Aching Backs: Treatment May Be Movement, Not Rest

Source: Tufts University
December 15, 2000 (Reviewed: February 17, 2003)

Introduction

Lower back pain is a common health complaint, especially among older individuals. Not surprisingly, people who are slowed by back pain may be tempted to avoid exercise in an attempt to sooth sore muscles. That may not be the better "tonic for aching backs," however. An article in the Archives of Internal Medicine suggests that muscle strengthening exercises may be key to the management of lower back pain.

A group of researchers in Japan assessed the percentage of body fat and waist-to-hip ratio (a measurement of abdominal fat) in more than 200 middle-aged and older men and women who suffered from lower back pain. They looked separately at people with generalized low back pain and those with back pain due to compressed bones in their spine. A group of men and women without back pain served as comparison group.

The researchers found that the waist-to-hip ratio was higher in women with generalized back pain, meaning that these women were more likely than others in the study to have excess abdominal fat. They also, on average, had less muscle in their back and legs than other study participants. There was no apparent link between body fat, muscle mass, and back pain among the men in the study.

The women with low back pain were not necessarily obese. In fact, their average body mass index (BMI), a measurement of body weight, was not significantly higher than the other female study participants. But what excess weight they carried was more likely to be centered in the abdominal area, a trait that is problematic for more than just back health. Scientists think that abdominal fat is metabolized differently than fat in other parts of the body, causing high blood pressure and elevated cholesterol levels--both risk factors for heart disease. Men are particularly prone to abdominal obesity, but it can be a problem for women as they reach menopause, when declining estrogen levels cause a shift in sites where fat is deposited in the body.

Take a stroll

The results of this study suggest that abdominal obesity and loss of muscle mass--both potential health problems for women as they get older--may contribute to chronic low back pain. Regular exercise can help reduce body fat and increase muscle mass. Aerobic exercise, like walking, is the most effective calorie burner for overall weight loss. But the researchers say that, given the apparent link between poor muscle tone and low back pain, exercise that strengthens and stretches the leg and back muscles is needed as well. That does not translate to three distinct workouts. A brisk walk combines aerobic exercise with muscle toning. (For those who are out of condition, begin slowly and step up the pace as you become more fit.) For a complete back workout, add a light stretch afterward.

Note: those who suffer from back pain should check with their healthcare provider before beginning an exercise program.

Source

• Lean body mass and body fat distribution in participants with chronic low back pain. Y. Toda, N. Segal, T. Tota, Archives of Internal Medicine., 2000, vol. 160, pp. 3265--3269

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