Stretching and strengthening exercises are more likely to relieve chronic low back pain and improve function than other types of therapy. Researchers from the Institute for Work and Health in Toronto, first analyzed 61 trials involving 6390 subjects that evaluated exercise therapy for treatment of low back pain. The analysis provided strong evidence that exercise helped in chronic (longer than 12 weeks) low back pain. On a 100-point scale, exercise reduced pain by 10 points more than no other treatment, and 6 points more than with other conservative treatments. For low back pain that had persisted for 6 to 12 weeks, there was a small benefit for graded-activity exercise programs, but for acute back pain (less than 6 weeks duration) there appeared to be no overall benefit from exercise therapy. In another study the researchers evaluated 43 trials of 72 exercise treatment groups and 31 comparison groups of patients with chronic low back pain. This analysis showed that an individually designed, high-dose exercise program delivered through supervised home exercises with regular practitioner follow-up was most effective, with a mean of 18 points in improvement in pain scores and 5.5 points in function scores compared with no treatment. Stretching was associated with the largest improvement in pain, while strengthening exercises appeared to be most effective in improving function, compared with aerobic, coordination and mobilizing exercises.
Annals of Internal Medicine,
May 2005