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Low Back Pain| Exercise| Trigger points

Posted Nov 17 2009 10:00pm

Sunday, August 16, 2009

Low back pain (LBP) is one of the most costly conditions to manage in occupational health. Individuals with chronic or recurring LBP experience difficulties returning to work due to disability. Given the personal and financial cost of LBP, there is a need for effective interventions aimed at preventing LBP in the workplace. The aim of this systematic review was to examine the effectiveness of exercises in decreasing LBP incidence, LBP intensity and the impact of LBP and disability.

A meta-analysis performed on controlled trials published between 1978 and 2007 showed that there was strong evidence that exercise was effective in reducing the severity and activity interference from LBP.

However, due to the poor methodological quality of studies and conflicting results, there was only limited evidence supporting the use of exercise to prevent LBP episodes in the workplace. Only 2 out of the 15 studies reviewed were high in methodological quality and showed significant reductions in LBP intensity with exercise. Future research is needed to clarify which exercises are effective and the dose-response relationships regarding exercise and outcomes. (Bell JA, Burnett A: Exercise for the primary, secondary and tertiary prevention of low back pain in the workplace: a systematic review. Journal of Occupational Rehabilitation. 19(1):8-24, 2009)

My own focus in preventing and treating low back pain is in the role of exercise localized to multiple individual muscles of the low back and lower limbs. This is a new concept derived from electrically stimulating nerves at trigger points. Mechanical stimulation can be done as for example as with a massage but is not suitable for reaching and stimulating deep trigger points.

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