Welfare|I claim
Exercise is a superior treatment for chronic back pain, but the pain often makes you fear movement. Jari Parkkari, professor of sports medicine at the University of Jyväskylä, talks about what kind of exercise can cure chronic back pain.
The story is part of the I argue series, where one expert shares his or her views on an interesting topic related to his or her field.
Jyväskylän Professor of Sports Medicine at the University, Specialist Jari Parkkari:
“Musculoskeletal and back pain are currently one of the most common reasons to see a doctor, and they cause a lot of absenteeism from work.
Only about 10 percent of back pain is found to have a clear medical cause, such as interstitial bulge, rheumatic disease, or infection. Most are so-called nonspecific back pain, the exact cause of which is unknown.
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Exercise is the most effective and safest treatment for chronic pain, especially back pain.
About 20-30% of the pain becomes chronic, ie the pain persists even if the cause has already disappeared. Meta-analyzes combining several good quality studies have shown that exercise is the most effective and safest treatment for chronic pain, especially back pain.
Back pain is not only somatic and physical, but is associated with mental and many other factors. A person may begin to fear pain, as a result of which he or she will avoid using the back. It is easy to drift into a downward spiral where immobility exacerbates pain and vice versa.
If your back becomes sore, it is not advisable to work with it for weeks, but to see a physiotherapist who is familiar with back pain soon. If the discomfort is associated with fever, numbness of the legs, or other serious symptoms, less common causes should be ruled out by a doctor.
Exercise known to affect pain at the cellular level. Exercise increases the production of the neurotransmitter serotonin and endogenous opioids, for example, which reduce the sensation of pain. Exercise also has an effect on cytokines that increase and control inflammation in the body.
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In order for chronic pain to be relieved, the body’s normal trajectories must be restored and the muscles reactivated in the correct order.
Most patients with back pain benefit from exercises that develop the nervous system to restore normal nervous system and muscle function. Namely, the pain stops the activation of the muscle and interferes with the contraction of the muscles during the movements. Controlling body position and movement can be deceiving. Some structures become too tight and others become too mobile.
In order for chronic pain to be relieved, the body’s normal trajectories must be restored and the muscles reactivated in the correct order. If these are wrong, for example, when bending, the greatest force can be applied to the lower back instead of strong thigh muscles, which aggravates the pain.
Just published In a meta-analysis of 21,000 patients, the top three exercise treatments for chronic back pain were pilates, the McKenzie method, and exercise-oriented exercise combined with psychosocial support. McKenzie is a well-known method of physiotherapy that seeks out the cause of back pain and directs it to individual exercises.
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Stretching alone is not a significant help for pain.
Strength training and aerobic exercise also had a significant positive effect on back pain. Stretching alone did not provide significant relief from pain.
Pilates is a good workout for people with back problems because breathing can affect muscle activation and autonomic function. When you do some heavy exercise during exhalation, the support of the superficial muscles weakens and the deep abdominal muscles become activated.
Right with exercise, functional pain is brought under control in a matter of weeks or months, depending on how long your back has been sore. Usually one or two pilates a week is enough. In addition, of course, you can move freely to your liking.
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It doesn’t matter how you lift your shopping bags or tie shoelaces.
If there has been a bulge in the back, it may take a long time before it takes a shaky motion, such as a run. However, your back may take up normal cycling, swimming, the gym and walking.
However, good muscle support and mobility alone are not enough, and the back must also be used smartly in everyday life. It doesn’t matter how you lift your shopping bags or tie shoelaces. These should be done with one foot in front to improve lower back support. Similarly, the car will take longer to brake on decelerators than if you always drive 40 kilometers per hour.
Those who experience chronic pain do not have to immerse themselves in despair: the pain is removed or at least relieved when support and movement are provided in the right place. ”
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