Should You Exercise if You Have Back Pain?

Low back pain, especially when chronic, can be very frustrating and even debilitating. It can make the simplest of tasks like tying your shoes or putting socks on feel impossible to accomplish. The longer it lasts, the more physical activity and exercise can suffer and a person may stop doing these things altogether. Here’s what the research says.

A couple of recent studies looked at the relationship between exercise and chronic low back pain (LBP). The first study, a 2021 systematic review, looked at different pharmacologic and non-pharmacologic treatments to determine which patients with chronic LBP achieved a clinically meaningful response.

This review included 63 randomized controlled trials with 15 interventions such as different medications, exercise, acupuncture, injections, and more. They found that exercise, serotonin-norepinephrine reuptake inhibitors (SNRIs), and oral NSAIDs all provided clinically meaningful benefits, but exercise was the only intervention with sustained long-term benefit and pain reduction.

The second study, a 2020 systematic review, looked at the effects of stabilization exercise on pain and disability in patients with chronic LBP. From the over 3,000 articles related to this topic, only 50 met the criteria to be included in the review.

They found that core-specific stabilization exercises for 20-30 minutes per session had the biggest benefit on pain and disability. The number of sessions per week is still up for debate but as of now 3-5 times per week is the recommendation.

References:

Kolber MR, Ton J, Thomas B, Kirkwood J, Moe S, Dugré N, Chan K, Lindblad AJ, McCormack J, Garrison S, Allan GM, Korownyk CS, Craig R, Sept L, Rouble AN, Perry D. PEER systematic review of randomized controlled trials: Management of chronic low back pain in primary care. Can Fam Physician. 2021 Jan;67(1):e20-e30. doi: 10.46747/cfp.6701e20. PMID: 33483410.

Mueller J, Niederer D. Dose-response-relationship of stabilisation exercises in patients with chronic non-specific low back pain: a systematic review with meta-regression. Scientific Reports. 2020 Oct 9;10(1):1-23.