Rehabilitative Treatments of Chronic Low Back Pain

被引:3
作者
Chung, Sun Gun [1 ]
机构
[1] Seoul Natl Univ, Coll Med, Dept Rehabil Med, Seoul, South Korea
来源
JOURNAL OF THE KOREAN MEDICAL ASSOCIATION | 2007年 / 50卷 / 06期
关键词
Chronic low back pain; Rehabilitation; Exercise; Physical therapy;
D O I
10.5124/jkma.2007.50.6.494
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic low back pain (CLBP) is a complicated clinical condition related with pathologic pain generators in the spinal column, weakened and deconditioned muscles in the trunk and extremities that control the motion and stability of the spine and pelvis, faulty biomechanics caused by connective tissue contractures, and behavioral problems such as fear-avoidance beliefs and emotional distress. Since it is initiated and maintained by these complicated causal factors, CLBP could not be successfully treated by one or two specific rehabilitative treatment options. A multidisciplinary approach with an appropriate individualization to each patient is known to be more successful than simple and passive physical therapeutic agents. Among the rehabilitative therapeutics, sustained exercise for 2 to 3 months appears to be the most effective, providing CLBP patients with significant pain relieves and functional improvements that last for a long-term period. There have been several different types of low back exercises including strengthening, flexibility training, aerobic exercise, lumbar flexion exercise, and McKenzie's extension exercise, with which favorable outcomes were reported. Recent advances in the field of spine biomechanics introduced a principle, the core stabilizing exercise, to stabilize the spine and pelvis by strengthening and improving the control of the several specific truncal muscles. Although supported by some reports showing excellent results, the core stabilizing exercise in itself may not be the most effective therapeutic exercise for CLBP. Instead, it could be a useful adjunctive measure to the exercises that have been used to date. A novel rehabilitative therapeutic modality is anticipated to be developed in the near future to theat the spine more specifically, addressing its particular pathologic conditions.
引用
收藏
页码:494 / 506
页数:13
相关论文
共 63 条
[1]  
Adams MA, 2002, BIOMECHANICS BACK PA
[2]   Core strengthening [J].
Akuthota, V ;
Nadler, SF .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2004, 85 (03) :S86-S92
[3]   The role of anticipation and fear of pain in the persistence of avoidance behavior in patients with chronic low back pain [J].
Al-Obaidi, SM ;
Nelson, RM ;
Al-Awadhi, S ;
Al-Shuwaie, N .
SPINE, 2000, 25 (09) :1126-1131
[4]  
[Anonymous], 2004, COCHRANE DB SYST REV, DOI DOI 10.1002/14651858.CD000447.PUB2
[5]  
Ariyoshi Mamoru, 1999, Kurume Medical Journal, V46, P91
[6]   Lowering fear-avoidance and enhancing function through exposure in vivo - A multiple baseline study across six patients with back pain [J].
Boersma, K ;
Linton, S ;
Overmeer, T ;
Jansson, M ;
Vlaeyen, J ;
de Jong, J .
PAIN, 2004, 108 (1-2) :8-16
[7]   The efficacy of lumbar traction in the management of patients with low back pain [J].
Borman, P ;
Keskin, D ;
Bodur, H .
RHEUMATOLOGY INTERNATIONAL, 2003, 23 (02) :82-86
[8]   Methodologic issues in low back pain research in primary care [J].
Bouter, LM ;
van Tulder, MW ;
Koes, BW .
SPINE, 1998, 23 (18) :2014-2020
[9]  
Bronfort Gert, 2004, Spine J, V4, P335, DOI 10.1016/j.spinee.2003.06.002
[10]   Efficacy of the transcutaneous electrical nerve stimulation for the treatment of chronic low back pain - A meta-analysis [J].
Brosseau, L ;
Milne, S ;
Robinson, V ;
Marchand, S ;
Shea, B ;
Wells, G ;
Tugwell, P .
SPINE, 2002, 27 (06) :596-603