Chronic low back pain (CLBP) is one of the most common conditions affecting people of all ages. It’s also one of the leading causes of disability, keeping many people away from work and significantly burdening healthcare systems worldwide. Despite exercise therapy (ET) being one of the recommended treatments for chronic nonspecific low back pain (CNSLBP), the results are often limited, especially when using low or moderate-intensity exercise.
However, recent research suggests that exercising at a higher intensity could lead to far better outcomes. In other chronic conditions, high-intensity training (HIT) has been shown to improve both general health and disease-specific symptoms more effectively than moderate-intensity training (MIT). But what about its impact on CNSLBP?
High-Intensity vs. Moderate-Intensity Training for Low Back Pain
A recent study explored whether HIT could improve outcomes for people suffering from CNSLBP. In this study, participants were divided into two groups: one group completed a high-intensity training (HIT) program, while the other followed a moderate-intensity training (MIT) protocol. Both programs ran for 12 weeks, with two sessions each week, focusing on a combination of cardiovascular, resistance, and core training.
The results were striking. The HIT group saw a 64% improvement in disability, while the MIT group only achieved a 33% improvement. In other words, the HIT group experienced twice the reduction in disability. This was also reflected in their overall exercise capacity, with HIT participants increasing their VO2 max (a key indicator of cardiovascular fitness) by 14%, compared to just 4% in the MIT group【5†source】.
What Does This Mean for You?
If you’re dealing with chronic low back pain, the idea of pushing yourself through high-intensity training might sound intimidating. But the evidence shows that HIT can actually deliver better and faster results. Not only does it help reduce pain and improve disability, but it also enhances your overall fitness and exercise capacity. The best part? This training is designed to be safe, feasible, and effective for people with CNSLBP.
For those leading active lifestyles or striving to return to physical activity, HIT could be the key to getting back to your best performance. Whether you’re looking to stay fit, return to your favorite sport, or simply move more freely in daily life, integrating high-intensity intervals and resistance exercises can offer superior benefits.
How HIT Works: A Closer Look
In this study, the HIT program involved:
- Cardiovascular Training: High-intensity intervals on a cycle ergometer, alternating between 1-minute intense bouts and 1-minute rest periods. Over time, the intensity and duration of these bouts increased.
- Resistance Training: Full-body exercises focusing on both upper and lower body strength, using 80% of the participant’s one-repetition max (1RM) for 12 repetitions.
- Core Muscle Training: Static core exercises like the glute bridge and planks, progressing in difficulty over time by adding resistance bands or increasing the hold duration【5†source】.
| 2 sessions a week | High intensity group (HIT) | Moderate intensity group (MIT) |
| Cardio respiratory(cycle ergometer) | 5-min warm-up interval training 5x 1-min bouts (110 repetitions per minute at 100% VO2max workload), Active rest between bouts: 1 min of active rest (75 repetitions per minute at 50% VO2max workload). | 5-min warm-up, 14 min of cycling (90 repetitions per minute at 60%VO2max workload). |
| Cardio progression | Bouts increased every two sessions+10 s, up to 1 min 50 s after 12 sessions. Recovery time (1 min) between bouts remained stable. | Duration increased every two sessions with 1 min 40 s up to 22 min 40 s. |
| General resistance | 3 upper body (vertical traction, chest press, arm curl) 3 lower body exercises (leg curl, leg press, leg extension) 1x 12 repetitions 80% of 1RM | 1×15 60% of 1RM. |
| Resistance progression | Increased the workload by 5% when able to perform 10 reps on 2 consecutive sessions | |
| Core training | 6 static core exercises [glute bridge, resistance band glute clam, lying diagonal back extension, adapted knee plank, adapted knee side plank, elastic band shoulder retraction with hip hinge1 x 10 repetitions of a 10-s static hold | Identical to the protocol described in “HIT” 1×10 repetitions of a 10-s static hold. |
| Core progression | Increase hold up to 12 s and progressing to more demanding postures through the use of increased body weight bearing using elastic resistance bands,or adding additional weights. | Made more difficult by increasing the time of the static hold each 6 sessions. |
These exercises target not only the muscles that support your spine but also your overall physical fitness, making them an effective, well-rounded approach to managing CLBP.
The Practical Benefits of HIT
One of the key takeaways from this research is the efficiency of HIT. By combining short bursts of high-intensity activity with rest periods, participants can achieve significant results in a relatively short amount of time. This means you don’t need to spend hours exercising to see improvements in pain, function, and overall strength.
Additionally, participants reported greater enjoyment during HIT sessions. This may seem surprising, but the varied pace and structure of HIT can make the workout feel less monotonous, which is crucial for staying motivated and consistent. For people with chronic pain, especially those who may have struggled with long-term low-intensity therapies, this increased enjoyment can lead to better adherence and longer-lasting results.
Results
| Test | HIT (n=19) | MIT (n=19) | Difference |
| Modified oswestry | 14.6% reduction (64% relative difference) | 6.2% reduction (33% relative difference) | 8.6% difference between groups (P > 0.01) in favor of HIT, with sufficient power (1 − ß = 0.83) was found. |
| Numeric pain scale | 3.2-point reduction (56% difference) | 2.2-point reduction (39% difference) | The 1.0-point difference between groups was non-significant (P = 0.08). |
| Patient-Specific Functioning Scale | 26% increase (37% relative difference) | 26% increase (39% relative difference | No difference between groups (P = 0.97) |
| V˙O2max | Increased with 4.9 mL·kg−1·min−1 (14% relative difference)Cycling time increased with 2.7 min (18% relative difference) | 1.8 mL·kg−1·min−1 (4% relative difference)1.7 min (13% relative difference) in the MIT group. | A difference of 3.1 mL·kg−1·min−1 between groups (P > 0.01) in favor of HIT, with sufficient power (1 − ß = 0.82) A 1.0-point difference between groups (P > 0.01) in favor of HIT, with borderline insufficient power (1 − ß = 0.79) was found. |
| Muscle strength | Abdominal strength – no improvementBack strength improved 0.39 N·m·kg−1 (10% relative difference) | Abdominal strength – no improvementBack strength improved 0.33 N·m·kg−1 (13% relative difference) | Abdominal strength – no differenceBack strength : No difference between groups (P = 0.88) was found. |
Takeaway
This study shows that high-intensity training could be a game-changer in the treatment of chronic nonspecific low back pain. If you’re seeking more effective ways to manage your pain and improve your overall fitness, consider incorporating high-intensity exercises into your routine. Whether you’re recovering from injury or trying to maintain an active lifestyle, HIT offers an efficient and impactful way to reduce pain, enhance strength, and reclaim your mobility.
Originally posted on May 17, 2022 @ 4:38 pm