While television might be considered a major reason for the sedentary lifestyle that can lead to back problems, at least one orthopedic specialist said the medium deserves some credit for new rehabilitation therapies.
“TV has greatly increased coverage of professional sports,” explained Dr. Vert Mooney of the University of California-San Diego and spokesman for the American Academy of Orthopaedic Surgeons. “That has led to greater exposure of rational sports medicine, which works to get the athlete back on the court or field as soon as possible without risk of further injury.”
Mooney said bed rest once was standard treatment for back pain. But in treating athletes, it was discovered that connective tissue and muscles actually respond best when progressively exercised. It has worked for hundreds of athletes in recent years, even players with more severe back pain, such as National Basketball Association stars Scottie Pippen and Charles Barkley.
Strong abdominal muscles are widely cited as important for a healthy back. Mooney doesn’t discount such toning — particularly for preventing back problems before they occur — but cautions that the important exercises after a disc injury are those that “lubricate” the area.
“A spinal disc doesn’t have its own blood supply,” he said. “Activity moves blood to the disc and keeps it hydrated with the proper fluids to avoid pain.”
Mooney said to imagine an injured disc as a “strong sponge” that needs to be moved so fluid can be absorbed and discarded at regular intervals. Even the occasional movement after prolonged sitting can help.
While massage, hot packs and ultrasound help relieve pain, Mooney said such therapies don’t address the dehydrated disc.
The following two exercises are recommended by the American Academy of Orthopaedic Surgeons for anyone with mild to moderate back pain:
Wall slides: Stand with your back against the wall and feet shoulder-width apart. Slide down into a crouch with knees bent about 90 degrees. Count to five and slide back up the wall. Repeat five times.
Back leg swings: Stand behind a chair with your hands on the back of it. Lift one leg back and up while keeping the knee straight. Return to the floor slowly. Raise the other leg and return. Repeat five times.
Leg lifts and partial situps also help, but proper form is critical. See a physical therapist or personal trainer.
Mooney said any intense pain down the legs during exercise typically means you are irritating a nerve in the spinal column. For patients with more acute back pain, he recommends lying on the stomach, propping the elbows to attain a slight curvature in the back, then doing 5 to 10 partial pushups.
Other forms of exercise provide relief to back patients. Dvera Berson is an 84-year-old woman from Boca Raton, Fla., who resorted to a swimming pool when she began suffering from crippling arthritis (both rheumatoid and osteoarthritis) in her early 60s. She found relief in the water and eventually developed an aquatic exercise program that has been positively reviewed in professional journals and included in a medical textbook.
“This is not about swimming,” said Berson. “I have developed 35 exercises that address various regions of the body, including the back.”
Berson advocates immersing your body in water to chin level for best results. She has developed two videos, “Pain-Free Arthritis” (three hours, $93) and “The Berson Program to Stop Chronic Back and Neck Pain” (91 minutes, $39.95). They are available only by mail-order: S&J Books, P.O. Box 276092, Palmetto Park Station, Boca Raton, Fla. 33427. The longer video includes a background lecture by Berson.
Another exercise option is the flowing movement of martial arts. Dr. Patrick B. Massey is co-director of the Alt-Med Back Pain program at Alexian Brothers Medical Center in Elk Grove Village. He has worked with more than 1,500 patients who usually come to Alt-Med after other therapies have failed. He said about 50 percent of the patients have eliminated chronic pain within eight weeks, and that most people eventually experience some form of relief, even those with sciatica, pain that peaks in the lower legs but often begins in the back.
“We have developed about 300 different movements that we mix and match depending on a patient’s condition,” said Massey, who discovered the benefits of martial arts when struggling with his own back problems in 1984. He has presented his data at various professional meetings and He currently is developing a research study for publication with an Alexian Brothers colleague, Dr. William L. Preston.
“We sometimes have to start with static exercises for less limber patients,” said Massey. “But the ultimate goal is getting people’s backs moving again.”
Next week: Chiropractic and other “alternatives.”
