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An update of stabilisation exercises for low back pain: a systematic review with meta-analysis

A commonly believed, yet widely disputed, explanation for the development and maintenance of low back pain (LBP) is dysfunction with the activation of certain trunk stabilisation muscles. Consequently, one of the most commonly used treatments for LBP is core stability exercises to address these proposed dysfunctions. However, the evidence for the effectiveness of these core stability exercises is unclear and a recent systematic review by Ben Smith sought to highlight the evidence for these programmes.

The review results state that there is no clinically or statistically difference between core stability exercises and using general exercise (e.g. walking) for pain and disability in the long-term, and that core stability exercise may actually increase fear avoidance. The authors conclude that it is not possible to recommend core stability exercises in preference to other general forms of exercise and future research in unlikely to alter this conclusion. This review highlights the need to re-consider the standard use of core stability exercises to treat LBP and the fears associated with these exercises. In this related podcast, the author discusses in detail the future use of core stability in clinical practice.
Ben Smith is a musculoskeletal Physiotherapist working in the NHS in Derby. He’s currently completing a Masters at Nottingham University and is working towards a PhD application. His specialist interest is integrating evidence into practice, particularly with spines and knees, and can be followed on Twitter @benedsmith