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Fitness and stretching expert Linda Minarik explains how you can avoid and treat back pain and injury with this illustrated guide to stretches for your back.

Today's busy world provides too much stress and not enough time for exercise. Instead of walking, running, and doing physical chores, we sit for hours at a desk, use machines to do work for us, and drive a car for even the shortest trips. As a result, more than sixty-five million Americans experience back pain, neck stiffness, and tension headaches. Dr. Kraus provides various approaches to back and tension problems, the primary focus being a series of carefully planned exercises to strengthen the whole body and to correct specific physical deficiencies.

Chronic low back pain, neck pain, hip and knee osteoarthritis, and fibromyalgia are the most common types of chronic musculoskeletal pain. Because no individual therapy has consistent benefit, a multimodal treatment approach to chronic musculoskeletal pain is recommended. Many nonpharmacologic, noninvasive treatment approaches yield small to moderate improvement and can be used with pharmacologic or more invasive modalities. Systematic reviews and guidelines support the effectiveness of various forms of exercise in improving pain and function in patients with chronic pain. Cognitive behavior therapy and mindfulness techniques appear to be effective for small to moderate short- and long-term improvement of chronic low back pain. Cognitive behavior therapy may also be effective for small short- and intermediate-term improvement of fibromyalgia. Spinal manipulation leads to a small benefit for chronic neck and low back pain. Acupuncture has a small to moderate benefit for low back pain and small benefit for nonpain fibromyalgia symptoms. Massage or myofascial release yields a small improvement in low back pain, hip and knee osteoarthritis, and fibromyalgia. Low reactive level laser therapy may provide short-term relief of chronic neck and low back pain, and ultrasound may provide short-term pain relief for knee osteoarthritis. Multidisciplinary rehabilitation may be effective for short- and at least intermediate-term improvement in pain and function for chronic low back pain and fibromyalgia. Patients should be encouraged to engage in a variety of therapies aligned with their preferences and motivation. Illustration by Jonathan Dimes

\"Therapeutic yoga expert Lillah Schwartz clearly explains movement principles, basic anatomy, breath awareness, and the central elements of alignment-based yoga to help you uncover your own healing potential and move toward back pain relief.Step-by-step instructions with 27 pose sequences, 285 color photos, explanations, hints, and cautions take the guesswork out of yoga so you can practice simple and powerful poses aimed at healing your back.Whether you are a seasoned yoga teacher or a first-time yoga practitioner, Healing Our Backs With Yoga offers the keys to unlock the natural healing capabilities of the body.The book includes clear instructions along with hints and cautions to guide the reader on his or her healing journey, and is written with all levels of yoga practitioners in mind. The average person and beginning yoga student will find the background information on physiology helpful in starting a practice to help heal back pain. Other levels of experience will learn to think of their practices in a new light. And, yoga teachers will find new ways to help students along with a new way to think of their own practices.\"-- Provided by publisher.

Chronic low back pain (CLBP) is a disease with significant functional, emotional and social impact. Several interventions are proposed for its management and exercise is one of main, land-based or water-based. This study describes a randomized controlled trial that will analyze the effect of a combined aquatic and land-based exercise program compared to an aquatic-based program on pain, functional incapacity and quality of life in adults with CLBP. Additionally, it will analyze the effects of exercise cessation in the same outcomes. A blind randomized controlled trial will be developed with a 1:1 allocation ratio. Around 30 adults with mechanical CLBP will be randomly allocated in two groups. The experimental group (ALG) will complete an aquatic and land-based exercise program and control group (AG) will carry out only an aquatic program, both for 8 weeks. Participants will be assessed with Visual Analogue Scale, Oswestry Disability Index, Short-Form 36, Tampa Scale of Kinesiophobia-13 and Modified-Modified Schober Test, collected at baseline (M0), after 8 weeks (M1) and 4 weeks after the end of the intervention (M2). This study may provide a relevant contribution to understand the potential effect of a combined land and aquatic exercise program on pain, functional disability, fear of movement, quality of life and lumbar mobility. The results may provide important information for CLBP management. This trial is registered with ClinicalTrials.gov (registration number: NCT06641570; date of registration: October 14, 2024).

