Exercise Therapy in Chronic Low Back Pain - Critical Review

Background: Temporary or constant unfitness for work originate most frequently in diseases of the musculoskeletal system. Injuries and pain in the vertebral column sector by far make up the most wide-spread diagnosis. Objective: This review investigated recent studies dealing with the effectiveness of various training methods concerning chronic back pain in order to find out whether a certain training modality is more effective than others concerning the treatment of chronic back pain and whether the methods presented in these publications meet the requirements drawn from the basic findings of sports science. Methods: 16 randomized controlled studies were reviewed concerning the training methods presented by the authors of these studies as well as the respective training results concerning strength, endurance and pain reduction. Results: A significant superiority of a specific training modality presented within the studies only occured when the control group received no treatment at all. Apart from that, no significant differences appeared between the various training modalities concerning the effectivity in chronic back pain. All the investigated studies showed severe flaws of training modalities which failed to meet the requirements postulated by sports science. Conclusion: Future research in view of the efficiency of exercise therapy of chronic back pain should take into account the basic findings of sports science which have been basically ignored so far.