By Jack Rogers | Chiropractor
The traditional methods of rest and recovery have served us well in the past, or have they? In recent years, we in the health and medical community have come to understand the importance of maintaining activity during times of pain. There is a growing trend in current medical literature to supports this as an effective management strategy for chronic pain.
A common learned behaviour in both acute, and chronic pain, is a fear of movement. It can be difficult to stay active when you are in pain, and some people are worried about moving too much. Movement becomes associated with pain and injury. We now know this not the case in non-specific back pain (around 95% of all back pain cases), which has a multitude of precipitating factors: muscular imbalances, pain processing problems in the brain, stress and emotional tension, amongst others.
The take home message is this: If your health professional has excluded (uncommon) serious causes of your pain, there is no need to be afraid of movement.
Inadequate movement has a detrimental effect upon general health, core and stabilising muscles of the body, and can lead to increased pain in the long term. With this in mind, patients are usually advised to stay active and increase our physical exercise. Along with a change in physical activity, it is highly advisable not to let pain restrict your activities too much. Continue your daily life as naturally as you can.
In recent years, over one hundred studies have explored the use of exercise programs, making it one of the most studied treatment approaches in pain therapy. What’s more, the evidence shows exercise is one of the few interventions clinically proven to reduce back pain. One of the simplest forms of exercise is walking.
Walking is an essential human function. It is simple to do, carries a minor risk of injury, and is associated with a multitude of health benefits. The benefits of walking upon levels of acute low back pain are well documented:
- One study, in the European Spine Journal, reported a significant reduction in pain levels in a cohort of acute low back pain patients after a single session of 10 min walking at a self-selected speed
- Other research indicates that brisk walking (Nordic walking) assist in relieving back pain if done regularly – approximately every two days, for 30 to 60 minutes duration.
It is important to be aware it is not simply any movement, but the CORRECT movement that will assist in pain rehabilitation. At Pinnacle, We can help you to find a suitable type of exercise that is tailored to your condition, and that you enjoy. Exercise programs should be prescribed by a health professional with proper experience, and form part of a comprehensive rehabilitation plan.
You may need patience to start off with: It can take a few weeks for the exercise to have an effect. Your body must also adapt to extra movement. It is normal to experience some aches as your frame adapts out of chronic pain.
References
Lieberman, D. E. “The Human Gluteus Maximus and Its Role in Running.”Journal of Experimental Biology 209.11 (2006): 2143-155. Web.
Eur Spine J. 2010 Oct; 19(10): 1613–1620. Published online 2010 Apr 23. The effectiveness of walking as an intervention for low back pain: a systematic review. P. Hendrick, A. M. Te Wake, A. S. Tikkisetty, L. Wulff, C. Yap, and S. Milosavljevic.
Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M et al. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med 2017; 166(7): 493-505. [PubMed]
Medina-Mirapeix F, Escolar-Reina P, Gascon-Canovas JJ, Montilla-Herrador J, Collins SM. Personal characteristics influencing patients’ adherence to home exercise during chronic pain: a qualitative study. J Rehabil Med 2009; 41(5): 347-352. [PubMed]
Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CC, Chenot JF et al. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J 2018 [Epub ahead of print].
Saragiotto BT, Maher CG, Yamato TP, Costa LO, Menezes Costa LC, Ostelo RW et al. Motor control exercise for chronic non-specific low-back pain. Cochrane Database Syst Rev 2016; (1): CD012004. [PubMed]
Sitthipornvorakul E, Klinsophon T, Sihawong R, Janwantanakul P. The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials. Musculoskelet Sci Pract 2018; 34: 38-46. [PubMed]
Steffens D, Maher CG, Pereira LS, Stevens ML, Oliveira VC, Chapple M et al. Prevention of Low Back Pain: A Systematic Review and Meta-analysis. JAMA Intern Med 2016; 176(2): 199-208. [PubMed]
Vanti C, Andreatta S, Borghi S, Guccione AA, Pillastrini P, Bertozzi L. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials. Disabil Rehabil 2017 [Epub ahead of print].
Wieland LS, Skoetz N, Pilkington K, Vempati R, D’Adamo CR, Berman BM. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev 2017; (1): CD010671. [PMC free article] [PubMed]
Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RW, Cabral CM et al. Pilates for low back pain. Cochrane Database Syst Rev 2015; (7): CD010265. [PubMed]
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Low back pain: Why movement is so important for back pain. 2012 Feb 9 [Updated 2019 Feb 14]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK284944/
