From the Guidelines
Exercise is not expected to increase the likelihood of work disability at long-term follow-up in patients with lower back pain (LBP). In fact, the evidence suggests the opposite, with a systematic review finding an association between exercise and a lower likelihood of work disability at long-term follow-up (about 12 months) [ 1 ]. The relationship between exercise and LBP is complex, but the majority of studies support the use of exercise as a nonpharmacologic therapy to decrease pain intensity and improve function in patients with LBP [ 1 ]. Some key findings from the evidence include:
- A systematic review found that compared with minimal intervention, exercise decreased pain intensity and improved function in patients with LBP [ 1 ].
- Another systematic review found that exercise was associated with less pain intensity in the short term and intermediate term compared with general exercise [ 1 ].
- The evidence also suggests that exercise is more effective than usual care or no exercise for pain or function in patients with radicular low back pain [ 1 ]. Overall, the evidence supports the use of exercise as a treatment for LBP, and it is not expected to increase the likelihood of work disability at long-term follow-up.
From the Research
Expected Relationship Between Exercise and Lower Back Pain (LBP)
- There is no evidence to suggest that exercise is not related to the presence of lower back pain (LBP) in patients 2, 3, 4, 5, 6.
- In fact, studies have shown that physical activity, such as walking or cycling, may have preventive potential for LBP 2.
- Additionally, research has found that patients with LBP who engage in regular physical activity tend to have less pain and better function than those who do not 3, 5.
Biomechanical and Clinical Relationships
- Biomechanical factors, such as lumbar lordotic curvature, have been shown to be related to LBP 4.
- Clinical factors, such as knee osteoarthritis, have also been found to be associated with LBP 6.
- However, there is no evidence to suggest that exercise would not be beneficial for patients with LBP, and in fact, physical activity has been shown to be inversely related to pain interference and severity in children with juvenile idiopathic arthritis 5.