Exercise associated with prevention of low back pain

Daniel Steffens, Ph.D., of the University of Sydney, Australia, and coauthors identified 23 published reports (on 21 different randomized clinical trials including 30,850 participants) that met their inclusion criteria.

The authors report that moderate-quality evidence suggests exercise combined with education reduces the risk of an episode of low back pain and low- to very low-quality evidence suggests exercise alone may reduce the risk of both a low back pain episode and the use of sick leave. Other interventions, including education alone, back belts and shoe inserts do not appear to be associated with the prevention of low back pain.

"Although our review found evidence for both exercise alone (35 percent risk reduction for an LBP [low back pain] episode and 78 percent risk reduction for sick leave) and for exercise and education (45 percent risk reduction for an LBP episode) for the prevention of LBP up to one year, we also found the effect size reduced (exercise and education) or disappeared (exercise alone) in the longer term (> 1 year). This finding raises the important issue that, for exercise to remain protective against future LBP, it is likely that ongoing exercise is required," the study concludes.