Low back pain: rest versus exercise therapy

Low back pain is a short-lived common disorder but this chronic condition can last for up to 12 months in some patients. Although current clinical guidelines recommend exercise therapy, this is not usually encouraged for patients suffering from low back pain who also show pathological alterations to the bone and spine (Modic changes). It has been hypothesized that a beneficial treatment for this patient group would need to incorporate adequate rest to allow the bone to heal.


Therefore to test this hypothesis, a randomized controlled clinical trial published in BMC Medicine, conducted by Prof Manniche and colleagues, compared rest and exercise therapies in 100 patients with chronic nonspecific low back pain and a high occurrence of Modic changes, at 10 weeks post-treatment and at a one-year follow-up. The study carried out at the Spine Center of Southern Denmark revealed patients who exercised once a week but continued their routine activity to have similar small improvements in pain, disability and general health to patients who had two hours daily rest and the choice of lumbar belt usage. 

The findings suggest patients with chronic low back pain and Modic changes can incorporate normal physical activity in their lifestyles. Further research will aid in identifying specific patient subgroups that would successfully respond to different treatments.


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