Self-management improves course of low back pain

December 02, 2003

Exercise, behavior and dietary changes have a significant impact on improving mental and physical function in low-income adults with chronic low back pain, according to a study published in the current issue of the Archives of Internal Medicine.

Researchers led by Teresa Damush, Ph.D., assistant research scientist at the Indiana University School of Medicine, who is also a Regenstrief Institute, Inc. research scientist, enrolled 211 inner city residents over age 18 in the study. The participants were predominately female (73 percent) and African-American (59 percent).

Study participants were divided into two groups, both of which continued to see their physician for treatment of low back pain. One of the groups participated in a self-management program. These individuals attended weekly classes in a neighborhood health center where back-strengthening exercises were taught to improve physical function. As importantly, the classes were designed to teach individuals how to fit exercise into their daily schedules.

Sessions also were conducted to teach study participants in the self-management group coping mechanisms for negative emotions such as depression and frustration. Dr. Damush, who is a health psychologist, said many study participants had deep fears of disability. All participants were counseled to communicate regularly with their physician rather than being a passive participant in control of their pain.

"Our study showed that empowering low income adults to deal with their pain through such self-management strategies as exercise, behavior and dietary changes, significantly improved both mental and physical functioning. With better mental and physical functioning individuals with low back pain can return more quickly to work and family activities," said Dr. Damush.

Back pain is the second most common neurological ailment after headache, in the United States, according to the National Institutes of Health. Acute or short-term low back pain generally lasts from a few days to a few weeks and is caused by trauma to the lower back from work or sports injury, accident or by disorders such as arthritis. Obesity, smoking, stress, poor physical condition or bad posture may contribute to lower back pain. Americans spend at least $50 billion each year on treatment of lower back pain, the most common cause of job-related disability.
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The study, which followed participants for an entire year, was funded by the National Institutes of Health and the Department of Veterans Affairs.

Indiana University

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