By: David Borenstein, MD, MACR, MACP
Low back pain is a complaint associated with 60 different illnesses. No single therapy works for all of these problems. The most common problems that people have are mechanical in origin. Mechanical disorders are associated with overuse of a structure like muscles, or changes associated with growing older.
Many individuals with mechanical forms of low back pain improve over a period of time measured in days to weeks. Both non-drug and drug therapies can be helpful in speeding recovery.
EXERCISE
Movement is necessary to keep the back flexible and strong. Walking on land or in the water can be helpful without jarring the spine. One should do the kind of exercise that is comfortable without increasing pain significantly. A general 30-minute exercise program should include a warm-up period, aerobic exercise like walking or running on a treadmill, core abdominal strengthening, and a cooldown period. Exercise programs are best done three times a week. Examples of exercises can be found at www.drborenstein.com. Physical therapists, like those at Arthritis and Rheumatism Associates, can tailor an exercise program to your specific needs. A frequently asked question is whether a physical therapist or a personal trainer is the most appropriate professional to get fit. I recommend a physical therapist for individuals who are having pain. A therapist will get you back to a pain-free state. Personal trainers are good for improving function at a time when you are pain-free.
COMPLEMENTARY THERAPIES
Acupuncture, yoga, and stress management are among a number of complementary therapies indicated for the treatment of low back pain. Some of these therapies are alternatives to exercise (yoga). Others are non-drug forms of pain management like acupuncture and massage therapy. None of these complementary therapies have been studied adequately to know their proven benefit for the treatment of low back pain. However, for the most part, these therapies are relatively risk free. They may offer a reasonable option where the risks associated with drug therapies outweigh their benefits in specific individuals
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