Exercise therapy for low back pain (Cochrane Review)

A substantive amendment to this systematic review was last made on 09 February 2000. Cochrane reviews are regularly checked and updated if necessary.

Background: Exercise therapy is a widely used treatment for low back pain.

Objectives: The objective of this review was to assess the effectiveness of exercise therapy for low back pain with regard to pain intensity, functional status, overall improvement and return to work.

Search strategy: We searched the Cochrane Controlled Trials Register (1999, issue 1), MEDLINE (1966 - April 1999), EMBASE (1988 - September 1998), PsycLIT (from 1984 to April 1999) and reference lists of articles.

Selection criteria: Randomised trials of all types of exercise therapy for subjects with non-specific low back pain with or without radiation into the legs.

Data collection and analysis: Two reviewers independently extracted data and assessed trial quality. Because trials were considered heterogeneous with regard to study populations, interventions and outcomes, we decided not to perform a meta-analysis but to summarise the results using a rating system of four levels of evidence (strong, moderate, limited or no evidence).

Main results: 39 RCTs were identified. There is strong evidence that exercise therapy is not more effective than inactive or other active treatments it has been compared with for acute low back pain. There is conflicting evidence on the effectiveness of exercise therapy compared with inactive treatments for chronic low back pain. Exercise therapy was more effective than usual care by the general practitioner and equally effective as conventional physiotherapy for chronic low back pain.

Reviewers' conclusions: The evidence summarised in this systematic review does not indicate that specific exercises are effective for the treatment of acute low back pain. Exercises may be helpful for chronic low back pain patients to increase return to normal daily activities and work.

Citation: van Tulder MW, Malmivaara A, Esmail R, Koes BW.. Exercise therapy for low back pain (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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