"Each physician bears the responsibility to evaluate and treat persistent pain as serious medical condition. Principal  treatment physician must approach each patient with respect and urgency and provide appropriate and timely referrals to a Pain Medicine specialist .."

  Topic of the month 

       Role of a physical fitness in treatment outcome of a lower back pain syndrom's

It is scientificly proven that most  patients with a chronic intractable lower back pain, who are not a candidates for surgical intervention essentialy have a very good prognosis for recovery, if they are physically fit and continue excersises to stay fit, immediatelly after acute phase of a post injury or trauma of any kind. The strenht of the core musles: the abdominal and a back muscles are important in stabilization of the posture and eventually the spine. It is however very important that the patient is doing correct excersises because a wrong ones can do more damage then help. It is absolutely crucial that every patient is individually evaluated (history, Physical exam and neurological exam with complete set of an additional diagnostic studies like MRI without contast, or at least CT scan) before any excersises regiment is initiated.

Off course differnt approach is to a patient who has notbeen atheltic and has numerose comorbidity. However the general principle stays the same. Patient is advised to began physical activity slowly and gradually increse the intensity as well as freequency, preferrebly under supervision( at least for the begining while learning the routines) because it will determine the long therm outcome of the recovery, which can be months or years but - recovery.It is almost the same as a person without chronic pain syndrom who use to excersises versus never excersised wants to get in shape for any reason; it takes time to reach certain level of fitness then it has to be maintained. The difference is that chonic pain patients will often need additional help- pain needs to be uder control. That means, on scale 0-10 , when 0 = no pain and 10 = the worse pain they ever experienced in their entire life, must be below 5 at least. When pain is decresed by any easure to the accepable level- when patient stops being preocupied by it and can do other things = simply -living, then is time to plan core muscles and flexibilty excersises.  

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 Our Favorete Links:

www.ncbi.nlm.nih.gov/sites/entrez/

www.drsulekha.com/blog/post/2006/06/yoga- and-back-pain.htm 

www.holisticonline.com/yoga/hol_yoga_

breathing_importance.htm

www.bocamag.com

www.undas.um..og

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