Aerobic Exercise for Chronic Non-Cancer Back Pain: A Review of Clinical Effectiveness [Internet].

Author: Banerjee S, Walter M.
Canadian Agency for Drugs and Technologies in Health
Conference/Journal: CADTH Rapid Response Reports
Date published: 2019 Oct
Other: Word Count: 392

Chronic pain is generally defined as pain lasting for 12 weeks or longer, or persisting beyond the time needed for normal tissue healing.1,2 Chronic pain conditions include chronic back pain, chronic neck pain, chronic tension headache, osteoarthritis, and fibromyalgia.1 Risk factors for developing chronic pain include female gender, older age, psychosocial factors, comorbidities, and genetics.1,2 Chronic pain is a global problem.2,3 It was estimated that in Canada, 25% of adults have a chronic pain condition.3 In another publication,4 it was mentioned that during the period 2007 to 2008, the prevalence of chronic pain in adults over the age of 18 years was 18.9% in Canada, and ranged between 16% and 22% for the different provinces. Variability in prevalence estimates may result from differences in the population assessed, and the methods of data collection.4 Chronic pain is associated with reduced quality of life, absenteeism from work, and increased healthcare costs.2,3 It was estimated that in Canada, the annual direct cost to the healthcare system was over six billion dollars and the annual indirect cost due to sick days and job loss was over 37 billion dollars.3 Chronic pain is a problem for the individual suffering and also a societal burden.5 Treatment options for managing chronic pain include surgery, pharmacological interventions, and non-pharmacological interventions.5 Pharmacological interventions include medications such as nonsteroidal anti-inflammatory drugs, muscle relaxants, antiseizure medications, antidepressants and corticosteroids.1,6 However these medications offer limited pain relief and are often associated with side effects.1 There is growing interest in non-pharmacological interventions. Non-pharmacological interventions include options such as acupuncture, massage, Pilates, Yoga, and aerobic exercises.6 Aerobic exercise predominantly depends on the aerobic energy-generating process and includes various types of exercises such as walking, running, and cycling.5 A Summary of Abstracts report published by CADTH in 2017 included 46 systematic reviews (12 with meta-analysis) that evaluated the clinical benefits and harms of exercise for adults with back pain.7 Various exercise programs (such as aerobic, strengthening, range of motion, motor control, balance, endurance, Pilates, yoga, McKenzie method) were investigated. Comparator interventions were variable and not always clearly defined. Overall, the abstracts indicated that exercise may be effective for symptom reduction in patients with back pain. The purpose of this report is to review the evidence regarding the clinical effectiveness of aerobic exercise for chronic non-cancer back pain compared with pharmacological interventions.

Copyright © 2019 Canadian Agency for Drugs and Technologies in Health.

PMID: 31873992
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