Exercise helps prevent low back pain

by Bruce Sylvester: Results from a meta-analysis of relevant studies suggest that exercise, alone or in combination with education, reduces the risk of low back pain. The findings appeared on Jan. 11, 2016 by JAMA Internal Medicine.

As background, the researchers noted that existing guidelines lack clear recommendations for prevention low back pain.

Daniel Steffens, Ph.D., of the University of Sydney, Australia, and coauthors conducted a search of the medical literature, and they found 23 eligible published reports on 21 different randomized clinical trials with 30,850 subjects.

The primary outcome measure for the new analysis was an episode of low back pain. The secondary outcome measure was an episode of sick leave associated with low back pain.

Two independent reviewers extracted data, and they assessed the risk of bias.

The investigators found that exercise alone produced a 35 percent risk reduction of a low back pain episode, and a 78 percent risk reduction for low back pain-related sick leave.

“Although our review found evidence for both exercise alone (35 percent risk reduction for an LBP [low back pain] episode and 78 percent risk reduction for sick leave) and for exercise and education (45 percent risk reduction for an LBP episode) for the prevention of LBP up to one year, we also found the effect size reduced (exercise and education) or disappeared (exercise alone) in the longer term (> 1 year). This finding raises the important issue that, for exercise to remain protective against future LBP, it is likely that ongoing exercise is required,” the authors said.

“Other interventions, including education alone, back belts, and shoe insoles, do not appear to prevent LBP. Whether education, training, or ergonomic adjustments prevent sick leave is uncertain because the quality of evidence is low,” they added.