What is the best treatment for back pain?

28 percent of Americans have suffered from lower back pain in the last three months. More than 90 percent will suffer from back pain at some point. The costs are enormous: 176 billion dollars in direct costs for medical treatment and 11 billion dollars in indirect costs for sick days and reduced productivity. Low back pain is by far the leading cause of disability worldwide. Treatments include over-the-counter and prescription medications, weight loss, exercise, physical therapy and surgery. Scientists have published thousands of studies on treatment methods and yet there is little consensus on the most effective treatment and prevention.

Daniel Steffens and colleagues from the University of Sydney concluded that exercise and education are the most effective methods for treating lower back pain. They looked at more than 6,000 studies and summarized the results of 23 studies in a meta-analysis. Exercise or exercise combined with education (learning how to protect the spine) were the only methods with a proven effect on reducing back pain.

Studies by Stuart McGill of the University of Waterloo in Canada showed that certain exercises such as trunk flexion training (e.g. sit-ups) can exacerbate back problems (see Backfit.com). His work shows that exercises that stiffen the spine work best when it comes to preventing lower back pain and promoting core fitness for sport.

Increased core stiffness transfers power and speed to the extremities, prevents lower back pain, increases the load-bearing capacity of the spine and protects the internal organs during exercise movements.

(JAMA Internal Medicine, published online January 11, 2016)

-.-.-.-.