In adults with acute back pain lasting up to three months, studies suggest that exercise programs that gradually increase activity can decrease absenteeism from work. “We found that adults with chronic low-back pain had modest improvements in physical function and pain with exercise therapy,” says lead investigator Jill Hayden.

With her colleagues, Hayden, a research fellow at the Institute for Work & Health in Toronto, examined 61 studies of more than 6,000 adults with low back pain. “The accumulated evidence supports a sea change that has occurred in medicine, away from recommending prolonged bed rest and activity restriction,” says Michael Von Korff, ScD, a senior investigator at the Center for Health Studies in Seattle. “We now recommend aerobic, flexibility and strengthening exercises and sensible resumption of normal activities as the worst pain subsides following an acute flare-up of back pain.”

Another approach to low back pain treatment is transcutaneous electrical nerve stimulation (TENS), a non-invasive treatment that stimulates nerves through electrodes on the skin. This treatment has been used for more than three decades.

But Lucie Brosseau, Ph.D., of the University of Ottawa, examined previous studies to determine the effectiveness of TENS and found only two studies of 175 patients that met standard criteria for drawing conclusions. One study found a significant short-term benefit for TENS treatment, but the larger, better quality study found no effect.

“Despite the lengthy history of TENS it is not possible to draw conclusions with confidence regarding its effectiveness for chronic low back pain,” says Dennis C. Turk, Ph.D., a psychologist and pain expert at the University of Washington in Seattle. “There may be some place for TENS as a component of treatment for people with chronic low back pain, but there is no evidence on which to base the conclusion that it is useful as a solo modality for this population.”; Source: Health Behaviour News Service