Exercise Puts Back Pain on the Run

But the program must be tailored for each patient

FRIDAY, Feb. 22, 2002 (HealthDayNews) -- Before you go under the knife or pop a pill for your lower back pain, first give exercise a try.

And not just any exercise, but an individualized program that suits your particular back problem, according to a Chicago sports medicine doctor.

Speaking yesterday at a pain management conference in New York City, Dr. Joel Press reported that many people who think they need surgery or medication for their low back pain should first try an individualized exercise program.

The problem is that exercise programs are often too generic, "one-size-fits-all," which do little to help patients get rid of their pain, said Press, a medical director at the Rehabilitation Institute of Chicago.

"Non-specific exercises aren't going to be helpful to people with acute episodes of back pain. You need to build a program on the basis of how patients move and tailor exercises for them that don't hurt," he said.

Press cited several studies done in the early 1990s that showed patients who followed an individualized program of exercises for their backs were better after three months and at one year than patients whose exercises were not tailored for them.

"We are beginning to train people and changing the mindset of what medical students learn," he said of his efforts to promote individualized exercise for low back pain. "About 40 to 50 percent of health professionals are starting to integrate it into their programs."

Press, director of the institute's Center for Sports, Spine and Occupational Rehabilitation, first assesses patients to determine their mobility and level of pain. Then he designs exercise programs to give them pain relief and build strength.

"In an exam, we move them in all the planes of motion -- sideways, forward and back and at angles -- to see how far they can move their bodies," he said. "We get an understanding of their pain, and will know when the pain is different or worse as they move."

He then creates an exercise program, often consisting of stretching and muscle strengthening, that's designed for them to alleviate the pain by moving their bodies away from the pain. If it hurts to lean forward, for instance, he will show them how to lean back, away from the pain.

"We give them direction away from their pain," he said, "and work on exercises that give them core strengthening to form a muscular corset."

The key to the program's success is its practicality, Press said. He prescribes exercises that resemble daily activities, like bending and stretching, so they are easy to follow.

"We aim for the average Joe with a program that takes no more than 10 to 15 minutes daily and that can be done anywhere," with little or no equipment, he said.

Renee Daniels works with many people with back pain as a rehabilitation specialist and fitness manager at one of New York City's Equinox Fitness Centers.

In an interview today, she said Press' advice is "right on point," and added that "it's the people with sedentary jobs" who are often susceptible to low back pain.

"You need to create individualized exercise programs to help strengthen weaker muscles and to promote better balance and flexibility," Daniels said. "The stronger the muscle gets, the less episodes of pain the individual will experience."

What to Do: Some tips on how to prevent back pain can be found at The American Academy of Orthopaedic Surgeons. For a diagram of the spine, visit The University of Illinois at Urbana-Champaign.

SOURCES: Interviews with Joel Press, M.D., medical director, Center for Sports, Spine and Occupational Rehabilitation, the Rehabilitation Institute of Chicago; Renee Daniels, certified medical exercise specialist, fitness manager, Equinox Fitness Center, New York City; Feb. 21, 2002, American Medical Association pain management conference, New York City
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