Abstract
Background Low back pain (LBP) is common in the elderly and an appropriate intervention for LBP management should be investigated. The aim of this study is to investigate the potential of mud-heat intervention combined with core exercise as an alternative intervention for relieving pain and improving motor function in individuals with nonspecific chronic LBP. Methods Thirty-one individuals with chronic nonspecific LBP were randomly allocated to either the intervention group (n = 16) or the control group (n = 15). The intervention group used a mud pack for 30 min and performed a core-exercise program for 50 min twice a day for 4 days (8 sessions). The control group performed the core-exercise program only, at the same time point as the intervention group. Pain intensity was assessed using a 100 mm visual analog scale and a pain pressure threshold (PPT) as the primary outcomes. The secondary outcome measures included functional disability by LBP (Oswestry Disability Index), muscle properties, and static/dynamic balance. Results There was a significant group difference in pain intensity at rest (p=0.048) and in the PPT at the two sites assessed (2 cm lateral to L3 spinous process, p=0.045; 2 cm lateral to L5 spinous process, p=0.015). No group differences were found in terms of muscle properties. Compared to core exercise only, moor-heat therapy and core exercise showed a significant improvement in static balance (p=0.026) and dynamic balance (p=0.019). Conclusion Mud therapy combined with core exercise is effective in relieving pain and improving motor function in patients with chronic nonspecific LBP. Further research is needed to underpin these preliminary results.
Highlights
Low back pain (LBP) is common in the elderly and an appropriate intervention for LBP management should be investigated. e aim of this study is to investigate the potential of mud-heat intervention combined with core exercise as an alternative intervention for relieving pain and improving motor function in individuals with nonspecific chronic LBP
It is known that nonspecific LBP is associated with a decreased range of motion (ROM), muscle strength, and flexibility of the lumbar and hip joints [3], which can result in tension, soreness, and stiffness. ese changes induced by nonspecific LBP can lead to functional limitations in daily living activities and a decrease in quality of life [4]
E guideline from the American College of Physicians and the American Pain Society recommends complementary and alternative interventions, such as exercise therapy, massage, or yoga, for the management of nonspecific LBP [9]. e systematic review of exercises used by LBP patients showed that a variety of exercises appeared to have beneficial effects for LBP and that exercise therapy for chronic LBP appears to be slightly effective in decreasing pain and improving function [10]
Summary
Low back pain (LBP) is very common, with an estimated 40% to 80% of individuals experiencing LBP over the course of their lives [1]. e majority of LBP is nonspecific (approximately 90% of cases), and nonspecific LBP is a common health problem that most people of all ages suffer from at some point [2]. Evidence-Based Complementary and Alternative Medicine opioids only have short-term effectiveness on chronic LBP, and approximately 50% of patients taking opioids long-term did not report an improvement in chronic LBP [7]. E guideline from the American College of Physicians and the American Pain Society recommends complementary and alternative interventions, such as exercise therapy, massage, or yoga, for the management of nonspecific LBP [9]. Mud-heat therapy combined with exercise may be more effective for chronic nonspecific LBP relief than exercise only. E purpose of the present study is to investigate the effects of mud-heat intervention combined with core exercise on pain, functional disability by LBP, and static/dynamic balance in people with chronic LBP.
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