Patients who stay active despite back pain recover faster, study says

Sep 21 2011
Rest and relaxation may not be the best treatments for acute back pain. On the contrary, patients who keep moving despite their pain can recover more quickly than those who don't, new research says.

Back pain is the second most common neurological condition, according to the Centers for Disease Control and Prevention (CDC); only headaches are more frequent. Eighty percent of Americans will experience back pain at some point in their lives. Data compiled by the CDC shows that more than a quarter of adults reported having lower back pain within the prior three months of being surveyed. Up to half of these people also had difficulty concentrating, moving, working or interacting socially.

The most common type of back pain is acute pain, according to the National Institute for Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a division of the National Institutes of Health. Acute back pain comes from sudden injuries, such as having a fall or lifting an object that is too heavy. These conditions should resolve by themselves within six weeks with the help of pain medication.

Exercise is generally not recommended for acute injuries, though doctors usually tell patients to go about their daily lives as normally as possible. Researchers from Sweden wanted to see what would happen if they tweaked this recommendation by advising one group of patients to work and move through their pain, and telling another to move as much as their pain would allow them.

More than 100 patients with acute lower back pain participated in the study. The researchers randomly told individuals to either "stay active even though it hurts" or "adjust your activity to the pain." The subjects also kept a diary for seven days to monitor their level of activity and how their body felt. A separate document recorded whether they were experiencing depression.

The results, published in The Clinical Journal of Pain, showed that patients in the more active group recovered faster and did not develop depression compared to the other patients, who became slightly depressed.

Based on the investigation, the researchers speculate that either depressed people perceive pain more severely, or that the perception of pain as severe makes patients less willing to move.

"If you don't keep moving, it's easy to get locked into a downward spiral, as inactivity combined with pain can, in a worst case scenario, turn into long term disability and an inability to work that, in turn, can lead to depressed mood and more pain," said study author Patricia Olaya-Contreras. She hopes this research will empower patients with acute lower back pain to take charge of their condition and successfully handle their pain.

There are several things people can do to help avoid back pain, according to NIAMS. Back muscles can be strengthened through exercises such as weight training, tai chi or yoga, which also increase balance. Proper lifting techniques in which most of the weight is borne on one's hips and legs will help prevent injuries. A diet rich in vitamin D and calcium helps to keep the bones of the spine healthy and strong.