EFFECTIVENESS OF THERAPEUTIC EXERCISES TO REDUCE PAIN AND DISABILITY IN PATIENTS WITH CHRONIC NONSPECIFIC PAIN IN THE LUMBAR SPINE
DOI:
https://doi.org/10.11603/1681-2786.2025.1.15359Keywords:
therapeutic exercises; nonspecific low back pain; pain syndrome; rehabilitation; functional disorders.Abstract
Purpose: To analyze and summarize current scientific data on the effectiveness of therapeutic exercises in reducing pain and improving performance in patients with chronic nonspecific pain in the lumbar spine. Materials and Methods. The study conducted a literature review that allowed us to analyze the key aspects of the effect of therapeutic exercises on pain and performance. Results. The European guidelines for the management of chronic nonspecific low back pain recommend therapeutic exercises as a first-line treatment. Regardless of the mechanism of injury to the lumbar spine, weakness of the deep trunk muscles and reduced spinal stability lead to a slow reduction in pain and limited range of motion. During rehabilitation, it is necessary to perform exercises to strengthen the deep muscles of the trunk (core muscles) to ensure stability and control of movements, as this area is the functional center of the kinetic chain between the upper and lower extremities. Exercise programs for the treatment of chronic lumbar pain are quite diverse, but their effectiveness depends on the individual characteristics of the patient, the correct dosage of the load, adherence to the principle of progression and an integrated approach. Given the available evidence, aerobic, strength, stabilizing, dynamic exercises, as well as yoga and Pilates classes are an important component in a comprehensive approach to the treatment of chronic lumbar pain, contributing to significant symptom relief and improvement of the functional status of patients. Conclusions. Therapeutic exercises are an effective method of pain reduction and improvement of performance in patients with chronic nonspecific lumbar spine pain and should be included in a comprehensive treatment plan, given their proven benefits for improving physical functioning and quality of life.
References
GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021 // The Lancet. Rheumatology. 2023. Т. 5. № 6. С. e316–e329. DOI: 10.1016/S2665-9913(23)00098-X DOI: https://doi.org/10.1016/S2665-9913(23)00098-X
Hartvigsen J., Hancock M. J., Kongsted A., Louw Q., Ferreira M. L., Genevay S. та ін. What low back pain is and why we need to pay attention // Lancet (London, England). 2018. Т. 391. № 10137. С. 2356–2367. DOI: 10.1016/S0140-6736(18)30480-X DOI: https://doi.org/10.1016/S0140-6736(18)30480-X
Hoy D., March L., Brooks P., Blyth F., Woolf A., Bain C. та ін. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study // Annals of the rheumatic diseases. 2014. Т. 73. № 6. С. 968–974. DOI: 10.1136/annrheumdis-2013-204428 DOI: https://doi.org/10.1136/annrheumdis-2013-204428
Foster N. E., Anema J. R., Cherkin D., Chou R., Cohen S. P., Gross D. P. та ін. Prevention and treatment of low back pain: evidence, challenges, and promising directions // Lancet (London, England). 2018. Т. 391. № 10137. С. 2368–2383. DOI: 10.1016/S0140-6736(18)30489-6 DOI: https://doi.org/10.1016/S0140-6736(18)30489-6
Qaseem A., Wilt T. J., McLean R. M., Forciea M. A., Clinical Guidelines Committee of the American College of Physicians, Denberg T. D. та ін. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians // Annals of internal medicine. 2017. Т. 166. № 7. С. 514–530. DOI: 10.7326/M16-2367 DOI: https://doi.org/10.7326/M16-2367
Airaksinen O., Brox J. I., Cedraschi C., Hildebrandt J., Klaber-Moffett J., Kovacs F. та ін. Chapter 4. European guidelines for the management of chronic nonspecific low back pain // European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2006. Т. 15. Suppl 2. С. S192–S300. DOI: 10.1007/s00586-006-1072-1 DOI: https://doi.org/10.1007/s00586-006-1072-1
Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview / C. B. Oliveira et al. European Spine Journal. 2018. Vol. 27, no. 11. P. 2791–2803. URL: https://doi.org/10.1007/s00586-018-5673-2 DOI: https://doi.org/10.1007/s00586-018-5673-2
Gugliotta M., da Costa B. R., Dabis E., Theiler R., Jüni P., Reichenbach S. та ін. Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study // BMJ open. 2016. Т. 6, № 12. e012938. DOI: 10.1136/bmjopen-2016-012938. DOI: https://doi.org/10.1136/bmjopen-2016-012938
Akca N. K., Aydin G., Gumus K. Effect of body mechanics brief education in the clinical setting on pain patients with lumbar disc hernia: a randomized controlled trial // Int J Caring Sci. 2017. Т. 10. № 3. С. 1498–1506.
