"Low-back pain continues to impose a huge burden on industrialized societies, in terms of symptoms, medical costs, productivity, and work absence. Annual costs related to back pain in the United States alone may run as high as $100 billion per year. But a systematic review of the literature for high-quality scientific trials published in the February issue of The Spine Journal finds exercise in workplace and community settings effective in preventing new episodes of low-back problems. ‘Strong and consistent evidence finds many popular prevention methods to fail while exercise has a significant impact, both in terms of preventing symptoms and reducing back pain-related work loss,’ said Dr. Stanley J. Bigos, University of Washington professor emeritus of orthopaedic surgery and environmental health. Bigos and his colleagues assessed methodological quality and potential for bias of clinical trials in preventing episodes of back problems. The researchers found 20 controlled trials to be high-quality according to Cochrane Collaboration Back Review Group criteria. Seven of the eight high-quality trials promoting various exercise programs were found effective, but other common and popular methods failed including: reduced lifting programs, back or ergonomic educational interventions, lumbar supports, shoe inserts and stress management. ‘Passive interventions such as lumbar belts and shoe inserts do not appear to work,’ Bigos said. ‘And eight trials found ergonomic interventions, of either reducing lifting, or back or ergonomic training sessions to be ineffective in preventing back problems.’"