An overview of functional progressions in the rehabilitation of low back patients

Low back pain is one of the most common dysfunctions seen by health care professionals. Eighty percent of the population will suffer from low back pain in their adult life.1-4 Accordingly, this societal problem has taken its toll via missed days of work and the adverse economic impact that results.3-9The good news is that most people with low back pain improve within a short period of time.1,9-11 Acute attacks of back pain and sciatica can last up to two weeks with chronic attacks persisting for more than three months.10 Vukmir reported that 74.2% of patients with low back pain improved within one month, 87.3% within three months, and 92.6% within six months.1 Additional good news is the fact that surgery is the appropriate solution for only a small percentage of the patients with low back pain.12,13 Saal and Saal report that nonoperative treatment for lumbar disorders, including intervertebral disc dysfunction prove most successful.13 Weber, in a landmark study, reported that patients who received surgery for lumbar disc herniations showed statistically better results at the one-year follow-up examination. However, at the four-year follow-up, there were no statistically significant differences in how patients who received surgery compared to the patients who did not receive surgery.14On a less positive note, people who suffer an episode of low back pain, have a greater chance of developing future episodes.10,15 Those patients who develop repeated episodes of low back pain and those patients who do not improve spontaneously over a short period of time can fall into the group known as chronic low back pain. This group creates a major drain on our economic resources and leads to a large number of people who are deemed disabled.1,7,8,12 Therefore, if the health care community is unable to cure all types of low back pain, keeping patients with low back pain functional should be of prime importance. Through the performance of functional activities, such as activities of daily living and working, the societal drain caused by low back pain, would hopefully decrease.