Back Pain? The Germans May Have Found A Cure

Dayton Kelly

This article was adapted from a combination of speeches given at the European Sports Science Conference 2017, most notably Spang, C. et al. [Sweden].

Low back pain plagues millions globally with 84% of people having reported back pain at some point in their lives. Among these, a large proportion suffer from chronic low back pain, a persistent form that may disturb daily living for years following onset. With the prevalence of this condition one would think doctors have a solution; unfortunately, efforts to date have largely been to no avail. While exercise and strength training does display efficacy in improving back pain and functional movement, programs seem to work sporadically and afflicted individuals have high rates of reoccurrence.

Why Exercise In The First Place?

Exercise has been and continues to be proposed as an effective means of alleviating back pain because it has the potential to alter posture. Back pain has been attributed to inflammation, pinching, or rubbing of the spine and associated tissue and, as well, tightness and inflammation of the back muscles. Such injuries occur when the musculoskeletal system spends too long in a specific position or is moved repetitively in the same way.

A common cause is the long-seated periods that occurs with sedentary lifestyle. With consistent exposure to one stimuli the body adapts accordingly: hypertrophy (growth) of utilized muscles occurs concurrently with the atrophy (degeneration) or stagnancy of those not in use. Resulting muscle imbalances shift posture putting excess strain on muscles in the back not normally recruited to this degree. Further, weaker muscles give out before newly hypertrophied ones, further exacerbating strain on individual muscles, leading to tightening. When excess strain is put on specific muscles or skeletal system is shifted into frictional positions, inflammation and pain are produced (note that this is a common mechanism of low back pain; others include congenital deformities, muscle wasting, and comorbidity).

Thus, by using exercise to strengthen weak muscles, the work is taken off strained ones and pain is alleviated. Stretching is often prescribed concurrently because it allows for temporary repositioning and mobility so the weak muscles can be strengthened.

Related Article: Using Pilates To Reduce Back Pain

So Where’s The Problem?

The correct exercise program for alleviating back pain is difficult to determine because individual injuries are, in many cases, unique. In a study where pain inducing posture was artificially produced, every subject recruited displayed a different pattern of muscular strain. Further complicating the issue are a host of psychological and social factors that influence pain perception and recovery. Such factors might include an job that forces a seated position for extended periods of times and high levels of stress. Based these different factors, individuals are more or less responsive to existing exercise programs. It thus makes it incredibly difficult to control for all of these factors and match the individual to the right program.

However…

German scientists believe they now have a program that works for most individuals. The program was developed by surgeons who realized that many of their day to day surgeries could have been alternatively treated with exercise. Their program is surprisingly simple, but relies critically on an exercise machine that is now considered the gold standard for back rehabilitation.

The machine operates in reverse of the ab crunch machine you likely see at your local gym, forcing the user to extend their body from a crunched to straight alinement. Similar to cable exercises, the machine provides even load throughout the movement and isolates muscle recruitment to those directly involved in the limb translation (stabilizing muscles are recruited to a lesser degree). The result is direct stimulation of muscles surrounding the spine.

Their program consists of one exercise session a week for 18 weeks on this machine. During each session, users are to perform a single set of 12-15 repetitions. In the first nine weeks, this set is performed at a submaximal load (you have the strength to lift the weight more than 15 times), progressing incrementally in range of motion and weight. In the next nine weeks, the sets are to be at an exhaustive weight (you can do more than 12 but less than 15 repetitions). Following completion of the program, the creators suggest that users require only one or so such workouts per month to continue fighting off back pain.

Too Good To Be True?

We were skeptical as well. However, in a sample of over 600 individuals unresponsive to any other form of treatment (the researchers operate out of a clinic that treats the worst of the worst), 88.5% reported pain alleviation. While more research is necessary, this treatment does appear very promising. Unfortunately, this treatment is currently available only Germany and a select few other nations. While this makes it tempting to try it out on your own, the researchers caution readers that participants received constant monitoring and adjustments, making this program only the primary component of a holistic approach to rehabilitation. Still, adopting some of their principles may be worth while in treating and preventing your own lower back pain.

Takeaways:

It appears that a machine similar or identical to the one used by the researchers would be a good tool to try out if you can find something similar. In line with the methodology of their program start very light (Recommended: 45% of your 12 rep maximum weight, between 15 to 39 degrees of extension). Progress over 9 weeks (one session of one rep/week) to larger ranges of motion and your 12 rep maximum, reducing the weight or range of motion if pain is experienced (Do not push through). For the following 9 weeks do one set to exhaustion per week.

Try to remove factors in your life that contribute to your back pain and reduce your time sitting. If you are overweight, this may too be contributing to your back pain and so weight loss may be recommended. Good luck and don’t forget to let us know whether this works for you! As always, we love to hear from our readers!
Caution: as always, speak to your doctor before beginning a new training program.
READ MORE ABOUT THE GERMAN SOLUTION ON THEIR WEBSITE AT: https://alfenspine.com/en/

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