Stretching Is the Key to Curing Backaches : Health: Doctors changing prescriptions from traditional rest and drug therapy to aggressive exercise.
We all know about the country’s budget deficit--but what about the back-pain deficit? As you read this, 31 million Americans are experiencing back pain, at an annual cost of $16 billion in medical treatments and disability payments. The additional cost to the economy in lost workdays is tens of billions of dollars.
That’s a lot of aching backs--and wallets. That’s a lot of worried people, too, because once injured, a back is four times more likely to get hurt again.
The latest advice from the leading back clinics, however, is to stop worrying and start stretching and strengthening your back muscles. Experts estimate that between 70% and 90% of back pain is caused by muscle or ligament problems, usually related to weakness in the lower back, rather than by serious damage to the spine itself. In most cases, the problem clears up on its own within a few weeks. The pain is very likely to return, though, if the underlying weakness isn’t corrected.
“In the United States, most doctors treat the pain, not the underlying disorder that caused the pain,” said Dr. David Imrie, director of the Back Care Centre in Toronto and co-author of “The Back-Power Program” (John Wiley & Sons, 1990, $9.95). “Then these people go back to their lifestyle impaired and end up hurting themselves again.”
Today, the name of the game is muscle rehabilitation.
“We’re in much the same place that cardiac rehabilitation was in the early 1970s, when doctors told heart patients to avoid all activity,” said Dr. Ted Dreisinger, director of research at the Columbia Spine Center in Missouri. “Back treatment programs are now changing from traditional rest and drug therapy to a new approach of aggressive exercise.”
Here are the most recent findings:
* A “slipped disk”--the traditional catchall explanation for chronic back pain--actually accounts for less than 5% of back injuries. In fact, with the increased use of CT scans, doctors are now finding that many people have disk abnormalities, which often don’t contribute directly to pain.
* Most back pain is caused by muscles that go into spasm.
* Two days of bed rest are enough for most acute backaches, according to a new study in the New England Journal of Medicine. More than two days’ rest can further weaken muscles.
* In a groundbreaking study at the Seattle Veterans Affairs Medical Center, stretching exercises reduced pain as well as or better than a popular electrical nerve-blocking therapy known as TENS (transcutaneous electrical nerve stimulation).
* Only about 1% of people with back pain require surgery.
“There are almost 20 times more back operations per capita in the United States than Canada,” Imrie said. “And it isn’t because the results are so good. Surgery is definitely overdone.”
The key is to improve the strength of the back’s extensor muscles, which allow you to uncurl from a tucked position and stand upright. Exercise programs aim to loosen tight hamstrings and hips while stretching and building up the extensors.
Doctors are also searching for other ways to make the back work better. These include stress reduction--because emotional strain causes back muscles to tighten--and innovative new muscle therapies. Dr. Leroy Perry, a chiropractic orthopedist in Los Angeles who treats world-class athletes, has devised an intriguing new treatment in which the patient exercises in a pool while wearing a buoyant vest with weights suspended from the waist. The idea is to stretch the spine and attached muscles; Perry reports 80% to 85% improvement among his patients.
Clinicians are also giving high marks to the MedX back and neck machines (cost: $45,000 to $60,000 each), developed by Arthur Jones, inventor of the Nautilus weight machines. The back machine holds the patient’s pelvis down with restraining mechanisms controlled by a therapist. Once the lower body is immobilized, the patient, who is sitting in a tucked position, pushes backward with the upper body against a preset resistance, working just the lower back muscles.
Dr. Michael Pollock, director of the Center for Exercise Science at the University of Florida, prescribes one session a week (a mere 10 to 12 repetitions) on the back machine. His patients have been improving at a rate of 80%.
If back pain does strike, you’ll need to wait for the discomfort to subside before you begin to sculpt your back muscles. Dr. John Frymoyer, a professor of orthopedics at the University of Vermont, suggests taking the following steps to relieve a backache:
* See a doctor and have a physical. Most patients don’t need X-rays; a few simple questions will determine those who do.
* Stay active if you can. If you must, take a day or two of bed rest.
* Resume physical activity as soon as possible. Choose a low-impact aerobic activity, such as walking, bicycling or swimming.
* Use medications judiciously.
