Stretching Is Not Always the Answer for Patients with Low Back Pain

Millions of Americans suffer from low back pain. The costs of missed work and loss of quality time with family and friends are enormous. A lot of medical research is directed at finding the causes of low back pain to help find effective cures and prevention measures.

This study focused on whether hamstring flexibility affects patients with low back pain. Researchers looked specifically at back pain sufferers whose problems did not have a known cause--for example, arthritis or obvious disc or vertebrae problems. The researchers found that muscle stiffness was not the issue, as has been traditionally thought. Instead, patients with back pain didn't tolerate stretching very well, specifically in their hamstring muscles.

Researchers compared 20 people with low back pain and 20 people with no back problems. Researchers divided the healthy group into a "flexible" group and a "stiff" group by having them bend at the waist and try to touch the ground. Then the subjects were placed on a leg-stretching table, where they had complete control over how far the stretch could go. They were asked to report what they felt as the stretch progressed. The subjects would stop the stretch when the tension, usually felt in the hamstrings, became too uncomfortable.

Both the stiff group and the back-pain group noticed the first sensation of pain at similar times, which happened much earlier than the flexible group. Yet there was a significant difference in how the stiff group and the back-pain group reacted to the stretching. During the stretch--often early--people with back pain had more sensitivity or irritability in the muscles of the back and leg. It is possible that fear of pain during stretching may have caused this unconscious reaction in the muscles.

Stretching is one of the common suggestions given to patients with muscle stiffness or back pain. This study makes it clear that stretching is not always the best choice. In fact, people with low back pain may actually get better results by using relaxation techniques to calm their overly sensitive back and hamstring muscles.

Jan P. K. Halbertsma, PhD, et al. Extensibility and Stiffness of the Hamstrings in Patients With Nonspecific Low Back Pain. In Archives of Physical Medicine and Rehabilitation. February 2001. Vol. 82. No. 2. Pp. 232-238.

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