From Anne Asher,
Your Guide to Back & Neck Pain.
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Scientific Research on Exercise as a Treatment for Back Pain

Chapter 3 provides a review the scientific research on the multifidus and its role in back pain, especially exercise as treatment. In this chapter, Johnson gives an overview of the process of scientific proof for medical treatments. How is one to really know what treatment will be effective? He discusses:

• natural history studies
• anecdotal evidence
• randomized control trials.

This is an excellent chapter, not only for understanding the rationale for the exercise program, but also for becoming an educated consumer of back pain treatments.

The Exercise Program

The exercises proposed by the author are geared for beginners -- those who either know little to nothing or don't really like to exercise. Johnson gives strength training guidelines, including definitions for reps and sets and a discussion of intensity and time, all for the purpose of implementing the program according to standard fitness protocol. He also talks about what you can expect once you have embarked upon the program, and how to progress and maintain the program.

Comment on the Exercise Program

Interestingly enough, Johnson's program consists of only 3 exercises (and variations meant to progress you as you become stronger). The exercises are excellent and can also be found in the Pilates repertorie, as well as other systems. The exercises have been adapted to target the multifidus muscle as it affects back pain. He instructs the reader to do the exercise in neutral position, but does not offer a lot of explanation has to how to establish, maintain and recognize that position.

Further Resources in Back Pain Treatment

Chapter 6 reviews other ways to address back pain including:

• manipulation
• stretching
• the best way to sit
• losing weight
• back support belt
• MacKensie exercises.

In this chapter, Johnson also maps out the common treatments according to their effectiveness for specific types of low back pain. He also discusses stress and low back pain.

Chapter 7 offers further reading for specific topics.