MONDAY, Jan. 19 (HealthScoutNews) -- A new Dutch study challenges the old notion that rest is the best remedy for a sore back.
Researchers studying airline workers who were laid up because of lower back pain found a structured program of exercises, with gradually increasing exertion levels, got them back on the job faster than simply holing up in bed did.
The study found the regime, called graded activity, was more effective in reducing the amount of work days lost. On average, those who exercised took 29 fewer sick leave days in the six months after treatment than those undergoing the standard care that involved rest.
But the researchers also found that graded activity didn't necessarily reduce the subjective level of pain the sufferers experienced.
The research appears in the Jan. 20 issue of the Annals of Internal Medicine.
"We say to the participants, 'Hurt doesn't harm,'" says Dr. Willem van Mechelen of Vrije University Medical Center in Amsterdam. "Just because you are feeling pain doesn't mean that it will cause any further damage."
"Despite their pain, they can still go back to work and can perform their work and do their duties, though you might need some adjustments and accommodation from the employer," van Mechelen adds. "But don't worry, they can do it."
Patients in the randomized control study were separated into two groups, both of which consisted of the current level of standard back care with an occupational physician.
Those in the graded activity group, though, exercised twice weekly under the supervision of physical therapists who insisted they complete the exercises despite pain. They graphed the progress of the patients, providing positive behavioral reinforcement and setting clear goals -- including their own return-to-work date.
The study found a large part of the program's success was addressing the psychology of the pain in the exercises to overcome it. Patients were taught that pain is something they need to live with, and to try to reinforce positive thoughts about it.
"Many people think the pain is really between the ears," says study author J. Bart Staal, also of Vrije University. "It's certainly real pain, but what we are aiming to do is change the way people perceive that pain and cope with back pain."
Van Mechelen emphasizes the participants were experiencing general back pain without a specific root cause pinpointed by a functional magnetic resonance imaging (MRI), CT scan or other diagnostic tool.
"It's organized for people to become active; 'Use it or lose it' is the mindset," says van Mechelen. "It's in the best interest of the patient, and the companies also, that they get back to work. People out too long stand a higher risk of losing their jobs or even developing other health problems."
The British Safety Council, a nonprofit occupational safety watchdog, praises the research.
"We think this is a positive study," says council spokesman Steve Tyler, "and one which would contribute to society and benefit people by helping them to return to work."
More information
Learn more about back pain from MedlinePlus or the Occupational Safety and Health Administration.
