Exercise Can Help Prevent, Reduce, Even Eliminate Lower Back Pain, Study Finds

Back-supporting belts don’t seem to help. Neither does education in lifting techniques. But exercise does make people less likely to develop low back pain, a study has found.

The report in the Journal of the American Medical Assn. reviewed 64 studies on preventing or reducing the symptoms of back pain.

The study found “limited evidence” to support the value of exercise but not enough to recommend one form over another.

Exercisers tended to have a reduced risk of developing pain, less severe symptoms when they did hurt and fewer lost work days, according to Dr. Richard A. Deyo, a researcher at the University of Washington School of Public Health and Community Medicine in Seattle.

“What this is telling us is that, on the average, people are better off exercising,” Deyo said.

Exactly what exercise is best has yet to be determined, Deyo said. The reviewers found improvements among people who did weight training as well as those who participated in endurance activities such as jogging and biking.

“My hunch is that some combination is probably optimal,” Deyo said.

But Deyo concedes that flaws in the studies limit the review article’s ability to draw conclusions. In one study, for instance, a five-week program combined aerobic exercise with training on back problems. Study subjects reported fewer back problems, but it’s not clear how much was due only to exercise, the review reported.

As a result, Deyo and his colleagues are conservative in their recommendations.

“There is limited evidence that exercise aimed at strengthening back or abdominal muscles and exercise aimed at improving overall fitness can decrease the risk of subsequent low-back pain,” the article said. “But the effect is modest and of unknown duration.”

It’s also unknown how much pain could be avoided by sedentary people who take up exercise, Deyo said. But people who keep themselves in good shape are likely to have fewer problems, he said.

There’s conflicting evidence on whether wearing corsets to support the lower back will prevent injuries, the review found. In one study, airline baggage handlers who wore the wide belts had no less pain than those who didn’t. But a study of warehouse workers found some reduction in absenteeism.

Because the findings disagree, the reviewers did not make recommendations.

Studies on the value of education showed only “minimal support” for its value, the review said. One study that followed Canadian nurses found no evidence that being taught about lifting affected subsequent back pain.

“Education alone in the absence of exercise or other strategies probably doesn’t have much effect,” Deyo said. People should be taught proper lifting techniques, but “that by itself doesn’t do the trick.”

But orthopedic surgeon Peter B. Slabaugh of Oakland, Calif., defends the value of education. Slabaugh worked on the American Academy of Orthopedic Surgeons’ “Lift It Safe” instruction program.

It is basic physics and physiology that, for instance, holding an object close to your trunk as you lift it is potentially less damaging than holding the object farther away, Slabaugh said. Holding the weight at arm’s length requires more mechanical leverage and winds up putting stress on the trunk, he said.

“Clearly, when you lift, the stress and torque on your back is less when you hold it next to your body,” Slabaugh said.

Slabaugh does support the value of exercise, however. His independent look at the medical literature also finds that exercise pays off.