Exercise As Medicine (Back Pain, Depression, Type 2 Diabetes)
Why Exercise Can Be The Best Kind Of Medicine For Chronic Disease
It’s not breaking news that exercise is good for our general health and well-being. When we think of those who exercise regularly, our minds tend to move towards happy, fit and most importantly, healthy people. Hardly seems like a coincidence does it?
So if it’s fair to say that regular exercise and good health go hand in hand, why isn’t exercise the first option when we aren’t healthy. This doesn’t just mean your average cold or virus, which quite often does require rest. Updated research is suggesting that exercise is a useful therapy in the treatment of many chronic diseases. These diseases range from musculoskeletal disorders (osteoarthritis, back pain, rheumatoid arthritis, osteoporosis); pulmonary diseases (asthma, cystic fibrosis); cardiovascular diseases (hypertension, coronary heart disease); metabolic diseases (type 1 and 2 diabetes, obesity, polycystic ovarian syndrome); neurological diseases (dementia, Parkinson’s, MS); psychiatric diseases (depression, anxiety, stress, schizophrenia) and cancer.
In part one of this blog, we will delve into a handful of the more common chronic diseases listed above and discuss how exercise can be beneficial to your health. Part one will include back pain, depression and type 2 diabetes. Next month, we will look into hypertension, anxiety and osteoarthritis.
BACK PAIN
Back pain is experienced by up to 80% of all individuals at some stage of their life with 70-80% of those cases not being able to be given a specific diagnosis. This can make back pain a very frustrating experience for the sufferer. Non specific back pain incidents are rising steadily within our population with many believing the cause to be sedentary, desk based occupations and lifestyles. Untreated acute back pain can often progress into chronic back pain as the cause of the initial injury heals but the pain remains. It is important to address bouts of back pain early to prevent it from becoming chronic.
Exercise for Back Pain
The general plan for exercise for back pain is to allow the individual to live a normal life. The goal is to get back into general physical activity as soon as possible. Rest has been found to be counterproductive to recovery so getting back into movement from day one is very important. Exercise in the early acute stages may require supervision. Walking, cycling and swimming are all great starting points to get moving without supervision. Remember to pace yourself and that this is not a time to be taking your body to fatigue as this can lead to further sensitivity of the affected area. The exercise program will be tailored to the individual and the symptoms that they present with.
The effects of exercise for back pain will often not be seen in the early stages of recovery so persistence is key for long term benefits.
*It is important to rule out fractures, tumour or infection before proceeding with any back pain exercise program. If you suspect that any of these might be present, consult with a specialist.
DEPRESSION
There are many studies that have looked into the link between exercise and depression and the general theme has been positive. Most studies found a positive link between exercise and the decrease in symptoms of depression. A recent study also suggested that low fitness was more closely related to depression than being fat (Becofsky et al., 2015). However, these studies were unable to find the direct link between the positive effects of exercise on depression.
Some believe that the positive effects are due to increased environmental and social feedback. Just being is a social setting can help with symptoms. Others think that exercising at a relatively high intensity make it difficult to think or worry which makes it a great distraction. Fatigue also plays a roll with depression which can have a negative impact on the mindset and motivation levels to exercise. Fatigue is quite often the hardest obstacle in starting an exercise regime for those suffering depression. Finding exercise buddy is a great way to keep yourself accountable. Depression is most commonly treated with antidepressants and/or psychological therapy.
Study on Prescribed Exercise VS Antidepressants VS Both for Severe Depression
Three groups: Four months of Prescribed Exercise, Four months of Prescribed Antidepressants or Four months of a combination of Exercise and Antidepressants.
Subjects: 156 individuals over the age of 50 with severe depression
Findings: After four months, all groups had positive results but there was significant difference between the three groups. After ten months, there were decreased amounts of relapse within the exercise groups.
Exercise for Depression
Frequent exercise is found to be more effective than infrequent. Aim for shorter, high intensity sessions four to five times a week over longer sessions once or twice a week. While it hasn’t been decided which type of exercise is best, it seems resistance and mixed training is preferred to aerobic training.
TYPE 2 DIABETES
The prevalence of type 2 diabetes is predicted to double from 2000 to 2030 with a projected 1 in 25 people expected to have it. It is the most common form of diabetes with 85-90% of all people with diabetes having type 2. Type 2 diabetes is thought to be caused by lifestyle factors such as family history, poor diet, low levels of physical activity and/or abdominal fat. These factors can lead to the body becoming resistant to the normal effect of insulin. This means that the pancreas is unable to produce enough insulin, which is used by the body to move glucose into the cells where is can be stored or used for energy. This inability to produce insulin means that glucose stays in the blood leading to higher than normal blood-sugar levels. Unfortunately exercise cannot be used as a replacement for medication for type 2 diabetes but rather as a way to manage symptoms associated with the disorder.
Exercise for Type 2 Diabetes
Exercise is one of the three key components to managing a healthy lifestyle with type 2 diabetes; with the other two being diet and medication. An increase in physical activity can produce a considerable improvement in glucose control in those with type 2 diabetes.
A combination of aerobic and resistance training was found to be the most beneficial with a preference towards higher intensity workouts compared to low intensity. However, due to many secondary health risks associated with type 2 diabetes, it is important to consult a health professional before starting a new fitness program, especially those involving high intensity training. Strength training should focus more on increased repetitions over increasing weight. If the individual experiences issues with their feet associated with their diabetes, non weight bearing exercising like cycling, swimming or rowing are recommended. Be careful to monitor blood sugar while exercising.
“Most importantly, the risk of NOT exercising poses a far greater health risk than exercising!”
REFERENCES
Blumenthal JA, Babyak MA, Moore KA, Craighead WE, Herman S, Khatri P, Waugh R, Napolitano MA, Forman LM, Appelbaum M, Doraiswamy PM, Krishnan KR. Effects of exercise training on older patients with major depression. Arch Intern Med 1999: 159: 2349– 2356.
Ihlebaek C, Hansson TH, Laerum E, Brage S, Eriksen HR, Holm SH, Svendsrod R, Indahl A. Prevalence of low back pain and sickness absence: a “borderline” study in Norway and Sweden. Scand J Public Health 2006: 34: 555–558.
Pedersen BK, Saltin B. Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2015: (Suppl. 3) 25: 1–72.
Sandanger I, Nygard JF, Brage S, Tellnes G. Relation between health problems and sickness absence: gender and age differences – a comparison of low-back pain, psychiatric disorders, and injuries. Scand J Public Health 2000: 28: 244–252.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004: 27: 1047–1053.
