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Exercise & education reduces the risk for getting low back pain

It's important to figure out strategies to prevent this very common condition

Low back pain (LBP) is one of the most common health conditions throughout the world. It's estimated that about 12% of the global population currently has LBP to some degree, and this makes it an extremely expensive problem as well due to the costs of treating it and time lost from work. In addition, about half of the patients who get LBP once will experience another episode within one year of recovering from it the first time. This shows how important it is to figure out ways to prevent LBP before it starts. There have been many studies that have investigated this topic, but it's still not clear what the most effective strategies are for preventing LBP. Therefore, a very powerful review of literature called a systematic review was conducted on high-quality studies that looked into treatments to prevent LBP. This was followed by a meta-analysis, which took all the data found and analyzed it in detail to help determine which methods were actually best for the prevention of LBP.

A search of medical literature leads to 21 studies used in the review

Researchers who were conducting this systematic review and meta-analysis searched through four major medical databases to identify studies that were relevant to the topic. They were looking for high-quality studies called randomized-controlled trials (RCTs) - the most powerful type of individual study - that investigated different strategies to prevent LBP. This search led to 21 RCTs being accepted for this current study. The 21 RCTs contained data on 30,850 different patients and investigated six different strategies for preventing LBP: exercise, education, exercise and education, back belts, shoe insoles, and other prevention strategies. These studies were then reviewed and analyzed in detail with the goal of identifying which of these strategies was the best overall.

Exercise alone is effective, but adding education may be even more helpful

When education is added to exercise, it appears that the combination is even more likely to reduce the risk for LBP. Unfortunately, this was not found to be the case with education alone, and it seems that it needs to be combined with exercise to have a significant effect. In addition, back belts, shoe insoles, and ergonomic adjustments were not found to prevent an episode of LBP or sick leave due to LBP. On the whole, this study further supports the combination of exercise and education as a strategy to prevent LBP. This adds to a group of research on this topic that continues to show the importance of these two components in the prevention of LBP. Patients concerned with their risk for LBP should, therefore, speak to their physical therapist for education advice and guidance on the best forms of exercise that will help prevent LBP.

-As reported in the February '16 issue of JAMA Internal Medicine
April 13, 2017