodes. Previous studies in this area of core strengthening in athletes did not demonstrate a reduction in low back pain. (See Nadler, Malanga et al, Medicine & Science in Sports & Exercise, 2002). Given how common low back pain is with its costs to individuals, healthcare, and society in general; anything that can help to reduce its occurrence is quite exciting. In addition, there is already evidence to show that patients that have low back pain from a variety of diagnoses can safety strengthen their spine, improve their function, and very often reduce their pain. This treatment is significantly underused in the treatment of patents due to unrealistic and unnecessary precautions by practitioners and fear and lack of motivation by patients. However, the evidence of effectiveness exists for this treatment which is noninvasive, cost effective, and without negative side effects. Perhaps it is just too low tech and old fashioned for many of us.
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