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Evidence summaries

Exercises for Prevention of Recurrences of Low-Back Pain

Post-treatment exercise programmes appear to prevent recurrences of low-back pain, but there is conflicting evidence on exercise as part of treatment during an episode of back pain. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 9 studies; 4 studies (n=407) evaluated post-treatment programmes and 5 studies (n=1 113) evaluated exercise as a treatment modality for low-back pain. Post-treatment exercises were more effective than no intervention for reducing the rate of recurrences at one year (RR 0.50, 95% CI 0.34 to 0.73; 2 studies, n=130), but not at long-term (2 to 5 years) follow-up (RR 0.75, 95% CI 0.53 to 1.07; 1 study, n=66). The number of recurrences was significantly reduced (MD -0.35, 95% CI -0.60 to -0.10; 2 studies, n=154) at one-half to two years follow-up. The days on sick leave were reduced by post-treatment exercises (MD -4.37, 95% CI -7.74 to -0.99; 2 studies, n=154) at one-half to two years follow-up. There was conflicting results for the effectiveness of exercise treatment in reducing the number of recurrences or the recurrence rate.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).

    References

    • Choi BK, Verbeek JH, Tam WW, Jiang JY. Exercises for prevention of recurrences of low-back pain. Cochrane Database Syst Rev 2010;(1):CD006555. [PubMed]

Primary/Secondary Keywords