J Korean Med Assoc.  2007 Jun;50(6):494-506. 10.5124/jkma.2007.50.6.494.

Rehabilitative Treatments of Chronic Low Back Pain

• Chung SG

• KMID: 2184859
• DOI: http://doi.org/10.5124/jkma.2007.50.6.494

Abstract

Chronic low back pain (CLBP) is a complicated clinical condition related with pathologic pain generators in the spinal column, weakened and deconditioned muscles in the trunk and extremities that control the motion and stability of the spine and pelvis, faulty biomechanics caused by connective tissue contractures, and behavioral problems such as fear-avoidance beliefs and emotional distress. Since it is initiated and maintained by these complicated causal factors, CLBP could not be successfully treated by one or two specific rehabilitative treatment options. A multidisciplinary approach with an appropriate individualization to each patient is known to be more successful than simple and passive physical therapeutic agents. Among the rehabilitative therapeutics, sustained exercise for 2 to 3 months appears to be the most effective, providing CLBP patients with significant pain relieves and functional improvements that last for a long-term period. There have been several different types of low back exercises including strengthening, flexibility training, aerobic exercise, lumbar flexion exercise, and McKenzie's extension exercise, with which favorable outcomes were reported. Recent advances in the field of spine biomechanics introduced a principle, the core stabilizing exercise, to stabilize the spine and pelvis by strengthening and improving the control of the several specific truncal muscles. Although supported by some reports showing excellent results, the core stabilizing exercise in itself may not be the most effective therapeutic exercise for CLBP. Instead, it could be a useful adjunctive measure to the exercises that have been used to date. A novel rehabilitative therapeutic modality is anticipated to be developed in the near future to theat the spine more specifically, addressing its particular pathologic conditions.

Keyword

Chronic low back pain; Rehabilitation; Exercise; Physical therapy

MeSH Terms

Connective Tissue
Contracture
Exercise
Extremities
Humans
Low Back Pain*
Muscles
Pelvis
Pliability
Rehabilitation
Spine

Figure

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  Figure 1 Williams flexion exercise.

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  Figure 2 McKenzie exercise.

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  Figure 3 The basic exercise triad for most stabilization programs consists of the (A) curlup, (B) side bridge, and (C) bird dog exercises.

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