Increased Walking Time Found to Lower Risk of Low Back Pain

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Hey There! Today’s post will look at reducing your risk of Low Back Pain (LBP), one of the most common conditions worldwide. Some researchers have found the average lifetime prevalence of LBP to be upwards of 38.9% and “most prevalent among females and persons ages 40–80 years” (1). While other researchers report that upwards of 80% of Americans will “experience at least one episode of back pain during a lifetime" (2).

Nonetheless, the prevalence is high, while the cost and burden is also significant. However, results of a recent study have found an association between walking and LBP. Researchers discovered that in a general population over 50 years old, “walking for more than 3 days per week for over 30 min at a time was negatively associated with LBP” and “similarly, walking for more than 5 days per week for over 1 h at a time was [also] negatively associated with LBP” (3).

it is also important to note that low back pain and pain in general is multifactorial and the sensation of pain extends far greater than an actual physical injury. Factors such as stress, anxiety, fear, poor sleep habits, and physical inactivity can all contribute to the presence of pain. Now if you find that walking doesn’t help, don’t worry, other forms of physical activity or exercise should still be your first line of defense. Most episodes of acute LBP have actually been found to resolve on there own, just keep moving and don’t limit your activity.

Though, if you still find your LBP has not resolved, seeing a Physical Therapist FIRST has proven time and time again to be the most appropriate path of care. Findings from a most recent study found “that seeing a PT First for a LBP episode significantly lowered the probability of having an opioid prescription, advanced imaging service, and ED visits compared to patients that did not” (4), which are similar in findings to many other studies (5,6).

Until next time,

Fuel Physio Team

  1. Hoy, D., Bain, C., Williams, G., et al. (2012). A systematic review of the global prevalence of low back pain. Arthritis & Rheumatism, 64(6), 2028-2037.

  2. Rubin, D. I. (2007). Epidemiology and risk factors for spine pain. Neurologic clinics, 25(2), 353-371.

  3. Park, S. M., Kim, G. U., Kim, H. J., et al. (2018). Walking more than 90 minutes/week was associated with a lower risk of self-reported low back pain in persons over 50 years of age: A cross-sectional study using the Korean National Health and Nutrition Examination Surveys. The Spine Journal.

  4. Frogner, B. K., Harwood, K., Andrilla, C. H. A., et al. (2018). Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health services research.

  5. Childs, J. D., J. M. Fritz, S. S. Wu, T. W. Flynn, R. S. Wainner, E. K. Robertson, F. S. Kim, and S. Z. George. 2015. “Implications of Early and Guideline Adherent Physical Therapy for Low Back Pain on Utilization and Costs.” BMC Health Ser- vices Research 15: 150–160.

  6. Fritz, J. M., G. P. Brennan, and S. J. Hunter. 2015. “Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges.” Health Services Research 50 (6): 1927–1940.

Say No to Drug Therapy for Chronic Pain. Choose a Physical Therapist.

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     The incidence of chronic pain is on a steady rise and chronic low back pain is one of the most common contributing conditions. Studies suggest the “the global number of individuals with low back pain is likely to increase substantially over the coming decades.”(1) The World Health Organization lists low back pain as one of the most debilitating conditions worldwide, but “the causes of lower back pain are rarely addressed.”(2)

     The prescribing of opioids has long been the approach to dealing with chronic pain, and studies show that “more than half of regular opioid users report [having] back pain.”(3) The prevalence of opioid use has increased so much over the years that the Centers for Disease Control and Prevention released a document intended for those medical doctors prescribing medication for chronic pain. This document is titled the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.

     The CDC states, that “in 2012, health care providers wrote 259 million prescriptions for opioid pain medication, enough for every adult in the United States to have a bottle of pills.”(4) The CDC also states, that “the overall prevalence of common, predominantly musculoskeletal pain conditions that can be chronic (e.g., arthritis, rheumatism, chronic back or neck problems, and frequent severe headaches) was estimated at 43% among adults in the United States.”(4) These are musculoskeletal conditions that physical therapists have expert knowledge of.

     The CDC guidelines endorse conservative management, stating that "based on contextual evidence, many nonpharmacologic therapies, including physical therapy… can ameliorate chronic pain.”(4) Numerous studies support the use of physical therapy for chronic low back pain and this may include the use of specifically targeted exercises, lumbar stabilization programs, physical therapy mobilizations, and many other treatment options.(5,6) A good physical therapist will aim to treat the underlying causes of pain or help put together a maintenance program, because yes some conditions may require life-long management.

     Also important to note that yes some musculoskeletal conditions may require medication intervention, but conservative treatment by a qualified physical therapist should be sought first.

- Patrick Berner, SPT

 

References:

1. Hoy D, Bain C, Buchbinder R, et al. A systematic review of the global prevalence of low back pain. Arthritis & Rheumatism. June 2012;64(6):2028-2037.

2. 6.24 low back pain, World Health Organization. 6. Priority diseases and reasons for inclusion. http://www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf. Accessed January 23, 2016.

3. Deyo R, Von Korff M, Duhrkoop D. Opioids for low back pain. BMJ (Clinical Research Ed). January 5, 2015;350: g6380.

4. Dowell D, Haegerich T, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. Atlanta, GA: CDC; 2016.

5. Specific rehabilitation exercise for the treatment of patients with chronic low back pain. Journal Of Physical Therapy Science. August 2015;27(8):2413-2417.

6. The effect of lumbar stabilization exercises and thoracic mobilization and exercises on chronic low back pain patients. Journal Of Physical Therapy Science. December 2015;27(12):3843-3846.