TREATMENT FOR LOWER BACK PAIN

With a significant part of the global population forced to work from home, lower back pain may increase. Lithuanian scientists have devised a spinal stabilization exercise program for managing lower back pain for people who perform a sedentary job. After testing the program with 70 volunteers, the researchers have found that the exercises are not only efficient in diminishing the non-specific lower back pain, but their effect lasts 3 times longer than that of a usual muscle strengthening exercise program.

According to the World Health Organisation, lower back pain is among the top 10 diseases and injuries that decrease the global population's quality of life. It is estimated that non-specific low back pain is experienced by 60% to 70% of people in industrialized societies. Moreover, it is the leading cause of activity limitation and work absence throughout much of the world. For example, in the United Kingdom, low back pain causes more than 100 million workdays lost per year in the United States — an estimated 149 million.

Chronic lower back pain, which starts from long-term irritation or nerve injury, affects the afflicted emotions. Anxiety, a bad mood, and even depression, also the malfunctioning of the other bodily systems — nausea, tachycardia, elevated arterial blood pressure — are among the conditions, which may be caused by lower back pain.

During the coronavirus disease (COVID-19) outbreak, with a significant part of the global population working from home and not always having a properly designed office space, lower back pain may increase.

“Lower back pain is reaching epidemic proportions. Although it is usually clear what is causing the pain and its chronic nature, people tend to ignore these circumstances and are unwilling to change their lifestyle. Lower back pain usually comes away itself. However, the chances of the recurring pain are very high,” says Dr. Irina Kliziene, a researcher at Kaunas University of Technology (KTU) Faculty of Social Sciences, Humanities and Arts.

Dr. Kliziene, together with colleagues from KTU and Lithuanian Sports University, has designed a set of stabilization exercises to strengthen the muscles that support the spine at the lower back, i.e., the lumbar area. The exercise program is based on Pilates methodology.

According to Dr. Kliziene, the stability of lumbar segments is an essential element of body biomechanics. Previous research evidence shows that to avoid lower back pain, it is crucial to strengthen the deep muscles, which stabilize the spine's lumbar area. One of these muscles is the multifidus muscle.

“Human central nervous system is using several strategies, such as preparing for keeping the posture, preliminary adjustment to the posture, correcting the mistakes of the posture, which need to be rectified by specific stabilizing exercises. We aimed to design a set of exercises for this purpose,” explains Dr. Kliziene.

The program, designed by Dr. Kliziene and her colleagues, comprises static and dynamic exercises, which train muscle strength and endurance. The static positions are to be held from 6 to 20 seconds; each exercise to be repeated 8 to 16 times.

To check the program’s efficiency, 70 female volunteers were randomly enrolled either in the lumbar stabilization exercise program or in a usual muscle strengthening exercise program. Both groups were exercising twice a week for 45 minutes for 20 weeks. During the experiment, ultrasound scanning of the muscles was carried out.

As soon as 4 weeks in the lumbar stabilization program, it was observed that the cross-section area of the multifidus muscle of the subjects of the stabilization group has increased; after completing the program, this increase was statistically significant (p < 0,05). This change was not observed in the strengthening group. Moreover, although both sets of exercises were efficient in eliminating lower back pain and strengthening the lower back area muscles, the effect of stabilization exercises lasted 3 times longer — 12 weeks after the completion of the stabilization program against 4 weeks after the completion of the muscle strengthening program.

“There are only a handful of studies, which have directly compared the efficiency of stabilization exercises against other exercises in eliminating lower back pain,” says Dr. Kliziene, “however, studies are proving that after a year, lower back pain returned only to 30% of people who have completed a stabilization exercise program, and to 84% of people who haven’t taken these exercises. After three years, these proportions are 35% and 75%.”

Research demonstrates that the spine stabilization exercise program is more efficient than medical intervention or usual physical activities in curing lower back pain and avoiding future symptoms.

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