Aggressive Exercise for People with Low Back Pain
by Britta Ann Herlitz
Orthopedic Product News, 1992

The effectiveness of the sports medicine approach, involving active, aggressive treatment of low back pain and injury, is no longer a theory but a fact." This statement, made by Gerald P. Keane, MD, of the SpineCare Medical Group here, will be supported and explored in a forum to be held on Thursday morning, October 25, at the 67th Annual Session of the American Congress of Rehabilitation Medicine in Phoenix, Arizona.

Dr. Keane's forum, coordinated by Jeffrey A. Saal, MD, also of the SpineCare Medical Group, is entitled The Sports Medicine Approach to Occupational Low Back Pain, and will be more of a discussion than a lecture. "I'll probably speak for a few minutes, but then we'll open up the floor," he explained.

The focus of this discussion will be on the value of functional restoration, according to Dr. Keane, who has been practicing this treatment technique for the past five years.

The Old School

"Formerly, it was taught that inactivity was the way to go for back patients-heat packs and bed rest were recommended, but this approach is no good. The major trend now is towards treating back injuries, particularly industrial back injuries, like sport injuries - aggressively". Dr. Keane, who was taught the “old way" at medical school, has become one of the country's strongest advocates of functional restoration.

"One of the reasons I volunteered and was asked to speak on this topic is because there are still many physicians who are proponents of the inactive therapy method." According to Dr. Keane, the results at his clinic are excellent, and there is enough confirming data generated by other studies to support the active, functional approach as far superior to the inactive approach.

“Functional restoration focuses on measurable gains, things that can be objectively tested," Dr. Keane explained. The focus on measurable gains, rather than on how a patient feels, is one of the most crucial differences between active and passive therapy. “In the industrial world, people who do not make progress towards recovery are pushed out. “ It is only through quantitative proof that insurance companies, employers, and patients can concretely measure progress and functioning capacity, rehabilitation experts assert.