Mind-Body Relief for Low-Back Pain
Two studies published earlier this year suggest that acupuncture and Pilates can both be helpful to clients with chronic low-back pain.
Individually designed acupuncture, standard treatment and sham (simulated) acupuncture were all more effective than usual care (i.e., standard medical care) in treating chronic low-back pain, according to a study published in the May 11 issue of the Archives of Internal Medicine (2009; 169 , 858–66). In a randomized clinical trial led by Daniel C. Cherkin, PhD, of Group Health Center for Health Studies in Seattle, researchers compared the effects of the various treatments on adults with chronic low-back pain at Group Health in Seattle and Kaiser Permanente Northern California in Oakland, California.
Investigators divided 638 subjects into four groups, who received treatments over 7 weeks. Participants reported any symptom changes and dysfunction from their back pain after 8, 26 and 52 weeks. The researchers then analyzed their data to assess which subjects had experienced clinical improvements in dysfunction and “symptom bothersomeness.” Participants in the individually designed acupuncture, standard acupuncture and sham acupuncture groups all experienced more improvement than those receiving usual care.
This result raises questions regarding acupuncture’s mechanisms of action. The study authors noted, “It remains unclear whether acupuncture or our simulated method of acupuncture provide physiologically important stimulation or represent placebo or nonspecific effects.” However, even though the reasons for acupuncture’s effectiveness remain unclear, the researchers expressed continued support for this type of treatment, since it produces results and avoids the potential adverse side effects of medications. More research is recommended.
As first reported in our June issue, Pilates mat exercises helped reduce the intensity, duration and frequency of symptoms for individuals with mild but chronic low-back pain, according to a small study published in Journal of Bodywork and Movement Therapies (2009; 13; 104–11).
Dorothy Curnow, MA, and colleagues at the University of Technology in Sydney, Australia, compared the effects of three different movement combinations. Thirty-nine subjects were randomly divided into three groups (A, B and C). All groups practiced four exercises: an abdominal curl, an oblique abdominal curl, a side-lying double leg lift (below, first photo) and a spinal extension (below, second photo). Group A was given no additional exercises. Groups B and C both performed one relaxation posture before exercising. Group C also practiced an additional postural training exercise (below, third photo). All subjects had less back pain after doing their exercises three times per week for 6 weeks.
Members of Groups B and C experienced the greatest improvement in symptoms (especially at week 6), suggesting that relaxation and postural training exercises might impact the effectiveness of exercise programs. However, differences among the three groups were not large enough to be considered significant. The study’s small sample size or short duration might explain this result, according to the authors. Curnow recommended that instructors consider ways to improve exercise outcomes by adding complementary techniques.
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Shown here are exercises 3 and 4 in the basic series used by Curnow and colleagues. Double leg lift (top) focused on maintaining static trunk stability, whereas spine extension (above) focused on thoracic flexion with lumbar stability. The other two exercises (1 and 2 in the series) were abdominal curl and oblique abdominal curl.
This postural training exercise focused on maintaining a neutral spine while hinging backward from the hips. Group C performed this exercise after the basic series.
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