ReviewExercise and nonspecific low back pain: A literature review
Introduction
Low back pain has been a major public health burden for many years, generating substantial work disability and healthcare costs. Among adults in the general population, 70–85% are believed to experience at least one episode of low back pain at some time during their lives [1]. Nonspecific low back pain, defined as pain with no identifiable cause, accounts for about 85% of cases. Studies of the many treatment modalities available for low back pain have failed to determine which strategy is optimal. However, there is convincing evidence of the harmful effect of bed rest, which was long recommended for acute low back pain. Patients should continue their everyday activities to the greatest extent possible. Exercise is being increasingly used to treat low back pain, and data on the effect of exercise is accumulating. We reviewed these data to clarify the role for exercise in the treatment and prevention of low back pain.
Section snippets
Methods
To identify articles on the effect of exercise in low back pain, we searched the Medline database using the following keywords: exercise, low back pain, physical training, and rehabilitation. Further publications were identified by examining the reference list of each selected article. We used the widely accepted classification scheme for low back pain based on symptom duration, which distinguishes acute pain (<6 weeks), subacute pain (6–12 weeks), and chronic pain (more than 12 weeks). The level
Exercise for the prevention and treatment of low back pain
We identified 20 reviews and meta-analyses of the efficacy of exercise in preventing and treating low back pain published between 1997 and 2007 (Table 1). They are discussed below.
Conclusion
Exercise is effective for the primary and secondary prevention of low back pain. Exercise is more effective in decreasing pain and disability from low back pain than control treatments or physician consultation. The results are less consistent in subacute low back pain, and the usefulness of exercise in acute low back pain remains controversial. The volume and intensity of exercises and the methods used for muscle strengthening, aerobic training, and stretching are not described in sufficient
References (60)
Epidemiological features of chronic low-back pain
Lancet
(1999)- et al.
Prescription of activity for low back pain: What works?
Aust J Physiother
(1999) - et al.
Exercise as a treatment for chronic low back pain
Spine J
(2004) A systematic review of workplace interventions to prevent low back pain
Aust J Physiother
(2000)- et al.
Exercise and chronic low back pain: what works?
Pain
(2004) - et al.
Randomized controlled trials in industrial low back pain. Part 3. Subacute/chronic pain interventions
Arch Phys Med Rehabil
(1997) - et al.
Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: a randomized trial
Pain
(2007) - et al.
Evaluation of a specific home exercise program for low back pain
J Manipulative Physiol Ther
(2002) - et al.
A fitness programme for patients with chronic low back pain: 2-year follow-up of a randomised controlled trial
Pain
(1998) - et al.
Intensive dynamic back exercises for chronic low back pain: a clinical trial
Pain
(1991)
The effect of exercise on percentile rank aerobic capacity, pain, and self-rated disability in patients with chronic low-back pain: a retrospective chart review
Arch Phys Med Rehabil
Comparison of short- and long-term outcomes for aggressive spine rehabilitation delivered two versus three times per week
Spine J
Evaluation of functional and neuromuscular changes after exercise rehabilitation for low back pain using a Swiss ball: a pilot study
J Manipulative Physiol Ther
Effects of aerobic exercise on low back pain patients in treatment
Spine J
Updated method guidelines for systematic reviews in the Cochrane collaboration back review group
Spine
European guidelines for the management of low back pain
Eur Spine J
Preventive interventions for back and neck pain problems: what is the evidence?
Spine
Dose-response of physical activity and low back pain, osteoarthritis, and osteoporosis
Med Sci Sports Exerc
A systematic review of controlled clinical trials on the prevention of back pain in industry
Occup Environ Med
The role of exercise in the prevention and management of acute low back pain
Occup Med
Occupational health guidelines for the management of low back pain at work: evidence review
Occup Med (Lond)
Low back pain interventions at the workplace: a systematic literature review
Occup Med (Lond)
The role of activity in the therapeutic management of back pain. Report of the International Paris Task Force on Back Pain
Spine
[Is exercise therapy and manipulation effective in low back pain?]
Tidsskr Nor Laegeforen
Diagnosis and treatment of low back pain
BMJ
Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions
Spine
Exercise therapy for low back pain: a systematic review within the framework of the Cochrane Collaboration back review group
Spine
Meta-analysis: exercise therapy for nonspecific low back pain
Ann Intern Med
Systematic reviews of bed rest and advice to stay active for acute low back pain
Br J Gen Pract
Simple low back pain: rest or active exercise?
Ann Rheum Dis
Cited by (116)
What is the effect of low back pain self-management interventions with exercise components added? A systematic review with meta-analysis
2021, Musculoskeletal Science and Practice