Back pain again: new studies

Sixty-rive million Americans suffer from chronic lower back pain. Recurring back pain often creates what researchers call “spiral of decline:” you take to your bed or couch because of the pain. This inactivity weakens muscles and joints, leaving your back and core even more feeble which then leads to more pain and more inactivity—and so on.

A new study of back pain, published in JAMA Internal Medicine, began by looking at 6000 previously-published studies on the topic of back pain prevention. Of this number, they found only 23 studies that they considered to be reliable. Those 23 studies looked at 30,000 people with back pain. The prevention techniques under review included education about lifestyle changes, shoe orthotics, back belts, various types of exercise programs, and exercise programs that also included some type of education about back pain prevention. 

Here’s what they found: educational efforts alone, back belts, and orthotics were almost completely ineffective. But exercise programs, either with or without an educational element, proved to be effective in preventing recurrences of back pain. In fact, according to one researcher, “the size of the protective effect” from exercise “was quite large.”  Exercise combined with education reduced the risk of an episode of low back pain in the next year by 45 percent. “Of all the options currently available to prevent back pain, exercise is really the only one with any evidence that it works.”

Interestingly, the type of exercise program didn’t matter: some regimens focused on strengthening muscles in the core and back; others combined aerobic conditioning with strength and balance training. But here’s the rub: stopping the exercise regimen will also halt its protective effects.

A technique called “mindfulness-based stress reduction” also works for some people. It’s a combination of meditation, body awareness and yoga and focuses on increasing awareness and acceptance of one’s experiences, whether they involve physical discomfort or emotional pain. The trick with this one is to find a certified instructor.

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