Tips for lower back pain

A number of individuals have experienced low back pain (LBP) at one point or the other in their lives, and experts advise that staying active is a sure-fire way to help ease the condition.

According to Dr A. J. Cianflocco, director of Primary Care Sports Medicine at Cleveland Clinic in the US, between 80-90 per cent of Westerners and those who have adopted the “western lifestyle” have experienced LBP “at least once in a lifetime”.

Speaking on the second day of the Abu Dhabi Medical Congress in the Capital on Monday, Dr Cianflocco cited some of the appropriate treatment and interventions for those suffering from LBP.

“Lower back pain is a common problem in primary care. Fortunately, this condition is (often) self-limiting and would resolve with little intervention. However, a third of the cases of LBP may not fully recover within six months, and there’s about 25-60 per cent recurrence rate within one to two years,” stated the sports medicine specialist.

Bad posture, lack of exercise and not being flexible are some of the factors that cause LBP, he told Khaleej Times.

According to him, LBP is prevalent in young professionals and labourers, or those between the ages of 20 and 50-60 due to degenerative spine in older people. LBP is also common among athletes due to stress fracture particularly for those into gymnastics, ballet, weight lifting and wrestling or those who “arch their backs”. The obese and those with big bellies are also affected due to their weight putting pressure on their lower back.

As intervention, Dr Cianflocco suggested patient education and advising them to “stay active, avoid bed rest and pursue early appropriate physical therapy activity as soon as possible — so-called self-care options”.

Smoking cessation, exercise and weight management should also be advised and that medications should be chosen based on patient age and risk profile.

For those with persistent back pain or an acute phase of between four to six weeks, formal physical therapy was advised. Older patients of between 50 and 60 years may go for laboratory testing and further imaging as appropriate.

While those with chronic low back pain (more than 12 weeks), aggressive exercise plus medications may be needed, advised Dr Cianflocco.

According to him, stretching, yoga and pilates, and aerobics are some of the exercises that are beneficial for patients with chronic LBP.

Stretching exercises have been known to benefit a number of patients; 80 per cent of the patients have reported improvement at the end of six-week training, according to the specialist.

“Yoga and pilates, these are the mind and body exercise regimen; they are quite helpful in patients that have psychological and physical components in their chronic LBP. These both address the physical and mental aspects by incorporating core strengthening, flexibility and relaxation.”

Walking, running, cycling and swimming are also great examples, as well as, impact exercises such as aqua therapy.

On the non-traditional options, Dr Cianflocco, who also advises on the US’ National Football League (NFL), suggested acupuncture, manipulation, chiropractic and osteopathic methods.

Citing the guidelines from the American College of Physicians, he said “acupuncture... should be considered as non-pharmacologic treatment with proven benefits for patients with chronic LBP (to) supplement other therapies”. It requires six to eight treatments.

Different types of massage in massotherapy include rolfing, Sweddish massage, acupuncture massage, myofacial release and craniosacral therapy are also effective in chronic LBP. This should be considered in conjunction with exercise to maximise the benefit.

“An experienced massotherapist also improves the outcomes,” he said.

olivia@khaleejtimes.com