Huber J., Lisiński P., Samborski W., Wytrążek M. The effect of early isometric exercises on clinical and neurophysiological parameters in patients with sciatica: An interventional randomized single-blinded study // Isokinetics and Exercise Science. 2011. Т. 19. № 3. С. 207–214. DOI: https://doi.org/10.3233/IES-2011-0418
Kennedy D. J., Noh M. Y. The role of core stabilization in lumbosacral radiculopathy // Physical medicine and rehabilitation
clinics of North America. 2011. Т. 22. № 1. С. 91–103. DOI: 10.1016/j.pmr.2010.12.002 DOI: https://doi.org/10.1016/j.pmr.2010.12.002
Searle A., Spink M., Ho A., Chuter V. Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials // Clinical rehabilitation. 2015. Т. 29. № 12. С. 1155–1167. DOI: 10.1177/0269215515570379
Gordon R., Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain // Healthcare (Basel, Switzerland). 2016. Т. 4. № 2. 22. DOI: 10.3390/healthcare4020022 DOI: https://doi.org/10.3390/healthcare4020022
Li Y., Yan L., Hou L., Zhang X., Zhao H., Yan C. та ін. Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis // Frontiers in public health. 2023. Т. 11. 1155225. DOI: 10.3389/fpubh.2023.1155225 DOI: https://doi.org/10.3389/fpubh.2023.1155225
Vanti C., Andreatta S., Borghi S., Guccione A. A., Pillastrini P., Bertozzi L. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials // Disability and rehabilitation. 2019. Т. 41. № 6. С. 622–632. DOI: 10.1080/09638288.2017.1410730 DOI: https://doi.org/10.1080/09638288.2017.1410730
Sany S. A., Mitsi M., Tanjim T., Rahman M. The effectiveness of different aerobic exercises to improve pain intensity and disability in chronic low back pain patients: a systematic review // F1000Research. 2023. Т. 11. 136. DOI: 10.12688/f1000research.75440.2 DOI: https://doi.org/10.12688/f1000research.75440.2
Searle A., Spink M., Ho A., Chuter V. Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trials // Clinical rehabilitation. 2015. Т. 29. № 12. С. 1155–1167. DOI: 10.1177/0269215515570379 DOI: https://doi.org/10.1177/0269215515570379
Iversen V. M., Vasseljen O., Mork P. J., Gismervik S., Bertheussen G. F., Salvesen Ø. та ін. Resistance band training or general exercise in multidisciplinary rehabilitation of low back pain? A randomized trial // Scandinavian journal of medicine & science in sports. 2018. Т. 28. № 9. С. 2074–2083. DOI: 10.1111/sms.13091 DOI: https://doi.org/10.1111/sms.13091
Jenkins N. D. M., Miramonti A. A., Hill E. C., Smith C. M., Cochrane-Snyman K. C., Housh T. J. та ін. Greater Neural Adaptations following High- vs. Low-Load Resistance Training // Frontiers in physiology. 2017. Т. 8. 331. DOI: 10.3389/fphys.2017.00331 DOI: https://doi.org/10.3389/fphys.2017.00331
Iversen V. M., Mork P. J., Vasseljen O., Bergquist R., Fimland M. S. Multiple-joint exercises using elastic resistance bands vs. conventional resistance-training equipment: A cross-over study // European journal of sport science. 2017. Т. 17. № 8. С. 973–982. DOI: 10.1080/17461391.2017.1337229 DOI: https://doi.org/10.1080/17461391.2017.1337229
