Avoiding rest and staying active by doing physical exercise are the advice of the experts of the Spanish Society of Rheumatology (SER) to recover sooner and better from low back pain, a condition that at least 80% of the population will experience at some point in time. their life, while 23% will suffer some episode of chronic low back pain, they warn.
The SER wanted to inform patients with rheumatic diseases of the importance of physical exercise to improve their well-being, and the general population of its usefulness in preventing the development of these pathologies, and to this end, in 2020 they launched the ‘Reumafit’ campaign, which also focuses on refuting false beliefs such as the need to take prolonged rest and avoid spinal movements when they have low back pain because “what has been shown is that avoiding bed rest and trying to return to activity as soon as possible facilitates recovery,” explains the Dr. Raquel Almodóvarrheumatologist at the Fundación Alcorcón University Hospital (Madrid) and one of the coordinators of this initiative.
“It is estimated that 23% of the general population will have at some point in their life an episode of chronic low back pain, that is, persistent pain lasting more than three months. Furthermore, in 11-12% of the population, low back pain will, on occasion, cause a limitation in their activities. These figures make low back pain the main cause of disability in Spain and worldwide, especially in adults of working age, which reflects the importance of addressing this manifestation and, to the extent possible, trying to prevent it,” he adds. the expert.
“Doing aerobic or cardiovascular physical exercise, as well as specific exercises to strengthen the hip and trunk muscles, reduces the risk of having lower back pain”
The SER explains the classification of the types of low back pain and its recommended treatment depending on the cause, “since the type of exercise must be individualized in each case,” details the specialist in Rheumatology. Specifically, it is estimated that 15% of cases of low back pain are due to a specific clinical condition that may be due to spondyloarthritis, disc pathology, lumbosciatica, canal stenosis or osteoporotic vertebral fracture, among others; while less than one in 1,000 are cases of low back pain as a warning sign of a serious problem.
The most common, however, is nonspecific or idiopathic low back pain, in which the cause cannot be determined, that is, the anatomical structure that is causing the pain. The specialist points out that “an important advance is that it is known that, in most cases, there is no permanent damage to any of the structures that make up the spine that is responsible for the pain.”
Nonspecific low back pain: why avoid rest
SER experts insist on refuting false myths and affirm that persistent low back pain is not usually due to significant tissue damage, that MRI is only useful in a minority of people with low back pain and that, although low back pain prolonged can be worrying, it is rarely dangerous.
Having lower back pain with some movements and when performing certain exercises does not mean that you are damaging your back, they say. And they add that having periods or moments of more intense low back pain does not mean that spinal damage is increasing. Furthermore, they explain that aging is not the cause of low back pain persisting over time, in the same way that the cause of persistent low back pain is not bad posture, and that infiltrations or injections in the spine or surgery usually do not They cure back pain.
They indicate that it has been known for years that recommending patients with low back pain to try to stay active is better than advising them to take prolonged rest, and therefore they should avoid bed rest and try to return to activity as soon as possible, as it facilitates recovery. .
“Physical activity has a beneficial effect on all tissues of the body and, especially, those that make up the musculoskeletal system. Physical activity and exercise have been shown to be an essential aspect of the prevention and treatment of low back pain. Performing aerobic or cardiovascular physical exercise (walking, running, swimming…) on a regular basis, as well as performing specific exercises to strengthen the hip and trunk muscles, reduces the risk of having low back pain (it has a preventive effect)” , details Dr. Almodóvar.
Likewise, it is recommended that people with low back pain try to make the most of simple measures that have no side effects and that they can use independently, whether the application of local heat, therapeutic exercise programs (tai chi, Yoga, Pilates…) or walking, among others.
Low back pain due to osteoporotic vertebral fracture: recommendations
In this case, the SER experts explain that it may be necessary to remain at rest for the first few days until the pain allows for short walks, which can be progressively increased depending on pain tolerance, because performing regular exercise, such as walking , contributes to maintaining bone density.
Once the period of intense pain has passed, these patients should be offered a program that combines strengthening and balance exercises, with the aim of improving muscle strength and reducing the risk of new falls. Two easy exercises to start with are the lying pelvic floor exercise and the lying trunk raise exercise. These specific exercise programs can also help reduce pain medication needs, according to Dr. Almodóvar.
Source: Spanish Society of Rheumatology (SER
