An Analysis of the Effectiveness of Strengthening or Stretching Exercises in Patients Performing Prolonged Sedentary Work with Non-Specific Lower Back Pain.

Abstract

Background: Non-specific LBP refers to back pain which arises from the spine, intervertebral discs and surrounding soft tissues in the absence of pathologic lesions. Most cases of non-specific LBP are not the result of a single injury from a high load, but the result of repetitive, cumulative micro-injuries. The aim of the study was to assess the effectiveness of strengthening, stretching and mixed exercises in patients with non-specific LBP and their impact on pain intensity.

Material and methods: We analysed 90 patients with non-specific LBP who performed prolonged sedentary work. Patients were qualified following history-taking, a physical examination and radiological evaluation if no pathology had been revealed on examination or on the available diagnostic imaging scans. The participants were randomly divided into 3 groups of 30 individuals each. The patients in each group performed one type of exercise (strengthening, stretching, mixed) for a period of 3 months. Both before starting and on completion of the exercise period, the patients were assessed with an original questionnaire as well as the Rolland-Morris, Oswestry and SF-12 scoring systems.

Results: Strengthening exercises were the most effective in reducing pain; on completion of the exercise period, pain assessed with the NRS scale was 2 points in the strengthening exercise group, 3 points, in the mixed group, and 4 points in the stretching group. The SF-12 questionnaire showed an improvement in the patients' health (increase in "excellent" and "very good" scores from 7% to 60%). According to the Oswestry disability questionnaire, strengthening exercises were the most effective (mean disability score of 4).

Conclusions: 1. The use of strengthening exercises in patients with non-specific LBP most effectively improves function and reduces back pain. 2. The use of stretching and mixed exercises in patients with non-specific LBP improves function and reduces back pain, but to a lesser extent than strengthening exercises.