Low back pain remains one of the top reasons patients seek treatment from physicians and Physical Therapists. Acute low back pain defined as lasting < 12 weeks is effectively treated by Physical Therapists with spinal manipulation, directional exercise, and strength training. Patient outcomes are significantly improved when patients are provided with treatments consistent with their clinical presentations. Optimal management in the acute phase helps prevent the persistent pain and loss of function commonly seen in chronic low back pain (> 12 weeks duration) population. At this phase in a patient’s recovery impairments can be noted in both the nervous systems processing of information preceding pain, as well as, muscle strength and cardiovascular endurance. A recent review of the medical literature highlights the most effective exercise programs for patients with chronic low back pain.
Authors in the British Journal of Sports Medicine reviewed 89 exercise training trials including over 5500 patients with chronic low back pain (Owen et al. 2019). Authors compared various forms of aerobic, mobility, and strength training exercises on improving pain and disability in this patient population. They found no differences between directional exercise and stretching when compared to a control group, but noted significant differences for other forms of exercise. Authors stated evidence supports the utilization of aerobic exercise, strength training, core exercises, and pilates for patients with chronic low back pain.