Virtual reality (VR) in different immersive conditions has been increasingly used as a nonpharmacological method for managing chronic musculoskeletal pain. We aimed to assess the effectiveness of VR-assisted active training versus conventional exercise or physiotherapy in chronic musculoskeletal pain and to analyze the effects of immersive versus nonimmersive VR on pain outcomes. This systematic review of randomized control trials (RCTs) searched PubMed, Scopus, and Web of Science databases from inception to June 9, 2024. RCTs comparing adults with chronic musculoskeletal pain receiving VR-assisted training were included. The primary outcome was pain intensity; secondary outcomes included functional disability and kinesiophobia. Available data were pooled in a meta-analysis. Studies were graded using the Cochrane Risk-of-Bias Tool version 2. In total, 28 RCTs including 1114 participants with some concerns for a high risk of bias were identified, and 25 RCTs were included in the meta-analysis. In low back pain, short-term outcomes measured post intervention showed that nonimmersive VR is effective in reducing pain (standardized mean difference [SMD] -1.79, 95% CI -2.72 to -0.87; P<.001), improving disability (SMD -0.44, 95% CI -0.72 to -0.16; P=.002), and kinesiophobia (SMD -2.94, 95% CI -5.20 to -0.68; P=.01). Intermediate-term outcomes measured at 6 months also showed that nonimmersive VR is effective in reducing pain (SMD -8.15, 95% CI -15.29 to -1.01; P=.03), and kinesiophobia (SMD -4.28, 95% CI -8.12 to -0.44; P=.03) compared to conventional active training. For neck pain, immersive VR reduced pain intensity (SMD -0.55, 95% CI -1.02 to -0.08; P=.02) but not disability and kinesiophobia in the short term. No statistical significances were detected for knee pain or other pain regions at all time points. In addition, 2 (8%) studies had a high risk of bias. Both nonimmersive and immersive VR-assisted active training is effective in reducing back and neck pain symptoms. Our study findings suggest that VR is effective in alleviating chronic musculoskeletal pain. PROSPERO CRD42022302912; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302912.

Background Chronic low back pain (CLBP) is one of the most common musculoskeletal problems worldwide. Even though regular exercise is recommended as the primary conservative approach in treating this condition, significant part of patients lead sedentary lifestyle. Motivation to exercise is one of the variables that effects the adherence of exercise-based treatments. This study aimed to characterize the motives for exercise, as posited by self-determination theory, in persons with CLBP, and to identify subgroups (clusters) of motivational profiles in combination with socioeconomic and clinical characteristics using k-means cluster analysis. Methods Data were collected between September 2022 and September 2023. A total of 103 adults with CLBP completed the paper-pencil Exercise Self-Regulation Questionnaire (SRQ-E) and provided self-reported measures on anthropometric and socio-economic characteristics. Inclusion criteria were age (≥ 18 years) and non-specific CLBP (lasting longer than 12 weeks). Exclusion criteria included specific lumbar spine pathology (e.g., fracture, cancer), worsening neurological symptoms, recent injection therapy (within 3 months), and current alcohol or drug misuse. Results Three distinct motivational clusters were identified among the 103 participants: two clusters were characterized by predominantly autonomous motivation (moderately motivated cluster: 31.1%; highly motivated cluster: 54.4%), while one cluster (controlled convinced cluster: 14.6%) showed a higher level of controlled motivation. Associations were observed between the controlled cluster and factors such as higher disability scores, longer duration of pain, greater number of completed physiotherapy sessions, and elevated BMI. Notably, the controlled motivation cluster was linked with poorer clinical outcomes. Conclusions This study provides insights into the exercise motivation of patients with CLBP, revealing that while most patients were primarily autonomously motivated, a notable subgroup exhibited lower, controlled motivation. The presence of controlled motivation was associated with worse functioning, longer pain duration, and increased utilization of physiotherapy services. Although these findings suggest a link between motivational profiles and clinical outcomes, the cross-sectional design limits causal inferences. Further research is needed to explore these relationships longitudinally. Trial registration ClinicalTrials.Gov Identifier: NCT05512338 (22.8.2022, NCT05512338).

Background Chronic non-specific low back pain (CNLBP) is a prevalent and costly condition that encourages research into self-management strategies. Mobile health (mhealth) applications are promising interventions, but current evidence on their effectiveness is still conflicting. The aim is to investigate the (cost-)effectiveness of a supervised and personalized mhealth intervention, compared with conventional exercise therapy in individuals with CNLBP. Methods A multicentre trial-based economic evaluation was designed to compare a mhealth intervention with conventional exercise. Participants will be recruited from two physical therapy rehabilitation clinics located within the participating centres. Adults aged between 18 and 59 years and with self-reported LBP > 12 weeks will be included. Following the collection of baseline data, participants will be randomly assigned to one of two groups using a permuted block randomization: (1) mhealth; (2) Conventional exercise delivered through a booklet. Outcome assessments will be conducted following randomisation at five distinct time points, resulting in a total follow-up period of 12 months. The primary clinical outcome is disability (Roland-Morris Disability Questionnaire), while secondary outcomes include pain (NRS), utility (Eq. 5D5L), fears and beliefs (FABQ), self-efficacy (PSEQ), and global perceived effect. A sample size of 146 participants was estimated (73 allocated to each group) to detect a 2-point between-groups difference on disability. A cost-effectiveness study will be conducted alongside the trial, comparing the two interventions in terms of costs and clinical outcomes. Discussion While mhealth applications show promise as interventions for people with LBP, there is still a gap regarding the type of delivery and personalisation strategies. This study investigates whether the implementation of stratified and tailored care within a mobile application, based on patient-reported outcome measures and supervised by a physiotherapist, is (cost-)effective. Trial registration: NCT06651099 (registration date 21/10/2024).