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Can Exercise Positively Influence the Intervertebral Disc?

PainSci » bibliography » Belavý et al 2016
updated
Tags: treatment, exercise, spine, back pain, self-treatment, pain problems

PainSci notes on Belavý 2016:

As of 2015, most evidence about the effect of exercise on the health of intervertebral discs was "from cell or whole-disc loading models and animal exercise models," and fell far short of proving that exercise is good medicine for this part of the spine. However, the authors believe that exercise is "likely" to be beneficial if it’s "dynamic, axial, at slow to moderate movement speeds, and of a magnitude experienced in walking and jogging." In contrast, inactivity and some other kinds of exercise are all "likely deterimental": weight without much movement or mainly twisting, and explosive and jarring loads.

These uncertainties were affirmed in a more technical review of how intervertebral cells respond to loading by Ruffilli et al: intervertebral discs almost certainly do respond to loading, but it’s not very clear how.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

To better understand what kinds of sports and exercise could be beneficial for the intervertebral disc (IVD), we performed a review to synthesise the literature on IVD adaptation with loading and exercise. The state of the literature did not permit a systematic review; therefore, we performed a narrative review. The majority of the available data come from cell or whole-disc loading models and animal exercise models. However, some studies have examined the impact of specific sports on IVD degeneration in humans and acute exercise on disc size. Based on the data available in the literature, loading types that are likely beneficial to the IVD are dynamic, axial, at slow to moderate movement speeds, and of a magnitude experienced in walking and jogging. Static loading, torsional loading, flexion with compression, rapid loading, high-impact loading and explosive tasks are likely detrimental for the IVD. Reduced physical activity and disuse appear to be detrimental for the IVD. We also consider the impact of genetics and the likelihood of a 'critical period' for the effect of exercise in IVD development. The current review summarises the literature to increase awareness amongst exercise, rehabilitation and ergonomic professionals regarding IVD health and provides recommendations on future directions in research.

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