Estimates that any one individual will have lower back pain run as high as 80 percent of the population in Western countries. Many people have suggested that a program of core stabilization exercises such as that found in Pilates programs might be a good way for lower back pain treatment. But is it?
Exercise and Lower Back Pain Treatment
An article published in 2007 indicates that data from studies done to date regarding core stabilization doesn’t support the universal application of specific stabilizing exercises for all patients with lower back pain. Such exercises may be beneficial when added to the physical therapy approaches that have already proven effective. However, lower back pain treatment programs need to be individualized.
Usually lower back pain resolves within two to four weeks, even without treatment. However, 60-80 percent of sufferers will have a recurrence of the pain. The muscles that support and stabilize the spine don't always completely recover from an acute episode.
Relationship of Core Muscles to Lower Back Pain Treatment
Recent exercise theory has suggested that exercises designed to strengthen trunk muscles (core stabilization exercises) can effectively treat low back pain and help reduce future injuries to the low back. (The muscles of the trunk include those in the abdomen and back; around the neck and shoulder blades; and around the pelvis, hips, groin, and buttocks.)
Although exercise programs aimed at core stabilization are being used by physical therapists, physicians, athletic trainers and other medical providers as well as a variety of fitness trainers in the community, there is no consistent, generally-agreed upon approach for these programs. There also is no clear proof of positive advantage resulting from core stabilization.
Approaches to Core Muscle Exercise
One approach emphasizes the importance of strengthening individual muscle groups, specifically the muscle group that you use to "suck in your gut " and the multifidi (muscles on either side of the spine from the skull to the bottom of the sacrum).
Another approach maintains that overemphasis on specific local muscles may be counterproductive. This approach makes use of functional motor patterns to ensure dynamic stability. It promotes the fact that no single trunk muscle is responsible for spinal stability. Individual roles of muscles change according to the activity.
Stabilizing Exercise May Help Lower Back Pain Treatment
In a study reported in the December 2007 issue of Archives of Physical Medicine and Rehabilitation, the authors concluded that the data clearly does not support the universal application of specific stabilizing exercises for all patients with lower back pain. Furthermore, if core stabilization is the best alternative, better-designed studies with larger populations need to verify this. Additionally, a more well-defined and universal program is in order before it can become the treatment of choice.
For further information, refer to: "Expert Opinion and Controversies in Musculoskeletal and Sports Medicine: Core Stabilization as a Treatment for Low Back Pain;" Standaert, C MD, Herring, S MD; Archives of Physical Medicine and Rehabilitation, December 2007; Volume 88 (12).
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