Clinical Question

Is exercise an effective treatment for adults with chronic low back pain?

Evidence-Based Answer

There is low- to moderate-quality evidence that exercise reduces pain and improves function in patients with chronic low back pain compared with no treatment, usual care, and other conservative interventions such as education, manual therapy, and electrotherapy. This effect is clinically significant in the short term (six to 12 weeks) but less pronounced six months after treatment completion. The review does not recommend a specific exercise regimen to treat chronic low back pain.¹ (Strength of Recommendation: B, inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

Over the past three decades, low back pain has been the main cause of worldwide disability.² The authors of this Cochrane review defined chronic low back pain as pain, muscle tension, or stiffness lasting more than 12 weeks that is not the result of a specific pathology or condition, or at least two episodes of recurrent low back pain each lasting more than 24 hours with at least 30 pain-free days in between.¹ This review sought to update a prior 2005 review that assessed whether exercise reduces pain and improves function in adults with chronic, nonspecific low back pain compared with no treatment, usual care, and other conservative therapies.