Two Exercise Interventions May Ease Acute Spine Pain

New research shows two non-invasive exercises that are effective for treating acute spine pain.

Key takeaways:
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    New research shows that acute back pain can be treated with two non-invasive exercises.
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    Spine pain is defined as pain that occurs in the neck or back.
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    Lower back pain has been the leading cause of disability worldwide since 1990.
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    Both the ICE care model and individualized postural therapy (IPT) significantly cut back pain compared to usual care.
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    The researchers are encouraging healthcare professionals to include both ICE and IPT in primary care.

A new study published in the JAMA Network found that two conservative treatments successfully relieve some acute and subacute spine pain.

A conservative intervention or treatment is a type of medical care that doesn't use invasive methods like surgery. This treatment style is typically done to keep the body working as it should.

The SPINE CARE trial included 2971 adults. Most participants were women (60%), and the average age was 51. The participants, who were chosen randomly, all expressed having back or neck pain that lasted less than 12 weeks.

The participants were put into groups based on how likely it was that they would go from having acute pain to chronic pain. Researchers used the "identify, coordinate, and enhance" (ICE) care model to make the distinction.

Patients with a low risk received one physical therapy (PT) visit and one coaching call. Patients with a higher risk received three PT visits, three coaching calls, and one e-consultation.

After 6-8 weeks of therapy, three-month results showed that pain for both the ICE and individualized postural therapy (IPT) groups improved significantly compared to usual care groups.

"We found that, compared to usual primary care, both interventions reduced pain-related disability at three months and that these changes were sustained and clinically meaningful at 12 months ― long after the interventions were over," said Niteesh K. Choudhry, MD, Ph.D., the lead author of the study.

The findings show the potential to cut medical spending related to spine pain.

“Both interventions reduced resource utilization, such as diagnostic imaging, procedures, and specialist visits. Because of this, both reduced spending unrelated to the interventions themselves," Dr. Choudhry said.

Dr. Choudhry added that the study proves to be fairly easy to include in primary care.

“We tested the interventions in a way that was integrated into primary care, so implementing them in other practice settings should be quite straightforward,” said Dr. Choudhry.

However, important factors like insurance coverage will need to be considered when planning to include both treatments.

Spine pain is defined as pain that occurs in the neck or back. The most common types of pain are lower back pain (28%), knee pain (19%), headache (16%), and neck pain (15%). Many of the U.S. population (80 percent) will experience back pain at some point in their lives.

Acute back pain tends to get better on its own. Because of this, medical guidelines often say that the best spine pain treatment is education and advice to stay physically active.

However, many people have back pain that returns. Also, some people with spine pain develop chronic back pain. Lower back pain has been the leading cause of global disability since 1990, according to the International Association for the Study of Pain (IASP).

The global number of people with low back pain increases yearly as the world’s population increases and ages.

"Spine pain is an exceptionally common reason for patients to visit their primary care providers," Dr. Choudhry said. “It accounted for more health spending than any other health condition in the U.S. in 2016.”

The research team encourages medical professionals to include conservative interventions in future primary care.

"Clinicians should more often recommend structured exercise programs for subacute back or neck pain, especially when the pain is recurrent," said Dr. Choudhry.


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