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What works best for Low Back Pain

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By Michael Hall,

What is the best treatment for Low Back Pain - Yoga, Stretching or a Self-Care Book?

Chronic low back pain (LBP) is a common problem that seems to have many different treatment solutions. But which one works best? A recent study (October 2011) set out to determine whether yoga, conventional stretching exercises or a self-care book is the most effective intervention for helping people with chronic low back pain.

In the study, a total of 228 adults with chronic low back pain were randomized to 12 weekly classes of yoga (92 patients) or conventional stretching exercises (91 patients) or a self-care book (45 patients). Questionnaires were used at the beginning, 6, 12, and 26 weeks by interviewers unaware of treatment group, to measure the outcomes.

The results indicated that Yoga classes were more effective than a self-care book, but not more effective than stretching classes, in improving function and reducing symptoms of chronic low back pain. These benefits were found to last for least several months. From this study it can be concluded that movement or staying active assists in helping people with LBP.

Bodywise Health Comment

Low back pain (LBP) is common and frustratingly difficult problem to cure. In fact, more than 70% of people report LBP during their lifetime. X-rays, CT scans and MRI scans often don’t correlate with the pain and symptoms reported and a definitive diagnosis is only made in 10-15% of cases. What’s more, the treatment approaches are many, with most often lacking proof. No wonder the public is confused.

There is no doubt the mechanisms behind low back pain (LBP) are complex. Research has shown that the brain “anticipates” movement and activates the deep core abdominal and back muscles to pre-stiffen the spine before the body moves (Hodges and Richardson 1996). These muscles hold the joints in ideal alignment and prevent potentially damaging movement. However, it has been shown that within 24 hours of a back injury, these muscles (i.e. transverses abdominus and multifidus) stop working effectively and even begin to waste away (Hides JA et al Spine 2001). Even the functioning of the brain changes in response to back pain (Schimdt-Wilcke et al 2006). Furthermore, it has been found that even if a person stays active (e.g. swims) and the pain does go away, the functioning of the brain and these muscles do not return to normal without specific training (Tsao et al 2009). With specific training however, there is evidence that the brain and deep core muscles begin to revert to normal within two weeks. And the protective effect of these exercises is lasting, with only 30% (compared with 84%) likely to suffer a recurrence within one year.

The connection between exercise and the treatment of LBP is not new. In fact, a review performed in July 2011 of 83 studies on the on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain concluded that only exercise therapy, multidisciplinary treatment and behaviour modification “are the only conservative treatments that should be used in daily practice in the treatment of chronic LBP”. This is not to say that other interventions don’t work, but that they don’t have a proven, lasting effect when used in isolation. In reality, this never occurs as modalities and techniques are always used in combination to enhance the effect of each intervention. For example, modalities such as cold packs, heat, ultrasound and electrical stimulation often reduce pain and muscle spasm so that joint mobilisation and manipulation is made more effective at freeing up joints and relaxing muscle. And joint mobilisation or manipulation can enhance the benefits of exercise therapy which aids in improving posture, movement habits and function and so on. Given that the evidence for treating LBP is conflicting, a physiotherapist may have to try different modalities and combinations of modalities to determine what works best for a particular patient. In reality, the best evidence that a particular management strategy is effective for a particular patient is whether or not the patient improves.

5 Top Tips for Dealing with Low Back Pain

1. Seek treatment early. Early intervention is the key to preventing pain from becoming chronic, costly and recurrent;

2. Undergo a thorough assessment. This is critical to identify the stage of healing and the sources / causes of the back pain, as well as to understand perceptions, beliefs and coping mechanisms;

3. Understand the nature of the problem and what the best strategy is for “fixing” it;

4. Implement a strategic management approach that:

a. addresses pain and the stage of healing;

b. targets the structures at fault,

c. specifically trains core muscles so that they regain their normal functioning;

d. corrects posture and improves movement habits;

e. addresses other concerns (e.g. home life, work life, work station set up etc); and

f. progresses conditioning to above and beyond the stresses likely to be encountered in everyday life so a reserve capacity is created to protect against challenging, unexpected activities and unguarded movements;

5. Incorporate these principals into the way that you live. In other words, live in a way that puts ideal stresses on to your body (i.e. sit correctly, stand correctly and move correctly), eat and exercise for optimal functioning and deal with physical and psychological “insults” quickly, comprehensively and completely so that healing can occur and the issues are fully resolved.

