LOMBALGIAS (6)

Activity and low back pain: A dubious correlation

Schiltenwolf M, Schneider S.
in http://www.ncbi.nlm.nih.gov/pubmed/19233563?dopt=Citation

EDITORIAL DA REVISTA PAIN de 17 Fev/2009 (alguns excertos para reflectir)

There is no doubt that modern sedentary lifestyle constitutes a severe risk factor for low back pain. Although the working conditions have been humanized, work loss due to back pain is still increasing.

Avoidance of physical activity impairs physical capability and back capacity. Leisure time physical activity gives better prognosis for preventing back pain disability. Additionally, graded and moderate activity is recommended for functional restoration regarding back pain. Learning to be active to prevent and mitigate back pain is a crucial therapeutic goal. (...)

Against this background the idea of a U-shaped correlation between physical activity and self reported low back pain seems amazing: according to this correlation, both physical activity and inactivity can represent a back pain risk factor.

People working in physically demanding jobs that put high levels of stress on their backs are more at risk of developing back problems: occupations associated with physically strenuous work involving one-sided postures, moving, carrying and holding heavy weights, and work typically performed under poor working conditions or bad weather are related with an above-average prevalence of back problems (Schneider S. et al, 2005). We can deduce that the risk of low back pain is associated with the appropriateness of the physical activity performed. (...)

Physical activity is protective – physically and mentally. Whereas power, endurance and flexibility are gained directly, improved mood and social contacts, as well as lowered pain thresholds are reached indirectly. (...)

Furthermore, not duration and intensity alone imply the load of an activity on the back (and other regions of the musculoskeletal system) but the quality of the performance also plays a role: well-balanced activity with regard to power, endurance, flexibility and coordination will do less damage than monotonous, over-ambitious, intensive training sessions. Such inadequate training programs are often associated with high load-levels and a lack of adequate supervision, training plans and sufficient recovery time. (...)

We are still on the way to understanding the influence of activity on the probability of low back pain: it is not a bidimensional relation, but a multidimensional relation. We need longitudinal studies that include aspects of the quality of the activity and of pleasure and mood accompanying the performance.

A VIDA É MOVIMENTO.