Spine Blog 2

An active lifestyle equals greater health! That is a simple statement which encompasses many aspects of improving ones overall health. We are focusing on spinal health. I am believer that the spine and the nervous system has its own checks and balances.

The spine itself is just bones put together like legos. Add the soft tissues, muscles, tendon, ligaments and fascia and you create a rigid but flexible structure. And this can only activity function as a finely turned system with the assistance from the nervous system. Therefore, caring for this body system as a whole is vital to spinal health.

Let’s look at the research on exercise and spinal care when an injury incident occurs. One of the most common misnomers is bed rest for low back pain (LBP). A Cochrane Collaboration review made these conclusions regarding bed rest: 1) has no positive effect for LBP, 2) may have slightly harmful effects, and 3) yields no improvement with 7 days over 2 to 3 days in LBP or sciatica. The Paris Task Force on Back Pain states bed rest maybe necessary if the pain indicates it, but after 3 days patients must be encouraged to progressively resume their activities.

So what should you do when LBP occurs? The first phase an individual enters is the Acute Phase of recovery. This typically lasts 4-6 weeks. Exercise recommendation in this phase has mixed opinions. Some researchers found performing specific spinal stabilization exercises does reduce the atrophy (weakening) of spinal muscles. Others found dictating specific exercises for the patient, either flexion or extension movements, could be beneficial for some but not all. In my opinion, each case of LBP is different and the exercises in this phase need be patient specific. The gem here is that some form of active recovery is best and will reduce the risk of chronicity and disability.

The second phase of recovery is the Subacute Phase (4 to 12 weeks). This is the phase in which exercise is vital for recovery. It is well documented that the longer a LBP patients stay off work the harder it is for them to return. A multidisciplinary approach is best practice here. A light exercise activity plan and education on how your pain is a guide not a stop sign for continued activity will achieve a greater return to work rate. Research of this phase revealed adding manual therapies such as manipulation, followed by exercise sessions was ‘best care’ practice for LBP.

The third phase of recovery is the Chronic Phase and Reactivation and Exercise Phase (After 12 weeks). Even the naming of the phase gives you the answer to recovery. Exercise! The same Cochrane Collaboration mentioned above states there is strong evidence that exercise therapy is more effective than usual care by a general practitioner for chronic low back pain. Many other studies have strongly suggested that exercise has long-term beneficial effects in the management of LBP. The key here is to challenge the misconception that exercise is counter intuitive to addressing LBP.

Moral of the story, exercise, exercise, exercise!!

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