Quite simply – YES.
A more difficult question to answer is “What kind of exercise?” I’ve found this question is even more difficult than “when is exercise bad for lower back pain?” Read on…
In 2000, the International Paris Task Force on Back Pain1 concluded:
“The Task Force is unable to recommend a specific physiotherapeutic technique, even though some techniques have been assessed scientifically. It appears that the key to success is physical activity itself—i.e., activity of any form—rather than any specific activity. The Task Force’s recommendation that there is scientific evidence in favor of programs combining strength training, stretching, and fitness is likely to cause a rethinking of widespread habits and convictions…”
Is it really that simple? Any exercise at all does seem to be better than none, however, more recent research has attempted to dig a bit deeper…
What kind of lower back pain do you have?
There are a number of different ways to categorise lower back pains. Researchers tend to split lower back pain into two categories:
- Those with nerve entrapment (usually caused by disc problems) and
- Non-Specific Lower Back Pain (NSLBP) – everything else, a huge category!!
So, what research has been done into exercise for these types of lower back problems?
In 2010 Fersum2, when looking at NSLBP, concluded that there is a little evidence that trying to sub-classify this group helps in determining which exercises to give to which sufferers. (But also that this sub-classification remains to be done.)
So, unlike the Paris task force 10 years previously, the suggestion is that the kind of lower back pain you have may dictate which exercises you’d benefit from. I know that may seem like stating the obvious, but you might be surprised at how often science proves the obvious to be wrong!
The below is quoted straight from the conclusion written by Steefel and Jadotte3. (I put in the bold and the italics)
“Although this review has shown that exercise therapy appears to be effective at decreasing pain and improving function in adults, according to the type of low-back pain, further research should include complete descriptions of the exercise interventions and the study populations at which the exercise intervention is targeted.” i.e. this study can’t offer any specific recommendations and indicates there is a gap in the research.
“What about Pilates?!” I hear you cry. There is a fair bit of research demonstrating that Pilates and core-stablising exercises are better than doing nothing for lower back pain, but so far the research hasn’t really shown them to be particularly good for any specific type of lower back pain, or indeed any better than other forms of exercise for lower back pain.
In summary, for non-specific lower back pain, there is surprisingly little evidence that one type of exercise is better than another. There are so many exercises you could do. Other key findings from the research are that supervision is important because it increases the chance you’ll actually do the exercises and that you’ll do them correctly. 😉
If you have nerve entrapment (most commonly caused by disc problems), the choice of exercise depends on whether the pain down your leg is better when you arch backwards or not – if it is, then best to do the McKenzie backbends.
There is hope…
There is one shining light in all of this: Professor Julie Fritz and colleagues4 are attempting to establish more clearly which sub-groups of lower back pain sufferers respond best to which types of exercises… I’m following her research closely, and second-guessing her next findings, I’ve put together programs for different types of lower back pain sufferers. If you’d like to be kept up to date with her findings, just subscribe to the blog, or get our RSS feed (the orange square with white bits in it), or like us on FB and you’ll see my posts there.
And if you’d like instruction on any of the proposed exercises, give us a ring.
Special note: Combining manual therapy with exercise brings more benefit than using either in isolation2.
1. Abenhaim, L., Rossignol, M., Valat, J.-P., Nordin, M., Avouac, B., Blotman, F., Charlot, J., Dreiser, R., Legrand, E., Rozenberg, S., Vautravers, P., for the Paris Task Force *, 2000. The Role of Activity in the Therapeutic Management of Back Pain: Report of the International Paris Task Force on Back Pain [Miscellaneous Article]. Spine February 15, 2000.
2. K V Fersum, 2010. Integration of subclassification strategies in randomised controlled clinical trials evaluating manual therapy treatment and exercise therapy for non-specific chronic low back pain: a systematic review. British Journal of Sports Medicine 44, 1054–1062.
3. Steefel, L., Jadotte, Y.T., 2012. Exercise therapy for the treatment of non-specific low back pain. International Journal of Evidence-Based Healthcare 10, 164–165.
4. Stanton, T.R., Fritz, J.M., Hancock, M.J., Latimer, J., Maher, C.G., Wand, B.M., Parent, E.C., 2011. Evaluation of a Treatment-Based Classification Algorithm for Low Back Pain: A Cross-Sectional Study. Physical Therapy 91, 496–509.