References:
1. Karen J. Sherman, PhD, MPH; Daniel C. Cherkin, PhD; Robert D. Wellman, MS; Andrea J. Cook, PhD; Rene J. Hawkes, BS; Kristin Delaney, MPH; Richard A. Deyo, MD, MPH Arch Intern Med. Published online October 24, 2011. doi:10.1001/archinternmed.2011.524

For more information or for an appointment, please call Bodywise Health on 1 300 263 994.

Please note:

• Rebates are available through your private insurance extras cover;

• For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 263 994.

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How We Can Help You

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By Michael Hall

Personal Healthcare

Motivated by the understanding that optimal healing can only take place in an atmosphere of peace, safety and personal attention, everything at Bodywise Health has been developed with you and your well-being in mind. From the way that you are greeted, to your personal treatment program, to the after-hours and ongoing support, Bodywise Health has developed the perfect blend of physical, nutritional and psychological healing to ensure that you not only get better quickly and fully, but that you are able to live and perform at your highest level.

Not only will you receive the best of treatment, you will receive the best of care, as you are educated about your condition, why it has occurred and how we can best work together to achieve the most optimal and fastest recovery. And we will be there, each step of the way, treating, guiding, supporting, teaching, motivating and empowering you. At Bodywise Health, we have put the “care” back into “health care” and you at the centre of all that we are about.

Fast Relief and Fast Results

You want fast relief and fast results, at Bodywise Health we are obsessed with providing them to you. Every service, every treatment program, every interaction is aimed at maximizing your results in the most nurturing and empowering environment possible.

“Hands on” therapy, movement correction techniques and exercise rehabilitation are combined with the latest clinically proven equipment including bodyflow and gait scan, to accelerate your healing and recovery. And with the provision of an information sheet on your condition, a graduated rehabilitation program, telephone support and after-hours advice, you will have the tools to ensure that you experience the fastest and best recovery possible, guaranteed.

Lifelong Wellbeing

A solution for life – you may not have thought about how you will be, how you will look, what things you will be able to do and what things you won’t be able to do in 5, 10, 20, 50 years time, but at Bodywise Health we do. Our goal is not just to provide you with fastest possible results, but just as importantly, to provide you with solutions that are going to work for you for the rest of your life. We will FREE you from the limitations of your condition by empowering you with the knowledge, training, instruction and on-going support that will enable you to take back control of your health and life. With information sheets, graduated exercise protocols, instruction in posture and movement correction as well as access to information nights and even a telephone help line, essentially, you will be given the tools to take your health to the next level and beyond and you will have Bodywise Health guiding and supporting you every step of the way.

For more information or for an appointment, please call Bodywise Health on 1 300 263 994.

Please note:

• Rebates are available through your private insurance extras cover;

• For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 263 994.

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Gift Certificates

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By Michael Hall

A Bodywise Health Gift Certificate is the perfect way to say,”Thankyou”, “Congratulations”, Merry Christmas” or I love You”. Guaranteed to make you and that special person feel fantastic, a Bodywise Health Gift Certificate is a sensational gift for any occasion. Whether it be a luxurious massage, a physical health assessment or an introduction to clinical pilates, you can be sure that your gift will make an impression that will long be remembered.

For more information or for an appointment, please call Bodywise Health on 1 300 263 994.

Please note:

• Rebates are available through your private insurance extras cover;

• For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 263 994.

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Better Health Talks

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By Michael Hall

There is so much conflicting health information these days. It seems everyone has the magic cure, the perfect potion or the best results. How do you sort out fact from fiction? What is marketing spin and what is evidenced based research? The Bodywise Health talks put you in control by presenting the latest research on topics that make a difference to your health, your happiness and your quality of life. Some of these topics include:

• How to prevent aches and pains before they ever become a problem
• How to perform better with more energy, focus and accuracy
• 5 Steps to Optimal Health

Our health care professionals can deliver a talk program that provides the latest in current knowledge and research information on common physical and nutritional health conditions.

We know that this service will pay you many times over in the productivity gains that will be achieved. Of course for more detailed information, please don’t hesitate to contact us here at Bodywise Health on 1 300 BODYWISE (1 300 263 994), and we will be delighted to answer any of your questions and direct you as to the best course of action.

For more information or for an appointment, please call Bodywise Health on 1 300 263 994.

Please note:

• Rebates are available through your private insurance extras cover;

• For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 263 994.

Read more...
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Bodywise Health

364 Hampton St,

Hampton

Victoria. Australia 3188

03 9533 4257

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