Back Pain and Exercise

In September 2021, a Cochrane review was published regarding exercise for treatment of chronic low back pain. Cochrane is a group of well respected members of the scientific community who use sophisticated methodologies, including systematic reviews and meta analyses, to determine weather various treatments are likely to be effective. Because new studies are continually added to the overall evidence base, advice can change over time. However, very consistently, exercise has demonstrated that it is effective as a healthcare intervention for various conditions, including chronic low back pain.

There are different types of low back pain. Some low back pain can be acute in nature and once off. Most people recover from episodes of acute low back pain without treatment.

Other types of back pain can be episodic in nature. Typically, this condition is life-long and tends to come and go over time. Hence it is episodice. It may pass with some time; or, interventions from a healthcare practitioner, such as a chiropractor, can be beneficial from time to time when the condition flares.

In any case, there are many benefits to ongoing healthy lifestyle choices such as exercise. Patients can be assured that exercise is beneficial for many health conditions, including low back pain. And there is no single "right" type of exercise for everyone. It tends to be an individual choice based on interests, goals, time, comfort and a variety of other factors. If you have any questions about the type of exercise you are doing or interested in doing, you can be reassured that we can help you work through it together. But in the mean time, if you do have an interest in increasing your physical activity, and also have a history of chronic low back pain, feel reassured that exercise is a good health decision that will be safe, effective and good for your body.

Key messages from the authors:

"- Exercise probably reduces pain compared to no treatment, usual care or placebo in people with long-lasting (chronic) low back pain.

- Exercise may reduce pain and improve disability compared to common treatments such as electrotherapy or education."

Interestingly, though, manual therapy still pans out as a comparable treatment: "Subgroup analysis suggested that exercise treatment is probably more effective than advice or education alone, or electrotherapy, but with no differences observed for manual therapy treatments." Hence, it may be helpful to combine manual therapy (such as chiropractic adjustments, dry needling, massage) to reduce pain and improve function, with exercise. It is important to provide relief, quickly, and in a contextual, implementable and pragmatic way.

Cochrane reviews are open access. More about this particular study can be read at the link below.

• Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD009790. DOI: 10.1002/14651858.CD009790.pub2.