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Patients with chronic low back pain often are deconditioned, have impairments in gait, and are disabled to some degree. Rehabilitative approaches are often very important and can address all of these problems over time. These approaches include physical therapy, the use of specific modalities for pain, occupational therapy, and other interventions.
Exercise can be very beneficial for low back pain. Scientific research supports the trend toward a more active treatment approach to chronic low back pain. (Mannion, 1999) (van Tulder, 2000). Active rehabilitation programs are proving to be more effective than passive therapies, such as ultrasound and heat therapy, in reducing pain and improving function. Active back exercises have also been found helpful in preventing recurrences of low back pain (Taimela, 2000).
Exercise programs are designed to increase range of movement, strengthen muscles, increase flexibility, and stretch tightened muscles or structures. Exercise can include low impact aerobics such as swimming and walking, lumbar extension strength training, mixed exercise regimens, isometric flexion exercises, hydrotherapy, mobilizing exercises, the McKenzie exercise program, and other regimens. Exercise programs are more effective when supervised by a trained practitioner.
A well-designed exercise program based on the nature of chronic back pain has been found to provide both physical and psychological benefits. Not only can it help improve strength and flexibility, but also contributes to a sense of well being and can reduce pain perception and psychological distress. Physical therapy, muscle strengthening and low impact aerobics have all been found effective in reducing low back pain. Maintaining regular exercise after treatment is also an important part of a successful treatment strategy in order to maintain positive results and avoid recurring episodes of back pain.
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