“At present, a variety of interventions, such as exercise, education, back belts and shoe insoles, are commonly prescribed to prevent an episode of low back pain,” said lead author Daniel Steffens of the University of Sydney in Australia.
But the effectiveness of these various interventions for low back pain hasn’t been clear, Steffens told Reuters Health by email.
The researchers reviewed 23 published reports of prevention strategies for nonspecific low back pain, including 21 randomized controlled trials.
In many cases, structured exercise programs lowered the risk of later episodes of low back pain. Lower quality evidence suggested that these programs might also reduce later use of sick leave from work.
There was no good quality evidence that other options, like back belts or shoe insoles, helped prevent pain, the authors reported in JAMA Internal Medicine.
“There was some variation, but in general trials included exercises to improve strength, flexibility, skill and aerobic fitness,” Steffens said. “The exercises did not just focus on the spine but included upper and lower limb exercises as well.”
Most trials had participants do two to three exercise sessions per week at the clinic plus at-home exercises, for eight weeks to 18 months.
“Regular exercise develops your muscles, bones and ligaments for increased strength and endurance,” Steffens said. It also helps with weight control, delays the aging process and reduces stress, “some of the main risk factor for low back pain,” he added.
Back pain is 25 to 33 percent less likely to recur for people who adhere to a structured exercise program, said Dr. Timothy S. Carey of the University of North Carolina at Chapel Hill, who coauthored a commentary accompanying the new results.
“Eighty percent of us will have back pain at some point in our lives,” Carey told Reuters Health by phone. “Most will get over it in a few days or weeks, but exercise appears to be a good thing in terms of prevention.”
Back pain is costly to the healthcare system and preventing it with exercise would be cost-effective for insurers, he said.
“It seems to matter less exactly what type of exercise you do than that you do it in a regular way,” he said.
People should do the type of exercise they are most likely to sustain, he said.
Professional societies should take a closer look at what exercise programs work and issue clear recommendations that will be easier for people to follow, he said.
“Simply telling somebody to go exercise isn’t likely to work,” he said.