Management of Non-specific (Chronic) Back Pain
posted in Exercise Science, Injury Management |Management of Non-specific (Chronic) Back Pain South East Alliance of
General Practice Newsletter 2006
When managing non-specific long term back pain, it can be difficult to decide what additional effective options to offer a patient. Often chronic back pain has its origins in weak spinal musculature, poor posture and incorrect use of muscles in day to day activities and often times is precipitated by a minor injury. If left unattended, these can frequently lead to muscle imbalances which cause pain and dysfunction.
An effective treatment option for these problems is functional exercise through a professionally guided exercise program. A functional exercise program draws on the
Specificity Principle of training. It is based around the day to day activities of the person, developing exercises specifically to support what the person does each day of their life.
While the overall focus is on education and developing body awareness, the core strategies of this type of program are to work on the flexibility of over-tight muscles, balance the strength of individual muscles and develop core stability.
Assessing and developing the flexibility of the muscles that are involved is the first aim of a functional exercise program, looking at how the tension in these muscles corresponds to the tension in other related muscles. Inadequate or inappropriate (out of proportion) strength in certain musculature is often an underlying cause of tension or of a flexibility issue in a muscle. Education, training and body awareness results in correct activation, timing and strength, balancing the muscle groups involved. As the patient develops and improves awareness and control, the correct movements are reinforced and strengthened through the training process.
An important component is the development of core stability, through strengthening of the Transversus Abdominis, Multifidus and Inner Obliques. These muscles provide vital support for the spine. They are underdeveloped in many people and often neglected in exercise programs.
Functional exercise intervention provided by an experienced Exercise Physiologist will improve core stability and muscle flexibility and strength. Whether the underlying cause of non-specific back pain is injury or degenerative or age related changes, any form of treatment will be of limited value without correcting existing underlying musculature problems.
Alex Cox Taylor,
Exercise Physiologist
and Judy Baker, Director,
Essents Whole Body Centre.