Kostadinović S., Milovanović N., Jovanović J., Tomašević-Todorović S. Efficacy of the lumbar stabilization and thoracic mobilization exercise program on pain intensity and functional disability reduction in chronic low back pain patients with lumbar radiculopathy: A randomized controlled trial // Journal of back and musculoskeletal rehabilitation. 2020. Vol. 33, No. 6. P. 897–907. DOI: 10.3233/BMR-201843 DOI: https://doi.org/10.3233/BMR-201843
Akhtar M. W., Karimi H., Gilani S. A. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial // Pakistan journal of medical sciences. 2017. Vol. 33. No. 4. P. 1002–1006. DOI: 10.12669/pjms.334.12664 DOI: https://doi.org/10.12669/pjms.334.12664
Coulombe B. J., Games K. E., Neil E. R., Eberman L. E. Core Stability Exercise Versus General Exercise for Chronic Low Back Pain // Journal of athletic training. 2017. Vol. 52, No. 1. P. 71–72. DOI: 10.4085/1062-6050-51.11.16 DOI: https://doi.org/10.4085/1062-6050-51.11.16
Gladwell V., Head S., Haggar M., Beneke R. Does a program of Pilates improve chronic non-specific low back pain? // Journal of Sport Rehabilitation. 2006. Vol. 15. P. 338–350. DOI: https://doi.org/10.1123/jsr.15.4.338
Comfort P., Pearson S. J., Mather D. An electromyographical comparison of trunk muscle activity during isometric trunk and dynamic strengthening exercises // Journal of strength and conditioning research. 2011. Vol. 25, No. 1. P. 149–154. DOI: 10.1519/JSC.0b013e3181fb412f DOI: https://doi.org/10.1519/JSC.0b013e3181fb412f
Carneiro K. A., Rittenberg J. D. The role of exercise and alternative treatments for low back pain // Physical medicine and rehabilitation clinics of North America. 2010. Vol. 21, No. 4. P. 777–792. DOI: 10.1016/j.pmr.2010.06.006 DOI: https://doi.org/10.1016/j.pmr.2010.06.006
Chou R., Qaseem A., Snow V., Casey D., Cross J. T. Jr., Shekelle P., Owens D. K. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society // Annals of internal medicine. 2007. Vol. 147, No. 7. P. 478–491. DOI: 10.7326/0003-4819-147-7-200710020-00006 DOI: https://doi.org/10.7326/0003-4819-147-7-200710020-00006
Wood L., Foster N. E., Lewis M., Bishop A. Exercise Interventions for Persistent Non-Specific Low Back Pain – Does Matching Outcomes to Treatment Targets Make a Difference? A Systematic Review and Meta-Analysis // The journal of pain. 2021. Vol. 22, No. 2. P. 107–126. DOI: 10.1016/j.jpain.2020.04.002 DOI: https://doi.org/10.1016/j.jpain.2020.04.002
Rydeard R., Leger A., Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial // The Journal of orthopaedic and sports physical therapy. 2006. Vol. 36, No. 7. P. 472–484. DOI: 10.2519/jospt.2006.2144 DOI: https://doi.org/10.2519/jospt.2006.2144
Miyamoto G. C., Costa L. O., Cabral C. M. Efficacy of the Pilates method for pain and disability in patients with chronic nonspecific low back pain: a systematic review with meta-analysis // Brazilian journal of physical therapy. 2013. Vol. 17, No. 6. P. 517–532. DOI: 10.1590/S1413-35552012005000127 DOI: https://doi.org/10.1590/S1413-35552012005000127
Byrnes K., Wu P. J., Whillier S. Is Pilates an effective rehabilitation tool? A systematic review // Journal of bodywork and movement therapies. 2018. Vol. 22, No. 1. P. 192–202. DOI: 10.1016/j.jbmt.2017.04.008 DOI: https://doi.org/10.1016/j.jbmt.2017.04.008
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Bulletin of Social Hygiene and Health Protection Organization of Ukraine
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
