Low Back Strengthening for the Prevention and Treatment of Low Back Pain

Introduction

The authors of this paper conducted a review of the literature to determine the effect of low back strengthening on the treatment of chronic low back pain (CLBP). It is intended that this paper will be able to separate effective treatment for CLBP from those that with little therapeutic value. 19th and 20th century spine rehabilitation shows that back disorders were commonly treated with aggressive and specific progressive exercise (PRE). Then beginning around the 1960-70’s, therapeutic back rehabilitation focused on passive care to symptom relief. However, recent spine rehabilitation programs have returned to active reconditioning specific and progressive exercises to strengthen the low back and restore normal musculoskeletal function.

Summary 

Following a history of spine rehabilitation and the lessons learned, the authors concluded that the research shows that lumbar extension exercises using PRE significantly increases strength and decreases pain in CLBP patients. The most favorable exercise occurs when the pelvis is stabilized using specialized equipment, this yields the most favorable improvements in low back strength, muscle cross-sectional area, and vertebral bone mineral density. These ideal improvements occur with a low training volume of 1 set of 8 to 15 repetitions performed to fatigue one time per week. Overall, CLBP patients participating in isolated lumbar extension PRE programs demonstrate significant reductions in pain and symptoms associated with improved muscle strength, endurance, and joint mobility. The authors found that these improvements occur regardless of diagnosis and are long lasting, resulting in less re-utilization of the health care system than other passive treatments.

Keywords: Resistance training, lumbar extension, rehabilitation, injury, lumbar, chronic low back pain

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