Exercise Can Reduce Disability chronic low back pain Clinical Pain Advisor

Exercise can reduce the severity of persistent low back pain, but the mechanism behind the effect is still unclear. These findings were presented in a study that was published in Behaviour Research and Therapy.

Participants (N=393) suffering from long-term chronic lower back pain were enlisted to take part in the study through advertisements within an Australian community Australia from June 2016 to September 2019. The participants were educated that the investigation was conducted to measure the treatment and activity choices of those suffering from persistent low back pain during the course of one year. The data were collected every 3 months.

The median age of participants in the study was 39.2+-12.2 years. 45percent reported having low back discomfort for a period between 1 and 5 years.

The rate of retention was very at a high level throughout the course of the study (range 91%-96%).

In general, the average Oswestry Disability Index (ODI) scores fell by 23.6+-11.2 points at the baseline, to 19.6+-12.8 points after 12 months. Similar to baseline, between the follow-up period of 12 months the visual analog scale scores on the pain (mean, 4.3 vs 3.6) as well as fear-avoidance Beliefs Questionnaire scores (mean, 13.3 vs 10.6), Paint Catastrophizing Scale scores (mean, 20.8 vs 15.5), Hospital Anxiety and Depression Scale (HADS) anxiety scores (mean, 7.6 vs 6.5) along with HADS Depression scores (mean, 7.2 vs 6.0) declined as time passed. Self-efficacy of the Chronic Pain Self-Efficacy Questionnaire scores rose from 54.2+-17.6 at the baseline, up to 58.5+-15.4 after 12 months.

In the course of the course of the study 59% to 74 percent of participants participated in physical activities and 51 percent to 59% of them took painkillers.

Based on changes by change ODI scores, those who reported no change were exercising in significantly fewer follow-up assessments (mean, 2.6; P <.05) as compared to those who had reported improvements of ODI scores (mean, 3.4) or worsening of ODI scores (mean, 3.2). People who showed improvements in ODI scores also reported taking pain medications in fewer follow-up tests (mean, 2.0; P <.001) as compared to those who experienced worsening or worsening of ODI scores (mean, 2.9) or not a change (mean, 3.2).

The mediation study revealed that exercises conducted in the initial 6 months showed a significant total impact on disability after 12-months (b, -2.09; 95 percent 95% CI, -1.01 to -3.18). More than half the impact (56 percent) from exercise in reducing disability could be due to those who mediated pain catastrophizing, fear depression, anxiety and self-efficacy. After correcting bias, these indirect results of anxiety, fear, pain (b, -0.46; 95 percent 95% CI, -0.15 to -0.85) and catastrophizing (b, -0.27; 95 percent C.I, -0.05 to -0.59) remain significant.

In the reverse path analysis, disability had an immediate effect on exercise after 6-months (b, 0.012; 95 percent confidence interval, -0.02 to 0.05) and a significant indirect influence of anxiety (b, -0.01; 95 percent C.I, -0.0004 to -0.021).

The study was limited due to the inability to evaluate specific treatments and their experiences.

Study authors concluded “The principal result of this study was that the link between exercise and disability during both the 6- and 12-month intervals was controlled by catastrophizing and pain. Exercise may reduce disability due to the effects on catastrophizing and pain, however, it is necessary to identify the key component within or as an conjunction with the exercise program to explain how this happens. Indeed, patients who suffer from chronic low back discomfort who had reported an increase in symptoms over the course of the year reported similar levels of exercise during the 12 months as those who experienced improved disability.”