Fitness Exercise for Chronic Low Back and Leg Pain Patients

Fitness Exercise for Chronic Low Back and Leg Pain Patients

Chronic low back and leg pain is a common condition among middle-aged and elderly individuals, often caused by strain, acute lumbar sprain, herniated discs, spinal calcification, deformities, and spinal osteophytes compressing nerves, leading to lower back pain and lower limb dysfunction. It is a common manifestation of neurological, muscular, and skeletal imbalances and is characterized by severe symptoms, prolonged course, frequent relapses, and significant impact on patients' physical and mental health. Surveys have shown that over 80% of adults have experienced low back pain at some point in their lives. Due to the prolonged treatment and high costs associated with chronic low back pain, many patients find it difficult to endure. The effectiveness of treatment is also uncertain, making "back pain issues" a persistent concern for people. As a result, rehabilitation through fitness exercise is gaining increasing attention from patients and the clinical community due to its low cost, simplicity, and patient acceptance. However, some patients often fear exercise-induced pain and are reluctant to move their backs excessively, leading to prolonged bed rest. This not only hinders recovery but also results in atrophy of the back muscles, muscle weakness, functional decline, and even exacerbates spinal deformities, worsening the back pain and impacting normal life and work. Therefore, for patients with chronic low back and leg pain, early rehabilitation exercise is essential to strengthen the back muscles, which can help alleviate pain and prevent further injury.

(1) Objectives of Fitness Exercise for Chronic Low Back and Leg Pain Patients

Chronic low back pain is closely related to the weakening of abdominal and back muscle strength. The relaxation and weakness of these muscles, along with the imbalance of muscle strength, lead to decreased spinal stability, noticeable lumbar lordosis, excessive pelvic anteversion, and abnormal stress on the lumbar vertebrae, resulting in pain in the lower back. Without timely correction, the pain tends to worsen continuously. Therefore, the objectives of fitness exercise are to select targeted training for pelvic retroversion, spinal ligament stretching, and abdominal and back muscle strength enhancement to improve overall and local blood circulation in the lumbar vertebrae, ensuring that the muscles and bones in the back receive more nutrients and oxygen. This includes enhancing the strength of the abdominal and back muscles, coordinating their movements, correcting bad postures, increasing spinal stability, rectifying abnormal postures such as lumbar lordosis and pelvic anteversion, and maintaining normal back function. Fitness exercise should help relieve muscle tension and spasms, release muscle adhesions, restore muscle elasticity, prevent muscle atrophy, and reduce pain. It should also promote the formation of compensatory mechanisms, enhance cardiopulmonary function, and prevent complications caused by lack of exercise. It should contribute to maintaining a positive and optimistic attitude, boost confidence, improve daily activities, work capacity, and enhance the overall quality of life.

(2) Key Points to Consider in Fitness Exercise for Chronic Low Back and Leg Pain Patients

First, it is essential to note that fitness exercise rehabilitation is mainly suitable for certain mechanical chronic low back pain, which can be classified into three main syndromes: posture syndrome, functional impairment syndrome, and intervertebral disc displacement syndrome. However, for patients with skeletal organic lesions such as pyogenic lesions of the lumbar vertebrae, spinal tuberculosis, spinal malignancies, and those experiencing acute exacerbation of chronic low back pain, fitness exercise should not be implemented.

Second, functional exercises should be started as early as possible. The earlier the exercises begin, the better the rehabilitation effects. Muscle strength exercises and joint movement exercises should complement each other to accelerate patients' functional recovery.

Third, functional exercises must be carried out under the supervision and guidance of physicians or professionals and tailored to each patient's specific condition to avoid violating the physiological and anatomical characteristics of joint muscles, causing further injuries. The intensity and duration of exercise should be individually determined by physicians or professionals based on each person's physical strength and disease condition, with mild pain being the limit, and severe pain should be avoided.

Fourth, it is necessary to wear properly fitting and comfortable sports shoes and clothing. Ill-fitting shoes and clothing may overload the lumbar vertebrae and even cause re-injury. In daily life, bending actions should be avoided as much as possible. If picking up relatively heavy objects from the ground, one should bend the knees and squat down to get as close to the object as possible. Then, use both hands to lift it with force to reduce bending of the lumbar back during the entire squatting process and avoid injuries.

Fifth, during acute exacerbations of chronic low back pain, bed rest is necessary, and exercise should be prohibited. Once the acute symptoms subside, exercise and rehabilitation should be initiated as early as possible. Combining exercise with rest is of great significance in relieving pain, strengthening muscle strength, and stabilizing the spine.

(3) Selection of Fitness Exercise for Chronic Low Back and Leg Pain Patients

The fitness rehabilitation exercise for chronic low back and leg pain is divided into two stages. The first stage (usually lasting 3 months) focuses on strengthening the abdominal and back muscle strength, particularly the dynamic strength exercises for abdominal muscles, to achieve the goal of correcting deformities and alleviating pain. The second stage involves functional fitness exercises, mainly selecting aerobic exercises for the whole body and strength exercises for the abdominal and back muscles to enhance physical fitness, improve physical strength, and consolidate the therapeutic effects. Aerobic exercises include jogging, qigong, tai chi, etc., with a focus on dynamic movements and a combination of dynamic and static exercises.

When selecting fitness exercises for patients with chronic low back and leg pain, the exercise function should be a primary consideration. Strength exercises should be emphasized, and the effects can be enhanced by incorporating endurance exercises, flexibility exercises, and balance exercises. Strength exercises generally include exercises that strengthen the muscles of the back and extension muscles, such as sit-ups, plank holds, push-ups, prone back stretches, etc. Endurance exercises can include combined walking and running exercises, tai chi, table tennis, and other low-intensity activities. Flexibility exercises can include yoga and stretching exercises. Balance exercises mainly focus on strengthening the muscle strength of the weaker side of the upper limbs, trunk, and lower limbs.