Can You "Bounce" Your Back Pain Away?
Back Pain. Who Hasn't Experienced Back Pain?
For far too many unfortunate souls, back pain is a source of ongoing frustration, debility, and generalized sadness. Studies report over two-thirds of adults experience back pain at some point in their lives with some individuals (up to 34% of adults depending on what study you read) dealing with moderate to severe back pain on a daily basis.
Chronic and/or severe back pain can make anyone consider skipping out on work, regardless of whether it is a Monday or if you have a deadline. In fact, low back pain is a significant source of decreased productivity in the United States.
One Person's Back Pain Is Not Another Person's Back Pain
The description of pain can vary:
"Sharp, stabbing pain."
"Like a vice-grip on my back."
That does not mean one description is correct and the others are wrong. Each individual experiences pain differently, both from a physiologic and mental standpoint. Furthermore, there are numerous potential sources of low back pain that likely produce different pain symptoms.
Name an anatomic structure in the lumbar spine and it is likely a potential source for low back pain.
The broad paraspinal muscles -- you bet!
The facet joints between vertebrae -- most definitely!
The interveterbral discs -- absolutely!
The stout iliolumbar ligaments -- of course!
Unfortunately, this merely scratches the surface of potential sources of back pain. No wonder that back pain really is a pain.
One thing most Spine Surgeons will agree on is that back pain with certain associated symptoms should not be ignored. These associated symptoms include, but are not limited to, fevers, radiating leg pain, leg weakness, loss of sensation, or changes in bowel or bladder continence. Such symptoms should prompt consultation with a physician.
It Is Not All Doom & Gloom
Look! Bouncy balls!
Unfortunately that probably did little to distract you from your back pain.
But bouncy balls, or more professionally referred to as exercise stability balls, have gained increasing publicity as a means to improve low back and core strength and reduce back pain (see video below).
There is some reasonable logic that an exercise stability ball can reduce back pain. Prolonged sitting and weak core/low back musculature have been strongly associated with low back pain. Many American jobs are desk-based and involve prolonged sitting throughout the day. If one were to change the seating dynamic while simultaneously activating core/low back muscles (e.g. exercise stability ball instead of desk chair), could this reduce back pain?
That is precisely the question posed in a recently published article in Spine, "The Effect of Sitting on Stability Balls on Nonspecific Lower Back Pain, Disability, and Core Endurance: A Randomized Controlled Crossover Study."
Study participants replaced their standard office desk chair with an exercise stability ball. They slowly increased the time they sat on the stability ball over the course of the 8-week study until they were sitting on the stability ball for 90 minutes/day, 5 days/week. The study group was compared to a control group who sat on their standard office desk chair.
Participants were asked to rate their low back pain and perceived disability using a questionnaire and also had their core muscle endurance examined through three exercises designed to stress the abdominal and low back muscles (an example can be found here).
So Should We All Rush To Buy A Stability Ball?
If only life were that simple. The study found no significant difference in perceived low back pain or disability between groups sitting on stability balls or standard office desk chairs.
So what do we make of these results?
As we discussed earlier, low back pain has a multitude of potential contributing factors that act together to produce low back pain and disability. It is unlikely that a single intervention (e.g. sitting on a stability ball) will be able to address all of these potential causes in every individual person.
A multi-faceted problem requires a multi-faceted treatment.
The stability ball intervention did have some positive effect as core muscle endurance improved with use of the stability ball. It is likely that improved low back/core muscle function will have a protective effect in preventing future episodes of low back pain and perhaps the study was not of a long enough duration to see this effect.
If you can rise above the ridicule from your co-workers as you inflate your stability ball at the office, you can tell them with confidence that the study found no negative effects of sitting on a stability ball. However, if you are hoping that the stability ball will allow you to "bounce" your low back pain away, I encourage you to incorporate additional treatment interventions to help you achieve this goal.
So whether you choose to inflate that stability ball or pop it with some scissors, medications, avoidance of prolonged sitting or standing, stretching, physical therapy, maintenance core exercise, proper lifting mechanics, and limitation of high-impact activities should always be key components of your low back pain treatment.