Effects of Recreational Physical Activity and Back Exercises on Low Back Pain and Psychological Distress: Findings from the UCLA Low Back Pain Study

Overview

Journal Am J Public Health

Specialty Public Health

Date 2005 Sep 28

PMID 16186460

Citations 47

Authors

Eric L Hurwitz

Hal Morgenstern

Chi Chiao

Affiliations

Soon will be listed here.

Abstract

Objectives: We sought to estimate the effects of recreational physical activity and back exercises on low back pain, related disability, and psychological distress among patients randomized to chiropractic or medical care in a managed care setting.

Methods: Low back pain patients (n=681) were randomized and followed for 18 months. Participation in recreational physical activities, use of back exercises, and low back pain, related disability, and psychological distress were measured at baseline, at 6 weeks, and at 6, 12, and 18 months. Multivariate logistic regression modeling was used to estimate adjusted associations of physical activity and back exercises with concurrent and subsequent pain, disability, and psychological distress.

Results: Participation in recreational physical activities was inversely associated--both cross-sectionally and longitudinally--with low back pain, related disability, and psychological distress. By contrast, back exercise was positively associated--both cross-sectionally and longitudinally--with low back pain and related disability.

Conclusions: These results suggest that individuals with low back pain should refrain from specific back exercises and instead focus on nonspecific physical activities to reduce pain and improve psychological health.

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References

Carey T, Garrett J, Jackman A, McLaughlin C, Fryer J, Smucker D . The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. N Engl J Med. 1995; 333(14):913-7. DOI: 10.1056/NEJM199510053331406. View

Hurwitz E, Morgenstern H . Immediate and longterm effects of immune stimulation: hypothesis linking the immune response to subsequent physical and psychological wellbeing. Med Hypotheses. 2001; 56(6):620-4. DOI: 10.1054/mehy.2000.1217. View

Hurwitz E, Morgenstern H, Harber P, Kominski G, Belin T, Yu F . A randomized trial of medical care with and without physical therapy and chiropractic care with and without physical modalities for patients with low back pain: 6-month follow-up outcomes from the UCLA low back pain study. Spine (Phila Pa 1976). 2002; 27(20):2193-204. DOI: 10.1097/00007632-200210150-00002. View

Abenhaim L, Rossignol M, Valat J, Nordin M, Avouac B, Blotman F . The role of activity in the therapeutic management of back pain. Report of the International Paris Task Force on Back Pain. Spine (Phila Pa 1976). 2000; 25(4 Suppl):1S-33S. DOI: 10.1097/00007632-200002151-00001. View

Krittayaphong R, Light K, Golden R, Finkel J, Sheps D . Relationship among depression scores, beta-endorphin, and angina pectoris during exercise in patients with coronary artery disease. Clin J Pain. 1996; 12(2):126-33. DOI: 10.1097/00002508-199606000-00007. View

Keen S, Dowell A, Hurst K, Moffett J, Tovey P, Williams R . Individuals with low back pain: how do they view physical activity?. Fam Pract. 1999; 16(1):39-45. DOI: 10.1093/fampra/16.1.39. View

Ware Jr J, Sherbourne C . The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992; 30(6):473-83. View

Lobstein D, Rasmussen C . Decreases in resting plasma beta-endorphin and depression scores after endurance training. J Sports Med Phys Fitness. 1991; 31(4):543-51. View

Deyo R . Comparative validity of the sickness impact profile and shorter scales for functional assessment in low-back pain. Spine (Phila Pa 1976). 1986; 11(9):951-4. DOI: 10.1097/00007632-198611000-00017. View

10.

Kujala U, Taimela S, Viljanen T, Jutila H, Viitasalo J, Videman T . Physical loading and performance as predictors of back pain in healthy adults. A 5-year prospective study. Eur J Appl Physiol Occup Physiol. 1996; 73(5):452-8. DOI: 10.1007/BF00334423. View

11.

Hildebrandt V, Bongers P, Dul J, van Dijk F, Kemper H . The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations. Int Arch Occup Environ Health. 2000; 73(8):507-18. DOI: 10.1007/s004200000167. View

12.

Zeger S, Liang K . Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1986; 42(1):121-30. View

13.

Sinyor D, SCHWARTZ S, Peronnet F, Brisson G, Seraganian P . Aerobic fitness level and reactivity to psychosocial stress: physiological, biochemical, and subjective measures. Psychosom Med. 1983; 45(3):205-17. DOI: 10.1097/00006842-198306000-00003. View

14.

Macfarlane G, Thomas E, Croft P, Papageorgiou A, Jayson M, Silman A . Predictors of early improvement in low back pain amongst consulters to general practice: the influence of pre-morbid and episode-related factors. Pain. 1999; 80(1-2):113-9. DOI: 10.1016/s0304-3959(98)00209-7. View

15.

Camacho T, Roberts R, Lazarus N, Kaplan G, Cohen R . Physical activity and depression: evidence from the Alameda County Study. Am J Epidemiol. 1991; 134(2):220-31. DOI: 10.1093/oxfordjournals.aje.a116074. View

16.

Deyo R, Centor R . Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance. J Chronic Dis. 1986; 39(11):897-906. DOI: 10.1016/0021-9681(86)90038-x. View

17.

Leino P . Does leisure time physical activity prevent low back disorders? A prospective study of metal industry employees. Spine (Phila Pa 1976). 1993; 18(7):863-71. DOI: 10.1097/00007632-199306000-00009. View

18.

Videman T, Sarna S, Battie M, Koskinen S, Gill K, Paananen H . The long-term effects of physical loading and exercise lifestyles on back-related symptoms, disability, and spinal pathology among men. Spine (Phila Pa 1976). 1995; 20(6):699-709. DOI: 10.1097/00007632-199503150-00011. View

19.

Fishbain D, Cutler R, Rosomoff H, Rosomoff R . Chronic pain-associated depression: antecedent or consequence of chronic pain? A review. Clin J Pain. 1997; 13(2):116-37. DOI: 10.1097/00002508-199706000-00006. View

20.

Carmack C, Boudreaux E, Brantley P, de Moor C . Aerobic fitness and leisure physical activity as moderators of the stress-illness relation. Ann Behav Med. 2000; 21(3):251-7. DOI: 10.1007/BF02884842. View