Improve Both Adrenal Function and Back Pain with Exercise

Published: August 12, 2012

This study suggests that exercise can also improve adrenal responsiveness. Remember the "E" in "SHINE" (exercise as able). Walking and warm water swimnastics are a good starting point for many. "As able" is critical as well. If you feel worse the next day, you did too much (aim for "good tired after and better the next day"). After 10 weeks of therapy with the SHINE Protocol, you can increase your walking by UP TO 1 minute a day as able. In this study, exercise not only improved adrenal function, but also decreased pain, increased over all function, and decreased associated anxiety and depression.

The Effect of Exercise On Adrenocortical Responsiveness of Patients with Chronic Low Back Pain, Controlled for Psychological Strain

D Chatzitheodorou, S Mavromoustakos, and S Milioti
Clinical Rehabilitation, April 1, 2008; 22(4): 319-28.


To investigate the effects of high-intensity aerobic exercise on adrenocortical responsiveness and on standard outcome measures in patients with chronic low back pain.


Controlled clinical trial.


Physical therapy department of a university general hospital.


Sixty-four patients with chronic low back pain were randomly allocated into positive and negative suppression test groups and assigned to exercise protocol.


Subjects in the positive and negative dexamethasone suppression test groups received a 12-week high-intensity aerobic exercise programme.

Main outcome measures

Dexamethasone suppression test as an index of adrenocortical responsiveness, pain measured with the McGill Pain Questionnaire, functional status measured with the Roland Morris Disability Questionnaire, and psychological strain measured with the Hospital Anxiety and Depression Scale.


Data analysis in the positive group identified a significant reduction of pain by 30% (t(30) = 11.2, P<0.001), a recovery of the lost functioning by 34% (t(30) = 19.7, P<0.001), a reduction of anxiety/depression by 25% (t(30) = 10.2, P<0.001), and a change in adrenocortical responsiveness by 40% (t(30) = 14.1, P<0.001). In the dexamethasone suppression test negative group, data analysis identified a significant reduction of pain by 8% (t(31) = 4.2, P<0.001), a recovery of lost functioning by 10% (t(31) = 4.8, P<0.001), a reduction of anxiety/depression by 11% (t(31) = 5.0, P<0.001), and no change in adrenocortical responsiveness (t(31) = 1.2, P=0.22). In univariate analysis between—subject differences were significant for dexamethasone suppression test (F(61) = 163, P<0.001), and for anxiety/depression (F(61) = 21.3, P<0.001).


Exercise alleviated pain, functional disability and anxiety/depression, also improved adrenocortical responsiveness in patients with chronic low back pain with dexamethasone suppression test positive values.

Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. His newest book (June 10, 2024) is You Can Heal From Long COVID. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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