 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Best Types of Exercise for Low Back Pain
3 May 2005 | Volume 142 Issue 9 | Page I-72
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The summary below is from the full report titled "Systematic Review: Strategies for Using Exercise Therapy To Improve Outcomes in Chronic Low Back Pain." It is in the 3 May 2005 issue of Annals of Internal Medicine (volume 142, pages 776-785). The authors are J.A. Hayden, M.W. van Tulder, and G. Tomlinson.
What is the problem and what is known about it so far?
Chronic low back pain is a common problem that causes discomfort and disability. Treatment goals include decreasing pain and helping patients resume their normal activities. Treatment options include exercise therapy, patient education, and pain-relieving drugs (such as nonsteroidal anti-inflammatory drugs). There are many forms of exercise therapies, and we do not know which particular types best improve outcomes.
Why did the researchers do this particular study?
To see which types of exercise therapies reduce pain and improve physical function in adults with chronic low back pain.
Who was studied?
Adults with chronic low back pain who participated in 43 trials of exercise therapy.
How was the study done?
The researchers searched the medical literature up to October 2004 to find randomized, controlled trials that compared exercise therapy with placebo, no treatment, conservative management, or another exercise group. They classified the types of exercises that made up the interventions. They also looked at several characteristics of the exercise therapy interventions, including whether they were delivered as group or as individual programs and whether they were supervised or done independently without supervision. They then combined data from the trials to explore which exercises reduced pain and improved physical function.
What did the researchers find?
Stretching and strengthening were the most effective exercises for improving pain and function, respectively. Exercise performed over longer periods of time seemed more effective than exercise involving less than 20 hours of total time. Also, supervised programs that were individually tailored seemed most effective.
What were the limitations of the study?
Studies used different ways to measure pain intensity and function. Some studies were small and of low quality. Although the researchers thoroughly searched for evidence, they may have missed unpublished exercise trials with pertinent evidence.
What are the implications of the study?
Stretching and strengthening exercises that are tailored to the individual and supervised by professionals may be the best forms of exercise therapy for adults with chronic low back pain.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  D. A Browder, J. D Childs, J. A Cleland, and J. M Fritz Effectiveness of an Extension-Oriented Treatment Approach in a Subgroup of Subjects With Low Back Pain: A Randomized Clinical Trial Physical Therapy, December 1, 2007; 87(12): 1608 - 1618. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Chou, A. Qaseem, V. Snow, D. Casey, J. T. Cross Jr, P. Shekelle, D. K. Owens, and for the Clinical Efficacy Assessment Subcommittee 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, October 2, 2007; 147(7): 478 - 491. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Chou and L. H. Huffman Nonpharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline Ann Intern Med, October 2, 2007; 147(7): 492 - 504. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. P Dawson, S. N McLennan, S. D Schiller, G. A Jull, P. W Hodges, and S. Stewart Interventions to prevent back pain and back injury in nurses: a systematic review Occup. Environ. Med., October 1, 2007; 64(10): 642 - 650. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. H.M. Pengel, K. M. Refshauge, C. G. Maher, M. K. Nicholas, R. D. Herbert, and P. McNair Physiotherapist-Directed Exercise, Advice, or Both for Subacute Low Back Pain: A Randomized Trial Ann Intern Med, June 5, 2007; 146(11): 787 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Hendry, N. H Williams, D. Markland, C. Wilkinson, and P. Maddison Why should we exercise when our knees hurt? A qualitative study of primary care patients with osteoarthritis of the knee Fam. Pract., October 1, 2006; 23(5): 558 - 567. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. H. Bridwell, P. A. Anderson, S. D. Boden, A. R. Vaccaro, and J. C. Wang What's New in Spine Surgery J. Bone Joint Surg. Am., August 1, 2006; 88(8): 1897 - 1907. [Full Text] [PDF]
|
|
|
|
 |
|
 E Ernst and P H Canter A systematic review of systematic reviews of spinal manipulation. J R Soc Med, April 1, 2006; 99(4): 192 - 196. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Moffett and S. McLean The role of physiotherapy in the management of non-specific back pain and neck pain Rheumatology, April 1, 2006; 45(4): 371 - 378. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Additional articles abstracted in ACP Journal Club Evid. Based Med., February 1, 2006; 11(1): 30 - 30. [Full Text] [PDF]
|
|
|
|
 |
|
 Evidence based journal watch Br. J. Sports Med., January 1, 2006; 40(1): 87 - 88. [Full Text] [PDF]
|
|
|
|
|
|
K. J. Sherman, D. C. Cherkin, J. Erro, D. L. Miglioretti, and R. A. Deyo Comparing Yoga, Exercise, and a Self-Care Book for Chronic Low Back Pain: A Randomized, Controlled Trial Ann Intern Med, December 20, 2005; 143(12): 849 - 856. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Hayden, M. W. van Tulder, A. V. Malmivaara, and B. W. Koes Meta-Analysis: Exercise Therapy for Nonspecific Low Back Pain Ann Intern Med, May 3, 2005; 142(9): 765 - 775. [Abstract] [Full Text] [PDF]
|
|
Read all Rapid Responses
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Article
