Is exercise the only cure for chronic low back pain?

Q: I'm having trouble finding someone who will take my back pain seriously and help me. The doctor says to exercise and it will get better. Well, I've tried exercise and the pain always comes back. Is it just me? Or do other people have this experience, too?

A: A recent study was done investigating patient satisfaction with health care for chronic low back pain. They found that the majority of patients were satisfied with their care. The number of visits didn't seem to affect satisfaction. Those who weren't happy didn't attribute their dissatisfaction with their health care provider. They might not have felt they got an adequate explanation of their problem, so decided to seek other opinions. That's a problem when it comes to chronic back pain because most of the time, the reason for their pain is unknown. Seeking more diagnostic help and spending more money to do so doesn't solve the problem.

Your physician's advice was based on sound research that shows regular exercise and change in behavior are the most effective ways to manage low back pain that is chronic (lasts more than three months). The results of the study mentioned showed that there are some other factors linked with dissatisfaction (younger age, race (Blacks and Hispanics), no insurance, and poor mental health). You may find yourself in one of these categories. It would suggest that there are other factors that affect how you think about your back pain and why you aren't happy with the health care advice given so far.

If your pain continues to return despite regular physical activity and exercise, you may need some specific type of exercise such as core training to stabilize the trunk and spine. A physiotherapist can help you identify specific areas of need and how to address those with exercise. Sometimes having a supervised, prescribed exercise program you can follow everyday at home makes all the difference.

Andrea S. Wallace, PhD, RN, et al. Comfortably Numb? Exploring Satisfaction with Chronic Back Pain Visits. In The Spine Journal. September 2009. Vol. 9. No. 9. Pp. 721-728.